The district of Pyinsalu, on the southwestern tip of Burma, is one of the most obscure, remote and impoverished places in the world, but it will go down in history for a uniquely grim distinction. Three and a half years ago it was washed away by the surge of the Boxing Day tsunami; over time, the collection of small coastal villages was rebuilt and the simple life of the fishermen returned to normal.

Then, nine days ago, Cyclone Nargis gathered force over the Bay of Bengal and pounded the exposed fields and rivers of the Irrawaddy delta. And Pyinsalu, so insignificant that it appears only on the most detailed of maps, achieved something unprecedented: it was wiped out for a second time by the region’s worst natural disasters in living memory.

It takes five hours by boat to reach Pyinsalu and none of the handful of foreign aid workers based in the nearest town, Labutta, has been allowed to travel there. But reports from survivors who have reached Labutta suggest that it is among the most stricken of all the devastated areas in the disaster zone.

Before the cyclone 12,000 people lived in the Pyinsalu subdistrict; the best estimates are that barely a quarter of them are still alive. The only buildings left standing are a school and a severely damaged health centre. The accounts of the few survivors tell of the appallingly destructive force of the cyclone and the terror of a catastrophe that turned trees into deadly projectiles and solid land into water.

From Burma’s biggest city, Rangoon, to Labutta it is a jolting, 11-hour drive. Fifteen miles from the end of it, late yesterday afternoon, we met the survivors of the worst of the storm. They were three men, simply dressed in cotton shirts and Burmese sarongs — widowers of Cyclone Nargis.

Each had lost his wife and all his children; they had travelled to Labutta to inform the brother of one of the dead women and to say the traditional prayers for their families seven days after their deaths. But they could not afford the offerings at the Buddhist temple necessary to earn merit for their dead children. “The Government came and gave us some food, but for the first days we had no water and no food except coconuts,” Aung Htan Tay, from the village of Kakayo, near Pyinsalu, said.

Mr Tay, a fisherman, was at home when the wind and rain began on the night of Friday, May 1. The waters rose quickly and overwhelmed the house of bamboo and palm leaves. “We ran out and I climbed up a tree,” he said. “My wife held on to my waist, but the water was too strong.” He climbed 14ft up the tree and clung on for three hours while the water surged just two feet below his toes.

When they receded, he found the body of his oldest child, a 7-year-old girl, close to the bottom of the tree. For a week, he looked for his wife and his two sons, aged 4 and 1. Two days ago, he gave up.

His two companions, Zaw Khin Oo and Tun Than Lin, have similar stories. All have marks on their inner arms where the rough bark of the palm trees rubbed their skin. On Mr Oo’s back is an area of raw flesh resembling a burn, caused by the lashing wind, rain and hail. At a stroke each became wifeless, childless, homeless and without any means of supporting themselves.

The atmosphere of crisis is obvious as soon as you enter the town of Labutta. Not a single building is undamaged; the streets are littered with fallen trees and the crumpled orange and white frame of a giant telecommunications mast. Large lorries line the town centre, unloading supplies of rice and canned fish supplied by the Government and by aid groups such as Médecins Sans Frontières and the World Food Programme.

It is wholly inadequate for the immense population of refugees, both the homeless of Labutta and the tens of thousands of people who have arrived from the obliterated coastal districts to the south, such as Pyinsalu.

The British charity Merlin estimates that a town of 30,000 people has increased by 70,000 to 80,000. “The needs are great and we’re definitely very concerned about health risks if health care is not made available,” Paula Sansom, a nurse with the organisation, said. “We’re concerned about the forecast of bad weather next week — there is a lack of food and lack of shelter and a small window of opportunity to remedy that.”

The situation is complicated, as it has been throughout this tragedy, by the disposition of the Burmese authorities, who appear to inspire as much fear as they bring relief.

Military teams have been delivering certain amounts of aid, and Merlin, for one, was promptly issued with visas for incoming staff by the Burmese Embassy in London. But the obligation of foreign staff from non-governmental organisations to obtain bureaucratic permission for travel outside town limits the scope of their work.

UN staff in Rangoon express alarm at the way in which approximately 16,000 refugees have been transported from Labutta and the town of Bogalay to refugee camps in less affected towns to the north. In theory these relocations are not compulsory, and conditions in the new camps are undoubtedly better than those in the disaster zone. But the refugees find themselves cut off from local networks of family and friends and parted from their villages in the all-important rice planting season.

Eighty per cent of Burma’s rice is planted in the next few weeks, much of in the Irrawaddy delta. The inundation of fields by salt water is bad enough, but the relocation of the farming population makes the chances of a successful crop all the slimmer — in a year when food aid will be needed the most.

“We mustn’t miss this rice crop, and I’m worried,” said Hakan Tongkul of the World Food Programme in Rangoon. “We’ve had no good answer why they’re moving these people. Is it so they can look after them better? But they won’t let us look after them where they are.”

Relief effort

— Burma’s state television set the number of dead at 28,458 and the number of missing at 33,416 yesterday

— A United Nations Humanitarian appeal has asked for $187,298,154 for aid (£96,122,244) including $56,000,000 for food and $20,300,000 for shelter

— Latest reports suggest that $33,584,377 (£17,235,935) has been donated so far, with a further $42,752,353 in uncommitted pledges

— The US has donated $3,250,000 and the European Commission has given $3,135,264

— Britain has pledged up to £5 million for relief efforts

— France has sent a naval ship with 1,500 tonnes of food, blankets and other supplies as well as contributing about $320,000

— The Burma Red Cross is distributing insecticide-treated bed nets and water purification tablets. The Government is to give 5 billion kyats ($4.5 million) for relief and resettlement

— The World Food Programme (WFP) had reached 27,000 people by the weekend, and the 38 tonnes of high-energy biscuits – seized in Rangoon on Friday – were returned

— The WFP flew into Rangoon with supplies such as temporary warehousing and generators Sources: UN; agencies

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