By MARGIE MASON
AP Medical Writer
Disease outbreaks spread by mosquitoes, dirty water and poor sanitation were among the World Health Organization's biggest concerns after a devastating cyclone hit Myanmar, home to one of the world's shoddiest health care systems.
WHO was waiting Tuesday for permission from the country's ruling junta to send in medical teams but demolished infrastructure would likely hamper early efforts, said Vismita Gupta-Smith, spokeswoman for WHO's regional office in New Delhi.
"The communications are broken down and the roads are not operational," she said. "But the officers are on the ground and are ready for rapid assessment, surveillance and mobilization."
Teams will work to prevent mosquito-borne diseases such as malaria, as well as diarrhea and other outbreaks that can spread quickly in the wake of natural disasters because of a lack of clean water and sanitation.
Major concerns also include respiratory illnesses among children forced to sleep outside and injuries suffered during the storm, Gupta-Smith said.
WHO was waiting for Myanmar's military leaders to request aid from a regional emergency fund the U.N. agency set up last year to fill the time gap between international donors' pledges and the actual arrival of aid. About $175,000 would be available right away, she said.
Officials said the death toll from the weekend storm could climb higher than the tens of thousands already feared dead. Up to 1 million people may be homeless, the World Food Program said.
The cyclone ripped down power lines and destroyed roads and homes. Fuel shortages and a lack of food and clean water have worsened the situation in some areas, said UNICEF spokeswoman Shantha Bloemen in Bangkok, the capital of neighboring Thailand.
She said it would likely take two or three days to assess the damage.
UNICEF planned to distribute water purification tablets, mosquito nets and health kits, while also responding to food shortages in a country where millions go hungry during the best of times and about one in three children is malnourished.
An estimated 90 percent of people in Myanmar live on just $1 a day. In 2000, WHO ranked its overall health care system as the world's second-worst after war-ravaged Sierra Leone.
Most people are too poor to afford hospital visits so thousands instead risk their lives each year to travel to a clinic at a border town in Thailand where free treatment is offered.
Several humanitarian agencies, including the French arm of Doctors Without Borders, have pulled out of the Southeast Asian country in recent years due to travel restrictions and tight government control.
Myanmar has been under military rule since 1962 and the junta has been widely criticized for large-scale human rights abuses and suppression of pro-democracy parties. In September the military crushed peaceful protests led by Buddhist monks and pro-democracy activists, killing at least 31 people and leading to the arrest of thousands more.
Margie Mason covers medical issues for The Associated Press across the Asia-Pacific. She is based in Hanoi, Vietnam.
(Copyright 2008 by The Associated Press. All Rights Reserved.)