It’s another complicated and tough day in the Philippines

More than a week after Typhoon Haiyan devastated a wide swath of the Philippines, resources are arriving, but many survivors still haven't seen an aid worker of any kind.

Thursday, the USS George Washington and its escort ships arrived off the coast of the Philippines to support the relief effort. The top US commander in the Philippines told the BBC this would provide an unprecedented level of support.

The confirmed death toll stands at more than 2300, but a UN official said the actual number was already higher, at least 4400. The UN says 11 million people have been affected by the typhoon.

Amidst all of the destruction and need, though, much of the international aid that's pouring into the country is piling up on cargo ships and airport tarmacs. One of the biggest contributions from the US Navy task force will be its roughly two dozen helicopters that can ferry aid to isolated communities cut off from the ports.

The BBC's Jonathan Head is in Tacloban, where a US Marine task force has been preparing a massive airlift from the city's damaged airport. He says the Marines needed to bring in their own infrastructure since the airport buildings were all heavily damaged. And he says there’s increasing panic in Tacloban from residents who have been waiting for help that hasn’t come. 

Philippine authorities say they're doing their best under extraordinary circumstances, but they're coming under increasing criticism for delays in providing relief.

Lt. Colonel Ramon Zagala, a spokesman for the Philippine military, says he understands people are desperate and hungry and that things will have to move faster. But he says delivering aid is a daunting task, especially because the Philippines has never seen this kind of tragedy before.

"This is an absolutely gigantic disaster," says Gregory Hartl, spokesman for the World Health Organization. "Because of the Philippines geography, it is basically the equivalent of eight different disasters."

And all have to come through a few damaged gateways.

"If you think about 20 field hospitals coming into a single airport at the same time, along with all the food and shelter supplies, that is going to create huge bottlenecks," he says.

The relief effort begins well before aid workers and supplies hit the ground. Work is going on all over the world. This week, a group of disaster-medicine doctors from Boston prepared to head to the Philippines.

Dr. Gregory Ciottone, director of the Disaster Medicine Training Program at Beth Israel Deaconess Medical Center in Boston, ran down a list of the most important supplies that each physician would need.

“One of them is a Camelback,” he said, referring to the water bladder popular with hikers and campers. “And make sure you have the chlorine tablets or a micro filter. And make sure you have some self-generated electricity. There is not going to be a lot of electricity there. It is going to be very, very dark at night, so have some sort of self-charging, preferably, or battery-power illumination device,” he added.

Then there are medical supplies. Each doctor needs to bring his or her own, enough to last a few days before they can be replenished by partner organizations already in the Philippines. Doctors also need to bring tents, sleeping bag, rain gear, mosquito nets, GPS devices and, surprisingly, dental floss, which is sometimes referred to as the duct tape of disaster zones.

And, like a camping trip, Ciottone said, “you should all be able to … put all of your equipment in a bag that goes on your back. You should not have any bag to carry. It should be everything in a backpack." 

Some of the Boston doctors were worried about security in the Philippines. Ciottone told them to stick together, and he gave them the name of a guy they can call in case of emergency.

"He will drop anything and everything and come and get you immediately if you're in any kind of trouble. He is that level of security. He is the kind of security that we used in Haiti. Former special operations guy, and he's tied into a huge and very robust network,” Ciottone assures.

And it's that network, tying the entire global response in the Philippines together, that is beginning to be assembled.