"Tell them we'll take whatever they have," shouts Emergency Coordinator Federico Soda into the crackling Skype line linking his office in Yangon's Trader's Hotel to the emergency response support team huddled around a speakerphone in IOM's Southeast Asia Regional Office in Bangkok.

The "whatever" is three USAAF C-130 transport planes on the tarmac at Thailand's Utapao military airbase – two of them loaded with 8,500 family hygiene kits and a third with 224 30 by 7 metre rolls of plastic sheet – the equivalent of 2,240 tarpaulins – donated by the United States Agency for International Development (USAID) for survivors of Cyclone Nargis.

A USAID donation earlier in the week, which included four Zodiac inflatable boats with outboard engines, 2,400 10-litre jerry cans and 768 hygiene kits, made Soda's day. The boats, which arrived in Yangon on May 26th, will play a key role in IOM's emergency response, allowing mobile medical teams based in Bogale in the Irrawaddy delta to reach outlying settlements desperately in need of help, but only accessible by water.

With as many as 130,000 people dead or missing and 2.4 million displaced and in need of humanitarian aid in the wake of the cyclone which struck the Irrawaddy delta and Yangon on May 2nd and 3rd, IOM and other relief agencies are under no illusion that the needs of survivors in a region already impoverished before the disaster are vast.

"We know that a month after the cyclone, aid has probably reached less than half of the affected population. So while our mobile teams are providing medical treatment and assessing needs in the delta, we are now shipping in whatever we can in terms of essential medicines and emergency shelter materials," says IOM Yangon Chief of Mission a.i. Mac Pieczkowski.

Donations of medical supplies and equipment, including a health kit to meet the needs of 10,000 people for three months donated by the NGO International Medical Corps (IMC), have flowed into Thailand for onward shipment to Yangon through a newly-opened United Nations (UN) logistics hub at Bangkok's Don Muang airport, according to IOM Emergency Logistics Officer Al Meneses.

"We are moving 40,000 plastic sheet tarpaulins and 147 portable water purifiers from suppliers in India, as well as locally-purchased medicines through Don Muang on UN-charter flights in the coming weeks," he says.

The relief supplies and equipment, which are offloaded on arrival to an IOM warehouse in Yangon and have included some 14 MT of medicines donated by the NGO AmeriCares Foundation and 10,000 treated mosquito nets donated by the Swiss Agency for Development and Cooperation (SDC), are distributed in the delta by IOM national emergency medical staff or through NGO partners, in close cooperation with UN and government counterparts.

IOM, which has operated in Myanmar under a Memorandum of Understanding with the Ministry of Health since 2004, had over 200 local staff mainly working on grassroots migrant health projects in Mon State before the cyclone. Since the disaster, it has redeployed some medical staff from Mon State to the delta, hired new local and international staff in Yangon and flown in emergency experts from neighbouring countries to support the mission.

"We now have eight medical teams working out of our Bogale sub-office. One team focuses on displaced people sheltering in temples and other temporary urban relief sites. The other mobile teams provide medical outreach to communities south of Bogale and in Mawlamyine Kyune, many of which can only be reached by boat," says Soda.

"Most of the cases are acute respiratory infection, injury and diarrhoea. But there is also a need for psychosocial care for people traumatized by the cyclone. We are now coordinating the work of international agencies that can help in this area at the Inter-Agency Standing Committee (IASC) Health Cluster in Yangon," he adds.

While IOM has ramped up its international staff in Myanmar to respond to the disaster, it is prepared to commit far more to the relief and reconstruction effort, if asked to do so by the government and the international community, according to Director General Brunson McKinley, who attended a donor conference co-chaired by ASEAN – the Association of South East Asian Nations – and the UN in Yangon on May 25th.

"Myanmar has stated a preference for aid workers from ASEAN member states. We have a pool of some 1,300 ASEAN national staff working in eight of the ten ASEAN countries, whom we can deploy at short notice, if the government decides to provide free access and issue visas," he notes.

Questions of access for aid workers and relief items continue to dog the international response to Nargis. Donors attending the Yangon conference, who have pledged to cover some 65 per cent of a USD 200 million UN Flash Appeal to help the victims, told the government that much of the money will be contingent on issuing more visas and allowing free access to affected areas for international relief workers.

At the time of writing, IOM had received visas for some 13 international staff, the majority of them nationals of ASEAN member states. The visas allow free movement in Yangon, but do not guarantee access to cyclone-affected areas in the delta.

There are some positive signs of greater access to the delta following the Yangon conference, with several agencies reporting access for international staff accompanied by ministry officials. But progress remains painfully slow in the face of the growing humanitarian needs of survivors yet to be reached and the onset of the monsoon.

IOM is appealing for USD 8 million for emergency shelter and health projects, as well as funds to coordinate the activities of a temporary settlements working group within the IASC Emergency Shelter Cluster to help people displaced by the cyclone now sheltering in camps, temples and public buildings.

It had already received USD 1.88 million, including USD 1.45 million from the UN Central Emergency Fund (CERF), USD 400,000 from Chevron Corporation and USD 31,500 from Denmark.