From beneath a pile of wrangled metal and concrete debris, the cries kept coming. But after days of digging desperately through rubble with bare hands, rescuers were losing hope of reaching victims of Myanmar’s earthquake. “The worst part is knowing they’re there but not being able to reach them in time,” said Tay Zar Lin, scraping through the wreckage of a collapsed block of flats in Mandalay, the South-East Asian country’s capital. The 28 year-old said rescue teams with little or no access to tools had been forced to rely on “sheer determination” to save some 90 people thought to be buried somewhere underneath him. And on Sunday there was finally a breakthrough, as 29 people were pulled alive from the rubble. That moment of joy was cut short when eight dead bodies shortly followed. There is a crushing sense here in Myanmar that more could be done, if only the embattled ruling military junta would give better support. “We want to do more, but we don’t have the equipment or knowledge to save as many lives as we should,” said Tay, who is volunteering with Myat Thadar, a charity. He said he was already exhausted but vowed: “We will keep digging, because if we don’t, who will? It is now more than 48 hours since a magnitude 7.7 earthquake rocked Myanmar on Friday at lunchtime. But without heavy machinery to assist in the search, progress to reach the thousands buried when homes, schools and offices collapsed has been agonisingly slow. After four brutal years of civil war – and decades of being run largely by kleptocratic and corrupt military regimes – Myanmar was ill-prepared to deal with a disaster of this scale. Even before the earthquake hit, the economy and health system were in tatters, three million people were displaced and one third of the population was reliant on humanitarian aid. Friday’s quake will compound this crisis. Already, its death toll has surpassed 1,600 – and there are fears this is only the tip of the iceberg. Modelling by the US Geological Survey suggesting fatalities could top 10,000 and financial losses could exceed Myanmar’s annual economic output. Scenes emerging from the hard-to-reach country are devastating: one video showed a group of monks ducking as a building collapsed entirely nearby, while reports of deaths included 12 children buried alongside their teacher at pre-school. Hospitals are struggling with a severe lack of medical supplies, with the military regime calling for more blood donors. “Our capacity is extremely limited,” Dr Aung Win, a doctor at Mandalay General Hospital, told The Telegraph on Saturday. “We urgently need reinforcements. It’s heartbreaking to see patients dying when they shouldn’t be, and we desperately need first aid kits. We were never prepared for a disaster like this.” The junta has made a rare plea for help and some aid is now flowing in. Teams from countries including Russia, China, Malaysia, South Korea and India have touched down this weekend, while the UK announced £10 million of funding and the EU committed an initial €2.5 million (£2.1 million). But those on the ground – especially outside the major cities – said this was yet to reach them. In Sagaing, a town close to the quake’s epicentre, residents said that there was no electricity, little drinking water – and no help. “What we are seeing here is widespread destruction – many buildings have collapsed into the ground,” Han Zin said. “We have received no aid, and there are no rescue workers in sight.” NGOs and humanitarian agencies preparing to ramp up their response also face challenges. Airports, bridges and roads have been damaged, making it hard to reach many areas, while communication systems are down, and there are even limits on how much cash you can withdraw from an ATM. Richard Horsey, of the Crisis Group think tank, said most people’s apartments were either destroyed or structurally unsound in the affected areas, meaning at least a few million people needed shelter, food, water and medical assistance. “The logistics of this are hugely challenging given the destruction of transport and communications infrastructure, including the main airports of Naypyidaw and Mandalay,” he said. “This humanitarian assistance phase will last for many weeks or months, so will also require substantial funds. It is not clear where those resources will come from, despite generous initial allocations from donors. The humanitarian system has little cash in the kitty.” But the ongoing civil war, triggered in 2021 when the junta overthrew a democratically elected government in a coup, is another major complication. Territory in the country is split between the military and a complex network of opposition groups, many parts of Myanmar are either very dangerous or simply impossible for aid groups to reach, and there is a “gauntlet of problems” to run to get aid to civilians. Joe Freeman, a Myanmar researcher at Amnesty International, said: “It is a good sign that the military has appealed for international aid. The main issue with that is what happens to the aid once it is delivered to the military. “Will they divert it to areas where they are engaged in armed conflict? You would hope so, but that seems unlikely, given their history of blocking aid to these areas. International aid groups must do the best they can to ensure that their aid is reaching people impartially. “There is also a problem of trust. Why would a community that has been bombed by the military trust it to deliver humanitarian aid?” Mr Horset added: “The regime and its opponents are locked in an existential battle – this makes the context particularly challenging. “But it must not be an excuse for dithering and inaction. The people affected by this tragedy deserve more.”