As the death toll from the devastating cyclone that hit Myanmar mounts, as the number of the missing grows, as the victims grow more hungry, more thirsty and more desperate, there is nothing that aid worker Pamela Sitko can do.
"We're waiting for visas. We need to airlift supplies into the country," Sitko, who works for the humanitarian group World Vision, told ABC News in Bangkok while waiting to fly into neighboring Myanmar. "Every day that goes by, more lives can be lost."
By last count more than 22,000 lives have been lost to Cyclone Nagis, according to Myanmar state radio. Some 40,000 people are still missing and as many as 2 million have been left homeless.
And yet many of the international aid workers the victims of the cyclone desperately need are stuck outside Myanmar, waiting for the government to grant them visas. They are bogged down by a bureaucracy still reluctant to open its borders to foreigners, despite the suffering from the worst natural disaster in the country's history.
The challenge those aid workers face is vast. The cyclone affected 24 million people. The area that was most directly hit, the Irrawaddy Delta, the country's low-lying rice bowl, is 12,000 square miles. It was difficult to reach the towns in the delta before the storm; today, it is nearly impossible.
"The situation is still bad, and nothing much beyond tree clearing is going on," Shari Villarosa, the American charge'd'affairs in Myanmar, told ABC News. "Water, food and fuel shortages are likely to worsen, along with public discontent. People are worried about potential for looting and violence. And in the delta it is much, much worse. I hope the military eventually realizes that they need international help to get relief to the people."
The capital of the country once known as Burma is without electricity for the fourth straight day. The basic essentials such as water, gas and bread have become precious. Residents are hoarding water and those who can't find it are being forced to pay. There are gas lines as long as streets. A single gallon can cost $15. Bread is nearly impossible to come by.
"The food security situation in the country, which was already severe, is likely to become more acute," according to the United Nations' humanitarian relief agency.
"People are actually trying to take a bath in the lake but at the same time they're taking drinking water out of that lake, so you can imagine what kind of consequences that might have on the health of the people," Birke Herzbruch, the country coordinator for Malteser International , told ABC News from Yangon.
Entire Villages Flattened
The epicenter of the storm may be Bogalay, where 10,000 people died and nearly every single structure was flattened, according to Myanmar state television. Nearly 95 percent of the buildings no longer exist.
Officials fear a second disaster could be in the making if diseases incubate as a result of the country's crippled infrastructure. In many areas, the cleanup is being spearheaded by legions of monks rather than government agencies.
The enormity of the crisis prompted President Bush today to increase the U.S.'s offer of aid from $250,000 to $3 million.
"The United States has made an initial aid contribution, but we want to do a lot more," Bush said from the Oval Office. "We're prepared to move U.S. Navy assets to help find those who have lost their lives, to help find the missing, to help stabilize the situation. But in order to do so, the military junta must allow our disaster assessment teams into the country."
The first foreign aid to arrive in the country since Cyclone Nargis struck left Bangkok this afternoon, sent off by the Thai military in an elaborate ceremony. Nine tons of aid arrived in Yangon a few hours later. It is, however, just a sliver of what victims need.
The World Food Program, which now has 800 tons of food in the region, announced it began to distribute food in Yangon for the first time today. The agency has taken initial steps to meet what will be an enormous logistics challenge of bringing in disaster relief supplies, equipment and prepared foods to coastal areas cut off and isolated due to flooding and road damage.
"We are in close contact with the government on the response," Chris Kaye, the WFP's Myanmar country director, said in a statement. "So far, the government has provided some valuable cooperation. In order to meet the needs of the persons most badly affected by the disaster, much more cooperation will be required in the short term."
Officials from the United Nations and other nongovernmental organizations are wary of criticizing the government, which residents accuse of failing to respond or to prepare its citizens adequately.
"What was most striking was the lack of any activity. The lack of any organized response," American Jay Saxon, who was traveling in Myanmar when the storm hit, told ABC News. "Trees and poles were down in the road and even military people were just standing around doing nothing about it."
Government Poorly Organized
A Burmese source in the country told ABC News that the government response has been poorly planned and rather than improving, the situation is deteriorating. The source said the capital was tense. Soldiers appear on the streets in large numbers for the first time since the cyclone hit on Saturday, according to witnesses.
As the government has failed to respond, the United States has increased its offers. The State Department said members of a disaster assistance response team are standing by and could get to Myanmar "very, very quickly" if the government gives permission for them to enter the country.
The U.S. Navy has three ships in the Gulf of Thailand carrying out a humanitarian exercise with Thailand called Cobra Gold 2008.
The group is led by the USS Essex, an amphibious ship that is basically a helicopter carrier. If ordered to Myanmar, it would take the group 4½ days to get around the Malay peninsula and reach Myanmar.
But a Pentagon spokesman says the U.S. military will not move the ships to Myanmar until assistance is authorized.
And that is the same authorization that people like Pamela Sitko are waiting for. "It's extremely pertinent that we get access," she said. "Things just keep getting worse."
Kirit Radia and Luis Martinez contributed to this report.