YANGON, Myanmar — More than six weeks have passed since Cyclone Nargis swept through the Irrawaddy Delta in southern Myanmar, leaving a trail of flattened villages and broken lives and arousing international sympathy that turned to anguish as the military government obstructed foreign aid.
Now doctors and aid workers returning from remote areas of the delta are offering a less pessimistic picture of the human cost of the delay in reaching survivors.
They say they have seen no signs of starvation or widespread outbreaks of disease. While it is estimated that the cyclone may have killed 130,000 people, the number of lives lost specifically because of the junta’s slow response to the disaster appears to have been smaller than expected.
Relief workers here continue to criticize the government’s secretive posture and obsession with security, its restrictions on foreign aid experts and the weeks of dawdling that left bloated bodies befouling waterways and survivors marooned with little food. But the specific character of the cyclone, the hardiness of villagers and aid from private citizens helped prevent further death and sickness, aid workers say.
Most of the people killed by the cyclone, which struck on May 2-3, drowned. But those who survived were not likely to need urgent medical attention, doctors say.
“We saw very, very few serious injuries,” said Frank Smithuis, manager of the substantial mission of Doctors Without Borders in Myanmar. “You were dead or you were in O.K. shape.”
The cyclone swept away bamboo huts throughout the delta; in the hardest-hit villages, it left almost no trace of habitation. Some survivors carried away by floods found themselves many miles from home when the waters receded.
But those who survived were not likely to be injured in the aftermath by falling rocks or collapsing buildings, as often happens during natural disasters, like the earthquake in China.
That appears to be the primary reason villagers were able to stay alive for weeks without aid. As they waited, the survivors, most of whom were fishermen and farmers, lived off of coconuts, rotten rice and fish.
“The Burmese people are used to getting nothing,” said Shari Villarosa, the highest-ranking United States diplomat in Myanmar, formerly Burma. “I’m not getting the sense that there have been a lot of deaths as a result of the delay.”
The United States has accused the military government of “criminal neglect” in its handling of the disaster caused by the cyclone. Privately, many aid workers have, too. The junta, widely disliked among Myanmar’s citizens, did not have the means to lead a sustained relief campaign, they say.
But relief workers say the debate over access for foreigners and the refusal of the government to allow in military helicopters and ships from the United States, France and Britain overshadowed a substantial relief operation carried out mainly by Burmese citizens and monks.
They organized convoys of trucks filled with drinking water, clothing, food and construction materials that poured into the delta.
“It’s been overwhelmingly impressive what local organizations, medical groups and some businessmen have done,” said Ruth Bradley Jones, second secretary in the British Embassy in Yangon, Myanmar’s largest city. “They are the true heroes of the relief effort.”
Aid workers emphasize that of the estimated 2.4 million Burmese strongly affected by the storm, thousands remain vulnerable to sickness and many are still without adequate food, shelter and supplies.
But their ailments are — for now — minor. Medical logs from Doctors Without Borders show that of the 30,000 people the group’s workers treated in the six weeks after the cyclone, most had flesh wounds, diarrhea or respiratory infections. The latter two afflictions are common in rural Southeast Asia even in normal times. Diarrhea can be especially dangerous for infants and young children, but doctors say that, while they have treated thousands of cases, the illness has not reached critical levels.
“I can’t say it was an outbreak,” said May Myad Win, a general practitioner who works for Doctors Without Borders and spent 25 days in the delta treating an average of 25 patients a day. “It was not as severe as we feared.”
The number of people in need of serious medical aid was judged to be low enough that officials at a British medical group canceled plans to bring in a team of surgeons in the days after the storm, said Paula Sansom, the manager of the emergency response team for the group, Merlin.
For several weeks after the disaster, the government prevented all but a small number of foreigners from entering the delta. Now a more comprehensive picture of the damage is being assembled by a team of 250 officials led by the Association of Southeast Asian Nations. The officials plan to release their findings next week.
The number of people killed in the storm may never be known. The government has not updated its toll since May 16, when it said 77,738 people were killed and 55,917 were missing.
In a country that has not had a full census in decades, it is not even certain how many people had been living in the area before the storm. Itinerants who worked in the salt marshes and shrimp farms were probably not counted among the dead, aid workers say.
But it is clear that in many villages, women and children died in disproportionate numbers, said Osamu Kunii, chief of the health and nutrition section of Unicef in Myanmar.
“Only people who could endure the tidal surge and high winds could survive,” Mr. Kunii said. In one village of 700, all children under the age of 7 died, he said.
With only minimal food supplies in villages, aid workers say, delta residents will require aid until at least the end of the year. The United Nations, after weeks of haggling with Myanmar’s government for permission to provide assistance, is now using 10 helicopters to deliver supplies to hard-to-reach places and alerting relief experts at the earliest sign of disease outbreaks.
Still, the military government continues to make it difficult for aid agencies to operate.
Last week, the government issued a directive that accused foreign aid agencies and the United Nations of having “deviated from the normal procedures.” The government imposed an extra layer of approvals for travel into the delta, effectively requiring that all foreigners be accompanied by government officials.
“They’re changing the goal posts,” said Chris Kaye, the director of operations in Myanmar for the United Nations World Food Program. “We have a whole set of new procedures.”
Myanmar’s government says it issued 815 visas for foreign aid workers and medical personnel in the month after the cyclone. But some aid workers were never allowed in, including the disaster response team from the United States Agency for International Development.
Local news media reported over the weekend that the government planned to build 500 cyclone shelters in the delta. These structures are used in neighboring Bangladesh, which has a relatively widespread early warning system.
When Cyclone Sidr struck Bangladesh in November, the winds reached an intensity similar to the 155-mile-an-hour gusts that blew through the Irrawaddy Delta last month.
Tellingly, the number of people killed by Cyclone Sidr — about 3,500 — was a small fraction of those killed in last month’s cyclone here.