Burma's military government has been slow to ease its restrictions for UN aid workers trying to enter the country, and a U.S. official warns the death toll from a weekend cyclone could reach 100,000.
Patrick McCormick, a spokesperson for the UN Children's Fund, said aid workers need the government's cooperation.
"We're hopeful they will start fast-tracking visas for humanitarian personnel," he said.
"The government clearly weren't prepared and needs to step up to the plate. We can't work in a vacuum, and we need the host government to work with us and to eventually take over."
Shari Villarosa, head of the U.S. Embassy in Myanmar, said Wednesday that food and water shortages are making the situation even worse.
"There is a very real risk of disease outbreaks as long as this continues," Villarosa told reporters.
A picture of chaos and desperation is beginning to emerge as Burma tries to cope with the devastation left by Cyclone Nargis. There are reports of corpses floating in floodplains, displaced residents trying to reach dry land and looting in the few shops still selling food.
State media in the Southeast Asian nation are officially reporting 23,000 deaths. More than 42,000 people are missing and about one million people have been displaced, according to United Nations estimates.
Aid has only just begun to trickle into the military-run nation as some agencies have managed to gain access, but there are fears the aftermath could be more deadly than the storm itself.
Local humanitarian workers on Wednesday began distributing water-purification tablets, mosquito netting, plastic sheeting for shelter and basic medical supplies.
However, heavily flooded areas could only be accessed by boat and aid-distribution was a daunting challenge, Richard Horsey, a Bangkok-based spokesman for the UN told The Associated Press.
Paul Risley, a spokesman for the UN World Food Program in Bangkok, said his workers on the ground were reporting that a few shops opened Wednesday in the Irawaddy delta region, but were quickly stormed by people.
"Fist fights are breaking out," he said.
Death toll could rise
CTV's Steve Chao, reporting from Thailand, told Canada AM the death toll may continue to rise unless the borders are opened.
"There are hundreds of thousands of people that have been without food, clean water and shelter for days now," Chao said. It is very hot and there's a real concern about water-borne disease. According to one UN official the fear is the aftermath could be much more lethal than the storm itself."
The Irawaddy delta region has been declared the worst-hit, with UN officials labelling it a "major, major disaster" on Wednesday.
"Basically the entire lower delta region is under water," Richard Horsey, a Bangkok-based spokesman for the UN told The Associated Press. Horsey predicted the casualty figure could rise "dramatically" beyond the latest figure given by Burma officials Tuesday.
The UN said Burma has authorized a planeload of humanitarian aid but permission was still pending for a UN co-ordination team set to travel there.
And for those who have been able to get in, it was still difficult or impossible to reach the area where most of the deaths occurred.
"According to some of the aid workers we've spoken to by phone, the situation is getting more dire by the day," Chao said.
"They're having a lot of difficulty getting into the Irawaddy delta. This is the hardest hit region, hit not only by the cyclone but by a massive wave over the weekend during the storm, and all the roads are cut off."
He said aid workers -- many of whom are preparing in Thailand to enter Burma when access is granted -- are calling for an "air bridge" to fly support into the affected areas.
In Yangon, the largest city in Burma, the price of rice, charcoal and bottled water has doubled.
The vast majority of residents are still without electricity or clean water.
However, state television on Wednesday quoted Yangon official Gen. Tha Aye as reassuring people that the situation was "returning to normal" in certain areas of Karen state that were hit by the cyclone.
Burma has come under international pressure to allow humanitarian agencies to provide help. However, Chao said the military government, traditionally wary of Western influence, fears a greater foreign presence will encourage dissident activity.
"The military government is very much about control and by giving or ceding control to these foreign countries, the fear is they will ultimately lose control. That's why they don't want any other outside bodies coming in," Chao said after speaking to an exiled Burmese dissident.
With files from The Associated Press
