Imagine this: a massive cyclone sweeps up and over low-lying coastal areas, swamping homes and utterly transforming the landscape. Flooding wreaks havoc and days later whole regions remain inaccessible. The number of dead and missing rises dramatically every hour. The sheer volume of debris and destruction triggers feelings of hopelessness and despair - how to know where to start?

Then in the country's hour of need, the government reaches out for help, and the world responds. More than 60 countries offer money, goods, and expertise to help the victims of the cyclone.

This scenario is the story of the people of New Orleans in the wake of Hurricane Katrina. America has the world's largest economy, and extraordinary resources and infrastructure. But even the most equipped government could not possibly have anticipated the scale of the devastation wrought on New Orleans.

Similarly, the scenes I am witnessing here in Myanmar have been dreadful. Enormous trees litter the roads and queues for fuel are four kilometres long, making travel in the country difficult. In the countryside, people are jammed into monasteries, school halls and any other buildings left standing. There they carve out a strip of floor where the remnants of their families huddle.

On the road to Bogalay, I saw people camped by the roadside. Already there are signs of malaria and skin infections. Beyond those camps there are still people we have not reached seven days after the cyclone, a situation that leaves me feeling frustrated at the pace of assistance, and guilty knowing that more can be done.

However, we are getting life-saving aid to people. Yesterday I attended two World Vision rice distributions on the outskirts of Yangon, each to more than 3,000 people. We are still able to purchase relief goods inside the country. What we must do now is turn this trickle of aid into a flood.

The scale of this disaster would be beyond the capacity of authorities and local organisations in any country. Here in Yangon, I have witnessed both of those groups performing well - but there is simply more need than can be met. Already it is clear this disaster will have an impact on Myanmar the equal of anything witnessed in countries like Sri Lanka and Indonesia after the tsunami.

In such circumstances, there are international conventions recognising that those affected by calamity are entitled to protection and assistance. Aid agencies are experts in providing that assistance. They have technical specialists in areas such as water and sanitation, shelter and health who are specially trained to respond effectively in large-scale disasters. However these staff, as well as cargo planes already loaded with essential items, have so far been unable to touch down and begin doing what they do best.

A number of aid agencies like World Vision have a long history of development work in Myanmar. In a delicate political environment, they have maintained independence that has allowed them to work steadily to improve the lives of the poor. Aid agencies try to navigate the limited humanitarian space, in often challenging contexts, in order to fulfil their imperative to meet need. This desire to meet need is a message that I have tried to convey while I have been here.

Impartiality is a fundamental principle of the humanitarian charter that governs major aid agencies. We seek to demonstrate this constantly in our work. For example, in Myanmar and elsewhere, agencies insist that if they fly aid into a country, they be allowed to distribute it as well.

In the absence of clean water sources, the spectre of water-borne diseases is now the most urgent concern. There is stagnant water everywhere. As people become more desperate, dysentery, cholera and malaria could take many more lives.

Movement throughout the southern delta region is extremely slow. Cyclone Nargis cut a broad swathe nearly 300 kilometres into Myanmar; by comparison the tsunami reached about three kilometres inland when it struck. Massive amounts of debris must be moved. Only then will any sort of assistance start to reach those who have been hardest hit. Temporary shelter needs to be set up to allow families some respite from the elements.

There will be longer-term structural problems for the country as well. The Irrawaddy delta area was the rice bowl of the nation. It is now a devastated wasteland. The banks and levees are destroyed. Rice prices have doubled from 2,000 to 4,000 kyat. Migration, the legacy of losing breadwinners or parents, and the struggle to rebuild homes and livelihoods all lie ahead.

With every day I spend here, my sense of urgency increases. There are thousands of people receiving aid every day, yet there are tens of thousands more still to be helped. The sight of so many people with out shelter or basic necessities is distressing. The work is urgent, the need great. As I write, there are hopeful signs of a breakthrough in discussions that will allow aid to start flowing into the country. But the clock is ticking in the race to save lives.

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