Relief workers are facing obstacles, including delays in getting visas, in their effort to aid cyclone-ravaged Burma.

Indian naval personnel load relief supplies onto a vessel at Port Blair early Tuesday before departure for Burma. (TRDEL/AFP/Getty Images)The reported death toll In Burma, also known as Myanmar, climbed past 22,000 Tuesday, with tens of thousands of people still missing and feared dead.

Aid was being distributed and the first international flights carrying emergency supplies arrived Tuesday following an appeal by the country's military junta for international aid.

The United Nations World Food Program began giving out emergency rice in Rangoon as more than $10 million worth of foreign aid arrived from Thailand on Tuesday, Reuters reported.

The national Red Cross staff and 18,000 volunteers are handing out plastic sheets, drinking water, insecticide-treated bed nets and clothes, said Eric Porterfield, spokesman for the International Federation of Red Cross and Red Crescent Societies.

Ned Olney of the relief organization Save the Children said his group was able to distribute food, plastic sheeting, water purification tablets and money to about 30,000 people.

1 million in need of supplies

But four days after the cyclone hit, and with up to one million people in emergency need of supplies, aid workers are facing logistical challenges in getting relief into some of the remote areas of the country, which has a population of more than 47 million.

The World Food Program said some villages have been almost eradicated and vast rice-growing areas are wiped out. Flooding and road damage has also cut off food supplies.

Residents make their way through fallen trees on Sunday following Cyclone Nargis. (Barry Broman/Associated Press)"The major bottleneck right now is in getting those supplies out to the affected communities, some of which are very remote and difficult to access," Richard Horsey, the UN disaster relief spokesman in Bangkok, told CBC News.

Cyclone Nargis came ashore early Saturday in Burma, sweeping through the most densely populated part of the country south and west of Rangoon before devastating the city.

According to state radio, Burmese officials confirmed that 22,464 people have been killed, with at least 10,000 reported dead in the town of Bogalay, located southwest of Rangoon, the country's largest city.

In parts of the delta coast, 95 per cent of the homes have been destroyed. More than 40,000 people have been reported missing.

'Vast areas under water'

Horsey said it's imperative to get water-purification tablets and other vital supplies to as many people as possible to prevent the spread of waterborne diseases.

Some aid agencies reported their assessment teams had reached some areas of the largely isolated region.

"The challenges of doing so, however, are enormous. There are vast areas under water still, and it's incredibly difficult to move around," he said.

Some relief workers also face the challenge of getting into the country, as the reclusive regime has not allowed many aid agencies to operate in the past.

“So the first step is to try and get people visas and get them into the country legally so they can do their work," said the CBC's Norman Hermant, reporting from Bangkok.

But UN workers were still awaiting their visas to enter the country on Tuesday, said Elisabeth Byrs of the UN Office for the Coordination of Humanitarian Affairs.

"The government has shown a certain openness so far," Byrs said. "We hope that we will get the visas as soon as possible, in the coming hours. I think the authorities have understood the seriousness of the situation and that they will act accordingly."

There are also concerns about the damage caused to the rice crop in the area, Burma's most fertile farming region. The harvest was just beginning, and officials are warning that food shortages could affect the entire country, as well as an already overheated rice market across Asia.

Regime appeals for aid

The military junta that runs the country made a rare appeal for international aid Monday, saying it couldn't cope alone with the scale of devastation in Rangoon and south of the city in the Irrawaddy River delta.

Despite the call for assistance, the Burmese information minister was quoted as saying they would only accept aid from those they considered to be friendly countries.

A military aircraft sent by the Thai government was expected first at Rangoon's airport, which reopened Monday after repairs and the clearing of runways blocked by storm debris. The Red Cross and UN agencies were also scheduling flights for Tuesday.

Canada is promising $2 million in emergency aid, and the United States Embassy in Bangkok said its donation of $250,000 US is just a first instalment of assistance. Many other countries are also promising help, but most say Burma must allow aid workers complete, unfettered access to storm-hit areas and survivors.

During Tuesday's question period, Prime Minister Stephen Harper said the Burmese regime must allow international aid from all countries to reach those who most need it.

"We will work with our international allies to encourage and exert pressure on the Burmese government to give the aid to its population," Harper told the House.

The White House said Tuesday it would send more than $3 million to help victims of the cyclone, up from the initial contribution of $250,000. The money will be funnelled to a U.S. disaster response team currently positioned in neighbouring Thailand.

Earlier in the day, U.S. President George W. Bush called on Burma's military junta to allow a U.S. disaster assistance team inside the country, saying it could do more to help the devastated country.

"We're prepared to move U.S. navy assets to help find those who have lost their lives, to help find the missing, to help stabilize the situation. But in order to do so, the military junta must allow our disaster assessment teams into the country," he said.

The State Department said permission was denied.

Referendum plans criticized

A map showing Burma, also known as Myanmar. (CBC)Burma has been criticized for deciding to go ahead with a May 10 constitutional referendum. The government says the referendum will be postponed in several of the areas worst hit by the storm, but voting will take place in the rest of the country.

Pro-democracy groups have criticized the vote for entrenching decades of authoritarian rule. Burma has been under military rule since 1962.

The referendum is the regime's response to widespread protests in March that left 31 people dead in a brutal government crackdown on what had been peaceful demonstrations.

In Rangoon, news agency reports say citizens are angry with the junta's response to the storm so far, accusing generals of failing to warn the country of the storm's severity and concentrating more on helping wealthy neighbourhoods.

With files from the Associated Press