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"Existing projects were major advantage in the first days' response"

Juli Niebuhr, MSF Deputy Country Manager in Myanmar, describes the situation in storm-affected areas as desperate.

"The villages that we have access to, most of them are 80 to 90 percent destroyed by the storm. It is a big mess.

"At the moment, our main concern is to get the essentials to people - to the most affected people - as quickly as possible. Meaning medical supplies, shelter materials, food, and clean water.

"We have 12 medical teams operating in the area right now. They are mobile teams, so they go from village to village and try to find the people most in need. The majority of the patients we see are injured patients with minor injuries. We see patients with infected wounds, fever, and diarrhoea patients. We see patients who have physical damage by the force of the rain.

"The biggest concern is the people left without shelter and, at the moment, without proper sanitation with a shortage of water and a shortage of food. There are hundred of thousands of people who are being displaced now, who have lost their houses and much aid and much support is needed and, at the moment, there is not enough available in the region.

"Our big advantage is that we have been operational in this country for over ten years with a big number of qualified staff and therefore we were able to send a large number of qualified medical people very quickly into the region who could start work immediately.

"We have to truck our supplies down as far as possible by truck; the roads have been cleared. From there we ave to move our supplies by boat, by small boat and even, at some points, by motorbike, to the different villages. So logistically it is very complicated as people are spread out and they are not easy to reach.

"We have been moving about 100 metric tonnes of rice, tens of thousands of plastic sheetings will be brought to the area and we have medical supplies that we could send immediately, but we will run out eventually so we are expecting flights to come in - MSF is expecting three flights to come in in the next two days and we hope we shall have clearance for those.

"In the areas where we have been so far with our teams we haven't seen any aid being delivered, so far. For the amount that has reached the people in the area where we are has been minimal. We have covered an area now with about 50,000 people and we have distributed rice, canned fish, jerry cans, plastic sheetings to those households most in need.

"Given the fact that there is not enough drinking water in the area and that large parts have been flooded there is, of course, a risk for an outbreak of diseases.

"The scale of this - the size of this - is enormous and the number of injured, dead, and missing people are increasing; the official figures are increasing by the day. It is a big area that has been hit and the impact of the storm has been enormous. Like I said, whole villages have been wiped away and the less-affected areas, as we call them where we work now, have 80 to 90 percent of their buildings destroyed.

"Thousands of people in Yangon have been badly affected by the storm as well. There is still no electricity. There is bad communication. Shops are closed. There is not enough food and many people have been made homeless by the storm or their houses have been damaged so badly that they are staying in temporary shelter.

"I think a lot of people are still in shock. People are trying to deal with it with whatever small means they have.

"All the MSF teams are working extremely hard at the moment. We have sent over 90 people down into the delta who are working non-stop. We send in more staff and more supplies on a daily basis. Of those 90 staff, about half of them are medical - already 17 medical doctors working in the are setting up new clinics, trying to reach new areas, trying to find the most vulnerable people in this situation, and be of assistance."