After the deluge, the deadly germs

Something hard and heavy slammed into Ko Kyaw Win’s leg as he clung to the top of a coconut tree, fighting for his life against hurricane-force winds and a surging torrent strong enough to bend steel.

The object swirling in the 20-foot swell smashed a silver dollar-sized hole in the fisherman’s right shin. At the time, it was the least of his worries.

Two friends who had tried to swim with him to a small boat drowned. He couldn’t make it into the storm-tossed craft himself, and figured that fate would eventually sweep him away too.

Tropical Cyclone Nargis destroyed at least 400 houses in his village near the southwestern town of Labutta, Kyaw Win said, adding softly, “Only 100 people survived.”

Somehow, the sinewy 45-year-old managed to hug the treetop long enough to remain among the living, surviving on coconut milk for five days.

But after beating those already bad odds, Kyaw Win now fears he faces a new fight for his life: An infection is taking hold in his festering leg wound, and no medical supplies remain in this village in the Irrawaddy River delta.

Kyaw Win is one of thousands of survivors across southern Myanmar still awaiting medical care a week and a half after the cyclone hammered the area.

To make matters worse, forecasters are predicting monsoon rains, and though they aren’t expected to be as destructive as Nargis, another major storm wouldn’t improve survivors’ chances of getting the care they desperately need.

Since the cyclone hit Myanmar, also known as Burma, on May 2-3, no doctor has visited the seven villages where local nurse U Tin Hling is the only trained medical worker. He ran out of medicine, bandages and the rest of his meager supplies days ago.

The first food aid from the military for about 3,000 people did not arrive until Tuesday. It consisted of 900 eggs, two 20-pound sacks of potatoes, 200 tins of sardines and packets of energy drink powder.

“We have no idea why more aid hasn’t come,” Abbott U De Thar Ni, head of a monastery sheltering scores of survivors, said with a resigned smile. “It must be our karma. But we need much more help.”

Fisherman Mg Min Zaw, who lost his wife, their young child and his mother to the cyclone, somehow managed to survive the collapse of the family’s house. A traditional doctor treated his broken arm with a paste made of ground leaves and a splint crafted from two wooden rulers and gauze, which is now filthy.

Min Zaw, 36, believes the salve has the power to mend the bones of his forearm, which are pushing up his skin at sharp angles. The swollen arm may already be infected, the village nurse said, so if the leaves don’t work their magic soon, Min Zaw may have to have the limb amputated.

Dozens of others in this village and six neighboring communities urgently need medical help, including 18-month-old Ma Pyi Pyi Po, whose right eye is swollen half shut.

Kyaw Win, who is unmarried, has been eating rotting rice from village stockpiles that were soaked by the storm. Chances are the rice is breeding bacteria that can cause diarrhea or other illnesses -- infections Kyaw Win is in no shape to take on.

His leg wound is deep but not very large -- certainly not an injury that would be life-threatening in a typical natural disaster somewhere else in the world, where armies of doctors, sanitation experts and aid workers would have set up camps and emergency shelters by now. Most anywhere else, Kyaw Win would be home free.

But in Myanmar, the only army allowed into the vast disaster zone is the one that has ruled the country since 1962. The reclusive generals controlling the nation see Western aid workers and journalists as likely spies sent to help end the military’s monopoly on power.

Under intense foreign pressure, the government has loosened restrictions on aid flights, allowing the U.S. Air Force, as well as several other countries and the United Nations, to fly several aircraft into Yangon’s airport. But it continues to deny entry visas to most foreign aid workers, who could quickly assess need and oversee the distribution of supplies. The small number who are now in Myanmar have been restricted to the principal city, Yangon, also known as Rangoon.

In Kyaw Win’s village, the only source of fresh water was a small reservoir dug by hand next to the river. It was swamped with seawater, although it could be refilled with clean rainwater if pumped out. But there is no diesel for the generator.

A poorly equipped hospital is in the nearby town of Bogalay. But villagers say they can’t afford the eight-mile boat ride or the government doctors who would treat them.

A woman whose right eye was swollen shut and whose forehead bore a large lump said it would cost her about $30 to see a doctor in Bogalay. That’s about a month’s income, in good times.

Tilting her head back to see better with one eye, she explained why emergency care was out of reach: “I have no money,” she said, and she laughed along with dozens of others who had taken refuge on the rain-soaked teak floor of the monastery.

The only treatment Kyaw Win received for his raw, red leg wound, which throbs with pain, was a few dabs of rubbing alcohol to clean out some of the dirt in the torn flesh.

The village nurse also gave him a few tablets of what he called metro, short for the antibiotic metronidazole. Hling described the drug as a painkiller. Actually, it’s meant to treat ailments such as dysentery, vaginitis and several other infections, as well as acute gum disease. It was the only medicine he received in emergency aid from Myanmar’s military: two boxes of metronidazole, a total of 4,600 tablets. They’re all gone.

Hling gave the pills to people with infected wounds, deep cuts from corrugated metal sheets and other flying debris, broken bones that hadn’t been set properly, bumps as big as golf balls.

Villagers in one devastated area said they had seen local officials hoarding packages of instant noodles and other supplies for themselves.

Elsewhere, survivors said they hadn’t seen any foreign aid at all, such as the World Food Program energy biscuits that were flown in by the ton. Instead, they said, the military has given them small rations, mainly wet, rotting rice.

Healthcare and living standards were low in the impoverished Irrawaddy delta before the cyclone struck, so many survivors were already undernourished and weak after making it through the 12-hour storm.

The cyclone surge sent waves from the Andaman Sea into Kyaw Win’s village, 30 miles away. As the water rose in his house, which he shared with other fishermen, he piled one table on top of another, until soon his head was touching the ceiling and the water was still rising.

The fisherman, who is about 6 feet tall, said the water level reached three times his height. All he could see in the darkness and driving rain were the tops of the coconut trees, and a fishing boat being tossed in the waves.

He and four friends swam toward the boat, and Kyaw Win exhausted much of his strength trying to tie it to a coconut tree. He was no match for the relentless waves and wind, and had to let go.

The craft capsized, and as Kyaw Win held on to the tree, he saw two of his friends disappear.

Days later, the weary fisherman is alone in a battle with his own body to survive.