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Manuel Aballe, left, holds his two-month-old daughter, Richelyn, aboard a government plane waiting to leave Tacloban. Debris-clogged roads have challenged aid efforts, and officials found themselves on the defensive Tuesday over the pace of relief work as Manila struggled to get supplies to the airport in Tacloban.jES AZNAR/The New York Times

On remote Philippine islands where entire cities have been reduced to rubble and where bodies lie baking in the tropical heat, aid workers are taking the first difficult steps to rescue hundreds of thousands of people struggling in the aftermath of Typhoon Haiyan.

Sandra Bulling, a spokeswoman for CARE who is with a team operating near the hard-hit city of Tacloban, said logistics are the first priority for relief workers, including setting up telecommunications and clearing roads.

For the people themselves, Ms. Bulling said, the most urgent needs are medical support, shelter, food and water. "People are drinking rainwater," she said, which is better than the water in puddles contaminated by filth. "But people have open wounds and nothing to clean them with."

The United Nations has launched an international appeal for $301-million to begin the rescue and cleanup effort, which is being co-ordinated by the Philippine government. And the Canadian government continued to roll out help, with some crews on the ground in Manila, more en route and others preparing to follow.

Some estimates of the death toll from the storm, which blew across the centre of the string of islands that make up the Philippines on Friday, were reduced Tuesday from 10,000 to perhaps 2,500. But the scale of the destruction is enormous; hundreds of thousands are displaced, and the difficulties of delivering aid by land, sea and air are daunting.

Many people are homeless, left without the basics of life in a country where communication lines are down, roads are blocked, whole towns are without electricity and the ferry service between the many islands has been wiped out.

As of Tuesday evening, about 30 Canadian officials were on the ground in Manila, including Foreign Affairs officers and soldiers. They're preparing for the arrival of another 43 soldiers, medical staff and engineers that are part of the Canadian Disaster Assistance Response Team, or DART.

Canada has pledged $5-million in funding, plus matching dollars for all donations made to registered Canadian charities, for typhoon disaster relief efforts until Dec. 9.

"Just getting the relief effort on the ground has been enormously challenging," said Pauline Ballaman, a humanitarian worker with Oxfam who is in the devastated region. "International military organizations are now here and they are beginning to clear the way. But even once we get into airports, then roads are strewn with trees, strewn with rubbish."

Robert Fox, executive director of Oxfam Canada, said his organization had to rent helicopters to fly aid workers to assess the damage in isolated communities. The people they found there are "desperate and traumatized," he said, and they will have to wait until at least Thursday for any real relief.

In cities that have been reached by aid agencies, burying the dead is a major priority, Mr. Fox said. In a hot, humid, tropical country, there is a significant risk that disease will spread from rotting corpses. Oxfam is focusing on creating latrines and bringing in fresh water.

When large numbers of people have "no sanitation facilities, no soap to wash their hands, this could very quickly be a situation where, a week after the typhoon hits, you could have a spike of disease and death from diarrhea or worse – cholera and dysentery," Mr. Fox said.

The DART crews are carrying relief supplies with them, including a mobile command centre vehicle, an ambulance, a forklift, food, water, temporary shelters, hand tools, generators, communications equipment and land surveying equipment. It's not yet clear where DART will go.

The Department of National Defence said the 43 DART soldiers will "prepare for the arrival of the main [DART] body," suggesting more troops are on the way. Some were dispatched from New Brunswick's CFB Gagetown to Ontario's CFB Trenton, DART's home base. The Gagetown troops are "likely elements of DART heading to Trenton for further deployment into the Philippines," one official said.

Joe Oliver, the Natural Resources Minister, said Canadians who want to help should donate money now. to donate cash to established charities. to charity and said cash is needed most. "Right now, because we don't have all the facts on the ground, I would encourage Canadians to give money to registered charities," he said at a news conference in Toronto. "When we know more, there will be an opportunity to provide goods that – that will be needed in individual areas."

Hossam Elsharkawi, the director of emergencies and recovery for international operations for the Canadian Red Cross, said he would not want to see a repeat of what happened after the massive earthquake in Haiti in 2010, when "hundreds and hundreds" of small groups showed up wanting to help but only became a burden. Giving money to a recognized aid organization, Mr. Elsharkawi said, "is the only way to go in these types of scenarios."

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