The United States and others are engaging in "a full-court diplomatic press" to get Myanmar to accept aid shipments after a weekend cyclone left as many as 70,000 dead and many more at risk of starvation and disease, a State Department official said.
The diplomatic push came as top U.S. military officials discounted an earlier suggestion that the United States might air drop relief supplies to survivors without Myanmar's permission.
"It's sovereign air space, and you'd need their permission to fly in that air space," U.S. Joint Chiefs Chairman Michael Mullen told reporters.
"I cannot imagine us going in without permission of the Myanmar government," U.S. Defense Secretary Robert Gates said.
But the United States is poised to move in with helicopters and supplies as soon as Myanmar gives permission, Mullen and Gates said.
"There is an opportunity here to save a lot of lives," Gates said. "We are fully prepared to help and to help right away. And it would be a tragedy if these assets, if people didn't take advantage of them."
According to the Myanmar government, the cyclone left as many as 70,000 people dead or missing. A top U.S. diplomat in Myanmar has said the death toll from the cyclone could top 100,000.
Though the United States and other international bodies have been barred, the Myanmar government today allowed the first major international shipment to land in Yangon, Myanmar, six days after the storm hit -- a United Nations flight carrying high-energy biscuits, medicine, water purification tablets and other aid items.
But most survivors of Cyclone Nargis have seen little evidence so far of help on the horizon.
Asked on a video provided by the Democratic Voice of Burma, an anti-government group based in Norway, if help was on the way, a woman replied, "No one comes. Who will come? ... No one comes and nothing is done. People are starving."
In the town of Tawkhayanlay, survivors told an ABC News producer they had to swim across the rice fields as the cyclone bore down on them. While they were swimming the water rose. The strong made it to shore, but 43 of the weak drowned. The town's 2,000 survivors are still waiting, having received no aid.
Daw Thay, 42, who took refuge in a monastery with her three children and her 99-year-old mother in a town 60 miles south of Yangon, told The Associated Press monks were going without food so others could eat.
"My children were crying all night," she said. "There is not enough food. There will be no food this evening."
But aid is available if Myanmar's government can be convinced to allow it in.
"We're trying to make the diplomacy work," State Department spokesman Sean McCormack said, adding that U.S. Secretary of State Condoleezza Rice has called China's foreign minister as part of an effort to have countries that have good relations with Myanmar to exert their influence.
The head of humanitarian affairs for the United Nations, John Holmes, said today that 1.5 million people were "severely affected," and in the five days since the storm struck they have become "increasingly desperate."
"There is a real danger that an even worse tragedy may unfold if we cannot get the aid that's desperately needed in quickly," Holmes warned.
Holmes said he was "disappointed" by the inability to get large amounts of aid or emergency relief teams into the ravaged country.
Earlier today, the head of America's disaster assistance agency hinted that the United States might ignore Myanmar's ruling junta and simply air drop food and supplies to desperate survivors of Cyclone Nargis.
USAID's Director of Foreign Disaster Assistance Ky Luu complained at a briefing that the Myanmar regime has not even responded to U.S. requests for visas for its experienced teams of emergency relief specialists who are awaiting approval in Thailand.
Fearing a wave of death by starvation or an outbreak of disease, Luu said, "We don't have time to wait."
Luu said the U.S. is considering air drops into Myanmar, but he said that is not their first choice and USAID would prefer to be granted permission first. Simply dropping supplies would not be an efficient way to disperse aid because there would be no coordination on the ground and no way to notify victims that aid was being dropped for them.
McCormack later seemed to downplay the idea, saying, "Air drops are not the most efficient way to get assistance to people on the ground."
Gates said three or four U.S. Navy ships are now sailing to Myanmar and that the helicopters abroad are headed to Thailand to preposition in case they are needed should Myanmar give a green light for U.S. military assistance.
The helicopters are being off-loaded from the amphibious assault ship USS Essex, Gates said. They'll go to a Thai base where they can be within reach of Myanmar within "a matter of hours."
Mullen said it would take the ships five days to get around the Malay Peninsula to be off the coast of Myanmar most affected by the cyclone. As Gates put it, "The ships are steaming to an area off Myanmar to be available."
Gates added that there are now six C-130s in Thailand that could be available to fly in on short notice.
Both with little aid getting in, U.S. and U.N. officials have made their frustrations clear.
"You look at the images of the people who are suffering there and you know that you have the tools just right here at your fingertips and they are at the fingertips of the Burmese to use and they are not picking the tools up to use them," said the U.S. ambassador to Thailand, Eric John. "That's incredibly … beyond frustrating. It's the level of tragedy that gets worse by the day."
As the aid sits on tarmacs in Dubai and Italy and Dhaka, Bangladesh, aid groups are beginning to hear of outbreaks of disease.
Officials at the U.S. Embassy said they believed people were suffering from diarrhea. And the World Health Organization has received reports of malaria outbreaks.
In the village of Aphyauk, villagers told an ABC News producer that they can't grow any of their crops because they spend their days cleaning up after the storm.
"Some people are ill but they are afraid to talk about it," Mae Thiwari said by phone. "At the moment, the only two things they want: food and water."
Myanmar's military government continues to refuse to issue visas to aid workers.
"A visa that they get today is worth a lot more lives than it is tomorrow," John said.
John paraded four members of a disaster response team in front of reporters to try to prove Americans were only interested in Myanmar to help. They included a 31-year-old named Anita Malley, from Kalamazoo, Mich., and a 30-year-old named Courtney Brown from Washington.
"These are humanitarian workers. They're ready to go in to help. They're not ready to go in to overthrow the government," John said with the four Americans behind him.
Asked whether aid could enter Myanmar without foreign aid workers, both American and U.N. officials said aid is useless without a team of experts who know how to distribute it.
"We will not, the World Food Program, will not just bring our supplies into an airport and dump it and take off, and that's one reason why there is a hold up now," Anthony Banbury, the WFP regional director, told The Associated Press. "Because we are going to bring in not just supplies but a lot of capacity to go with them to make sure the supplies get to the people who need them."
As of right now, those supplies are nowhere near the people who need them.
A farmer who refused to give his name showed an ABC News producer his house. It was flattened, but he still lives there. He had nowhere else to go.
"It will take him at least two years to work to try and rebuild," Thiwari said. He earns only $2 a day and "nobody has asked him what he needs."
Teddy Din told the Adventist Development and Relief Agency International that he returned to the town of Piensalu, where he rode out the storm and believes that of 150,000 villagers, up to 50,000 might be dead. The village, he said, is struggling under horrific conditions.
"During the last days they ate and drank coconut juice to survive -- which saved them. At most places there is no drinking water, everything salty. There are many coconut trees around. Found some rice and shared among all. People start picking up floating stuff. Immediate after the cyclone ate fresh flesh from dead animals [cows, buffalos], but now they can't eat them anymore."
The woman who spoke with the Democratic Voice of Burma said she survived, but that her daughter-in-law didn't.
"My pregnant daughter-in-law fell into the water and since then disappeared," she said. "We searched, but we did not find her. There are many dead bodies. How can we easily distinguish who is who?"