Heavy rains have lashed parts of earthquake-hit Myanmar, complicating relief efforts and raising the risk of disease as the death toll from the powerful quakes that struck the country on March 28 rose to at least 3,471.

Aid workers in the hard-hit city of Mandalay, near the epicentre of the earthquake, said on Sunday that rains and winds hit tent camps in the area overnight and in the morning, soaking survivors and their belongings.

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More bouts of rain were expected later in the day, while temperatures were also forecast to climb to 37 degrees Celsius (98 degrees Fahrenheit).

“The weather is very extreme,” Tun Tun, a specialist with the United Nations Development Programme, told the AFP news agency.

Aid agencies have warned the combination of unseasonable rains and extreme heat could cause outbreaks of disease, including cholera, among quake survivors, who are camping in the open.

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The magnitude 7.7 earthquake hit a wide swath of Myanmar, home to 50 million people, causing significant damage to six regions and states, including the capital, Naypyidaw.

It left many areas without power, telephone or mobile phone connections, and damaged roads and bridges, making the full extent of the devastation hard to assess. It also worsened an already dire humanitarian crisis triggered by the country’s civil war that has internally displaced more than three million people and left nearly 20 million in need, according to the UN.

State media in the military-led country now say the earthquake has caused 3,471 deaths and injured 4,671 people, while 214 remain missing.

It has damaged some 5,223 buildings, 1,824 schools, 4,817 pagodas and temples, 167 hospitals and clinics, 169 bridges, 198 dams and 184 sections of the country’s main highway.

‘Traumatised and fearful’

Damage has been particularly severe in the city of Sagaing near the epicentre, as well as in Mandalay, Myanmar’s second-largest city.

UN aid chief Tom Fletcher, who is in Mandalay, described the scale of the damage as “epic” and said survivors, who are “traumatised and fearful”, need food, water, shelter and electricity urgently.

In a video posted to X, Fletcher noted the quake had brought devastation to communities that were already in crisis. “It’s a compounding crisis,” he said. “It’s earthquake, on top of conflict, on top of huge existing need.”

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He noted that aftershocks continued in the region more than a week after the earthquake. The United States Geological Survey said a magnitude 4.7 quake struck south of Mandalay late on Friday.

Though Myanmar’s military government, led by Senior General Min Aung Hlaing, who seized power in a coup in February 2021 overthrowing the civilian government of Aung San Suu Kyi, declared a temporary ceasefire on Wednesday, the UN Office of the High Commissioner for Human Rights said on Friday that the army was restricting aid in areas that did not back its rule.

The UN agency also said it was investigating reported military attacks against opponents, including after the ceasefire.

Free Burma Rangers, a relief group, told the Reuters news agency on Saturday that the military had dropped bombs in Karenni and Shan states on Thursday and Friday despite the ceasefire announcement, killing at least five people.

The victims included civilians, according to the group’s founder, David Eubank, who said there had been at least seven such military attacks since the ceasefire.

There was no immediate comment from the military on the allegations.

US aid team fired

Myanmar’s neighbours, such as China, India and Southeast Asian nations, have dispatched relief supplies and rescuers over the past week to the country, while the US – which was until recently the world’s top humanitarian donor – has pledged at least $9m to support earthquake-affected communities.

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Current and former US officials say the dismantling of the country’s foreign aid programme has affected its response.

Three US Agency for International Development workers who had travelled to Myanmar after the quake were told they were being let go, Marcia Wong, a former senior USAID official, told Reuters.

“This team is working incredibly hard, focused on getting humanitarian aid to those in need. To get news of your imminent termination – how can that not be demoralising?” Wong said.

The three USAID workers have been sleeping on the streets in the earthquake zone, Wong said, adding that their terminations would take effect in a few months.

In neighbouring Thailand, meanwhile, authorities said the country’s death toll from the quake had risen to 24. Of those, 17 died at the site of an under-construction skyscraper in the capital, Bangkok. Another 77 are still missing.