As Burma's military regime used vital aid as propaganda, relief officials say the country is on the verge of an outbreak of disease that could be even more devastating than Cyclone Nardis itself.

Tim Costello, chief executive of World Vision Australia told CTV Newsnet on Saturday from Rangoon, Burma that, "We are deeply fearful that we are on the cusp of an epidemic."

He said the biggest worry is an outbreak of cholera or typhoid. Both are primarily spread by contaminated water.

"If they break out, they could claim as many lives as the cyclone."

State media claim that 23,335 people died, with about 37,000 more missing. But international aid groups say the death toll will likely climb to more than 100,000.

The United Nations estimates that 1.5 to two million of Burma's nearly 49 million citizens have been severely affected.

Costello said it is important that not only food and water supplies get into Burma but also aid workers trained to help control the spread of disease.

His group has 600 Burmese aid workers and unlike many other groups, they have been allowed to deliver aid within Burma. But that's not enough he says.

"This is of such scale that we simply do not have the capacity . . .nor the Burmese military . . . to do what is necessary, proportionate to the sheer horror and suffering caused by the cyclone," he said.

Propaganda exercise

State-run television continuously showed images of the country's military regime handing out international relief supplies, with the names of top generals stamped on them.

The junta has so far refused to allow foreign experts to deliver aid to assist their country, ravaged the cyclone, saying it will only accept donations and then take responsibility for distribution.

"We have already seen regional commanders putting their names on the side of aid shipments from Asia, saying this was a gift from them and then distributing it in their region," said Mark Farmaner, director of Burma Campaign UK.

"It is not going to areas where it is most in need," he said in London.

Richard Horsey, who speaks for the United Nations' humanitarian operations, said international organizations are needed to examine the logistics of getting help into the Irrawaddy delta, the worst-hit area.

"That's a critical bottleneck that must be overcome at this point," he said in Bangkok, Thailand.

Burma's government has only a few dozen helicopters and almost no transport plane capacity.

Time running out

Relief workers have only reached about 220,000 survivors so far, the Red Cross said Friday.

Heavy rain is expected in the coming days, which could make matters worse.

The Burmese government seized two planeloads of high-energy biscuits on Friday -- enough to feed 95,000 people.

However, the UN's World Food Programme is sending three more planes on Saturday from Dubai, Cambodia and Italy.

"We are working around the clock with the authorities to ensure the kind of access that we need to ensure it goes to people that need it most," WFP spokesman Marcus Prior said in Bangkok.

Burma's government said it would allow a U.S. aircraft to land and deliver a load of relief supplies on Monday.

Referendum presses ahead

The aid delivery problems comes as the junta presses ahead with a constitutional referendum, and witnesses say it has won overwhelming approval and there was visible intimidation of voters.

The new constitution would guarantee the military one-quarter of the seats in Burma's parliament and give it the right to dissolve parliament at any time and take over the government, CTV's Steve Chao told CTV Newsnet on Saturday.

"We understand that the turnout is rather good in some parts of the country that were not affected by the cyclone," he added.

"Part of it is that the government is ordering people to go to the polls. They want them to vote yes."

Witnesses and local officials who are watching the counting say 80 to 90 per cent are in favour of the charter.

Witnesses have also said they saw intimidation of voters around the country, including attaching fingerprints to ballot papers.

Results are not expected to be announced until after late voting on May 24.

With files from The Associated Press