YANGON, Myanmar (AP) -- Bodies floated in flood waters and survivors tried to reach dry ground on boats using blankets as sails, while the top U.S. diplomat in Myanmar said Wednesday that the toll from the cyclone and its aftermath may reach 100,000.
Hungry crowds stormed the few shops that opened in the country's stricken Irrawaddy delta, sparking fist fights, according to Paul Risley, a spokesman for the U.N. World Food Program in neighboring Thailand.
Shari Villarosa, who heads the U.S. Embassy in Myanmar, said food and water are running short in the delta area and called the situation there "increasingly horrendous."
"There is a very real risk of disease outbreaks as long as this continues," Villarosa told reporters. The death toll could hit or exceed 100,000 as humanitarian conditions worsen, she said.
State media in Myanmar, also known as Burma, reported that nearly 23,000 people died when Cyclone Nargis blasted the country's western coast on Saturday and more than 42,000 others were missing.
U.N. humanitarian chief John Holmes said Thursday that the cyclone's death toll may rise "very significantly."
The military junta normally restricts the access of foreign officials and organizations to the country, and aid groups were struggling to deliver relief goods.
Internal U.N. documents obtained by The Associated Press showed growing frustrations at foot-dragging by the junta, which has kept the impoverished nation isolated for five decades to maintain its iron-fisted control.
"Visas are still a problem. It is not clear when it will be sorted out," according to the minutes of a meeting of the U.N. task force coordinating relief for Myanmar in Bangkok, Thailand on Wednesday.
U.N. Secretary-General Ban Ki-moon urged Myanmar's government to speed up the arrival of aid workers and relief supplies "in every way possible."
State television in military-ruled Myanmar, though, said that the government would accept aid from any country and that help had arrived Wednesday from Japan, Bangladesh, Laos, Thailand, China, India and Singapore.
Local aid workers started distributing water purification tablets, mosquito nets, plastic sheeting and basic medical supplies.
But heavily flooded areas were accessible only by boat, with helicopters unable to deliver relief supplies there, said Richard Horsey, Bangkok-based spokesman for the U.N. Office for the Coordination of Humanitarian Aid.
"Most urgent need is food and water," said Andrew Kirkwood, head of Save the Children in Yangon. "Many people are getting sick. The whole place is under salt water and there is nothing to drink. They can't use tablets to purify salt water," he said.
Save the Children distributed food, plastic sheeting, cooking utensils and chlorine tablets to 230,000 people in Yangon area. Trucks were sent to the delta on Wednesday, carrying rice, salt, sugar and tarpaulin.
A Yangon resident who returned home from the area said people are drinking coconut water because of lack of safe drinking water. He said many people were on boats using blankets as sails.
Local aid groups were distributing rice porridge, which people were collecting in dirty plastic shopping bags. He spoke on condition of anonymity because he feared getting into trouble with authorities for talking to a foreign news agency.
Elisabeth Byrs, a spokeswoman for U.N. relief efforts in Geneva, said the U.N. received permission to send nonfood supplies and that a cargo plane was being loaded in Brindisi, Italy, but it might be two days before it leaves.
The U.N. is trying to get permission for its experts to accompany the shipment, Byrs said. She said U.N. staff in Thailand were also awaiting visas so they could enter Myanmar to assess the damage.
Some aid workers have told the AP that the government wants the aid to be distributed by relief workers already in place, rather than through foreign staff brought into the country.
Relief teams and aid material are waiting to deploy from Thailand, Singapore, Italy, France, Sweden, Britain, South Korea, Australia, Israel, U.S., Poland and Japan, according to minutes from a U.N. relief meeting in Geneva that were obtained by the AP.
However, Myanmar state-run television said Wednesday that Japan had sent tents, while planes from Bangladesh and India brought medicine and clothing. China sent 1,300 pounds of dried bacon, while Thailand sent 1.2 million packets of noodles.
Britain has offered about $9.8 million to help the crisis, and the U.S. offered more than $3 million in aid. President Bush said Washington was prepared to use the U.S. Navy to help search for the dead and missing.
However, the Myanmar military, which regularly accuses the United States of trying to subvert its rule, was unlikely to accept U.S. military presence in its territory.
The U.S. military started positioning people and equipment as it awaited word from Myanmar's government. An Air Force C-130 cargo plane landed in Thailand and another was on the way, Air Force spokeswoman Megan Orton said Wednesday morning at the Pentagon.
"When they accept, or if they accept - and we know what supplies they need - those planes will be there to transport those," she said.
The Navy also has three ships participating in an exercise in the Gulf of Thailand that could help in any relief effort - the USS Essex, the USS Juneau and the USS Harper's Ferry - but Navy officials said they are still in a holding pattern.
The Essex is an amphibious assault ship with 23 helicopters aboard, including 19 that are capable of lifting cargo from ship to shore, as well as more than 1,500 Marines.
Because it would take the Essex more than four days to get into position for the relief effort, the Navy is considering sending some of its helicopters ahead, according to an official who spoke on condition of anonymity because it was still in the planning stages. The aircraft would be able to arrive in a matter of hours, and the Essex could follow, he said.
In Yangon, many angry residents say they were given vague and incorrect information about the approaching storm and no instructions on how to cope when it struck.
Officials in India said they had warned Myanmar that Cyclone Nargis was headed for the country two days before it made landfall there.
The state-run Indian Meteorological Department had been keeping a close watch on the depression in the Bay of Bengal since it was first spotted on April 28 and sent regular updates to all the countries in its path, department spokesman B. P. Yadav said.
Myanmar told the World Meteorological Organization in Geneva that it warned people in newspapers, television and radio broadcasts of the impending storm, said Dieter Schiessl, director of the WMO's disaster risk reduction unit.
State television news quoted Yangon official Gen. Tha Aye on Wednesday as reassuring people that the situation was "returning to normal."
But city residents faced new challenges as markets doubled prices of rice, charcoal and bottled water.
At a market in the suburb of Kyimyindaing, a fish monger shouted to shoppers: "Come, come the fish is very fresh." But an angry woman snapped back: "Even if the fish is fresh, I have no water to cook it!"
Electricity was restored in a small portion of Yangon but most city residents, who rely on wells with electric pumps, had no water. Vendors sold bottled water at more than double the normal price. Price of rice and cooking oil also skyrocketed.
The cyclone came a week before a key referendum on a proposed constitution backed by the junta.
State radio said Saturday's vote would be delayed until May 24 in 40 of 45 townships in the Yangon area and seven in the Irrawaddy delta. But it indicated the balloting would proceed in other areas as scheduled.
A top U.S. envoy to Southeast Asia said Wednesday that Myanmar's military junta should be focusing all its efforts on helping victims of a devastating cyclone, not pressing forward with a planned constitutional referendum.
"It's a huge crisis and it just seems odd to me that the government would go ahead with the referendum in this circumstance," said Scot Marciel, who was appointed last week as the first U.S. ambassador to the Association of Southeast Asian Nations.
Myanmar has been under military rule since 1962. Its government has been widely criticized for suppressing pro-democracy parties such as the one led by Aung San Suu Kyi, a Nobel Peace Prize laureate who has been under house arrest for more than 12 of the past 18 years.
At least 31 people were killed and thousands more were detained in September when the military cracked down on peaceful protests led by Buddhist monks and democracy advocates.
© 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.