After the Cyclone: Fear and Disease

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Phyusin Ngwethaw / EPA

A passenger ferry is washed ashore in Laputta, Irawaddy Delta region on May 8, 2008, following Cyclone Nargis.

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Fishermen face grave challenges too. Their boats are smashed or sunken. The powerful cyclone shifted sandbanks into unknown positions, making once-familiar waterways perilous to navigate. And everywhere human bodies float uncollected. Another Laputta aid worker counted 45 corpses in an hourlong voyage through the delta. "The smell is terrible," he says. With all the rain, bodies hastily buried in village graveyards by relatives are now resurfacing.

These terrible conditions could drive thousands more to flee to overcrowded camps in Laputta town. Every square foot of sheltered space at Lay Htat monastery is occupied by survivors — perhaps as many as 8,000, estimates Malteser, which runs a small clinic there. Most are children. Hundreds of people sit on scraps of plastic or tin laid out on the mud beneath the monastery, which rests on stilts. There are hundreds more sleeping in the floor above and in other buildings on the compound. Some are surrounded by what few possessions they could salvage. Others have nothing at all. Some women are boiling their precious rice on small fires, and the air is thick with wood smoke. One man taps my shoulder and points to his mouth: no food. Children refill plastic drinking bottles from large ceramic jars full of murky water.

A week ago, most new patients at Laputta hospital were being treated for cyclone injuries, such as lacerations and bone fractures. Some men have what look like serious burns or grazes on their backs. They had hunched over to protect themselves during the cyclone, and the rain and wind had sandblasted the skin from their shoulders.

Injury cases have since tailed off. These days, a quarter of new patients have diarrhea. Now, lack of shelter increases the risk of respiratory disease. The cramped conditions provide the perfect conditions for disease to spread, although there have been no epidemics. "Not yet," says Alexandra Piprek, a doctor with Malteser. "Give it a few days and we'll see. The concentration of people is very high." Piprek also fears for the mental health of the survivors. Some are showing signs of trauma, such as listlessness or hyperactivity. "Many people have lost everything," she says.

Only a handful of foreign aid agencies — including UNICEF, Doctors Without Borders and Merlin — are now working in Laputta, and all had a strong presence in Burma before the cyclone hit. With the junta barring access to many expatriate aid workers, the Burmese citizens on their staff are vital. Unlike foreigners, their movements in the delta is not restricted, at least not yet. Julio Sosa Calo says that more of Malteser's Burmese experts — including a second doctor, a nurse and three water and sanitation specialists — would arrive in the coming days.

But the massive influx of aid and aid workers has yet to begin, despite the delta's increasing needs. Take the road north from Laputta and you arrive at Maungmya, where there are another 12,900 refugees in 27 camps, estimates Save the Children. Walk Laputta's streets, and you move through a gloomy landscape of sodden brown debris where the only bright color — a flash of electric green — brings no comfort. They are rice seedlings which these farmers would have soon been planting. Scattered by the cyclone, watered by the heavy rains since, they now sprout useless amid the ruins.

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