Devastating cyclones, floods and ruined crops have made Bangladesh 'the world's most aware society on climate change'

Rebecca Sultan's life has been shattered twice in a few years. First, the 140mph winds of Cyclone Sidr ripped through her village, Gazipara, flattening houses, killing 6,000 people and devastating the lives of millions as it slammed into southern Bangladesh in 2007.

Then, 18 months later, as Sultan was recovering, Cyclone Aila tore in from the Bay of Bengal with torrential rains, breaching the coastal embankments and flooding her fields with salt water.

Storms of this intensity historically happen in Bangladesh once every 20 to 30 years. But two "super-cyclones" in two years, followed by a narrow escape when super-cyclone Nargis killed 100,000 people in nearby Burma a year later, convinced Sultan and her village, as well as many sceptics in government, that climate change was happening and Bangladesh's very survival was at stake.

Gazipara, like thousands of other villages in coastal Bangladesh, is now racing to adapt to the increased flooding, erosion and salt-water intrusion.

Sultan and 30 other women have raised their small houses and toilets several feet up on to earth plinths. Others are growing more salt-tolerant crops and fruit trees, and most families are trying different ways to grow vegetables. "We know we must live with climate change and are trying to adapt," said Sultan.

Elsewhere in Bangladesh, hundreds of communities are strengthening embankments, planting protective shelter belts, digging new ponds and wells and collecting fresh water. Some want to build bunkers to store their valuables, others want cyclone shelters.

"I am quite amazed at how people are grappling with climate change and are adapting," said Saleemul Huq, a Bangladeshi scientist who is head of the climate change group at the International Institute for Environment and Development in London and an adviser to the Bangladesh government on how to adapt to climate change.

"It's by far the most aware society on climate change in the world," Huq said. "It has seen the enemy and is arming itself to deal with it. The country is now on a war footing against climate change. They are grappling with solutions. They don't have them all yet but they will. I see Bangladesh as a pioneer. It has adapted more than any other country to the extremes of weather that climate change is expected to bring."

With the latest research showing more droughts in the country's north and rising sea levels, more than 30 million Bangladeshis are liable to lose everything from climate change in the next 30 to 50 years, said Atiq Rahman, director of the Bangladesh Centre for Advanced Studies and a lead author of the Intergovernmental Panel on Climate Change's fourth assessment report.

"It's extreme events, like super-cyclones and the droughts, that will dominate in future, not the mean [average]," Rahman said. "It's the extra days of heat or cold or the intensity of the cyclones that will affect life most. Poor people cannot wait for global leadership on climate change – they are acting now. They are paying with their own lives, their own resources, their own efforts. They cannot wait. It is not a question of choice."

The trouble, Rahman told a conference on community adaptation last week in Dhaka, is that traditional knowledge about when to plant which crops, or to harvest, may not be sufficient. "Government recognises it is a very real threat. But what happens in the future will not be indicated by what has happened in the past. There is a new knowledge challenge," he says.

"Many know to plant more tolerant crops in hard years, but lack the drought-tolerant or salt-resistant seeds now needed to deal with worsening conditions. We need new technologies, funds and knowledge."

But, said the foreign minister, Dipu Moni, rich countries had not given the money they had pledged to help Bangladesh and other vulnerable countries adapt. "Climate change is real and happening," Moni said. "A 1C rise in temperatures for Bangladesh equates to a 10% loss of GDP. One event like Sidr can take 10 to 20 years to recover from and cost us billions of dollars. But we don't see the money coming.

"The people being affected are not the big banks but the poor. Our plight goes quite unnoticed. It does not make the rich countries produce trillions of dollars overnight. It's a shame, but we keep trying."

According to her ministry, Bangladesh has received $125m (£78m) so far, including $75mfrom the Department for International Development (DfID). "But [countries] have refused to [say] if the climate change money is taken out of [the existing] aid basket," said a senior civil servant. "We want clear guarantees that this money will be on top of official development assistance money. DfID has not clarified this is additional to ODA."

On the coast, Sultan pondered the changes. "The difference we've all seen in the weather in just a few years is great. Now we are getting sudden rains, we don't know when to expect them; the water levels rise faster, the erosion is greater and we are getting more salinity. We used to know when the seasons would change; now they are temperamental. We are resilient and determined to adapt to whatever happens, but it is hard."

With her hard-earned money, a poor woman makes a most unusual household purchase

Today, Hla Myo, who is the manager of a tiny sewing project, helped me to do the accounts to work out how much profit, or helping money as they call it, each of the seamstresses will receive from my time selling their products in Australia and Malaysia. Their helping money is distinct from their wages.

Some of the seamstresses, I discovered, bought gold earrings with their sewing money, which I, with my western notions, thought a strange extravagance for women living in poverty. But I was wrong. The gold earrings are as good as money in the bank: better in fact, for there are no bank charges. When the women are really hard up, they can pawn their gold earrings, or in a complete catastrophe (like Cyclone Nargis) they can sell them.

I have just found out what Hla Myo's wife, Pyone Pyone, plans to buy with her helping money: brick dust. Nothing remotely feminine for her, or indeed made of gold. She wants it to raise the level of their ground floor and the brick dust will be delivered next week by bullock-cart.

It was only then I realised all the houses round here have tamped earth floors. Rich folk would have a concrete floor downstairs – but I don't know any rich folk.

Every morning, Pyone Pyone draws up water with a hand lever to fill their water tank, which empties steadily throughout the day as they draw water for washing. And because they throw buckets of water over their head, the earth floor becomes slippery quite quickly. All the women do the washing, every day, by hand, which is another way the packed earth readily turns to mud. Pyone Pyone intends that her brick dust will sop up the water.

After the floods last year Hla Myo bought half a cartload of bricks, and raised the area around the water tank by one brick, but either the bricks have sunk or perhaps the water table has risen.

None of my friends has hot water. On the corner of many streets are open-air communal washing places where both men and women, each wearing a sarong-like longyi, pour freezing buckets of water over themselves to remove the froth of soap bubbles.

Will Pyone Pyone's brick dust work? I'll be back in June, at the beginning of the rainy season: then we'll find out.

Every week Guardian Weekly publishes a 'Letter from' one of its readers from around the world. We welcome submissions – they should focus on giving a clear sense of a place and its people. Please send them to weekly.letter.from@guardian.co.uk

Caring for the displaced in the Burmese jungle – and fleeing with them as the army advances

Weighed down with 10kg packs of medical supplies – as well as her clothes, food and three young children – Hsa Mu Na sets out from her organisation's headquarters in Mae Sot, Thailand, for five hours by car, four hours by boat and three days by foot to a conflict-plagued region of Burma where medical care would be nonexistent were it not for her and her colleagues.

"I have to cross streams, go over mountains and through the jungle to get there. I sleep in villagers' homes along the way," said Hsa Mu Na, a 36-year-old ethnic Karen health worker. "There's no security, so we can't travel freely. That is the most difficult thing. There is no security and no food, so the health problems are serious. There are no services for obstetric care. It is difficult to transport people who need care."

In parts of Burma where communities constantly uproot themselves to survive, clinics are not an option, so Hsa Mu Na and the roving medics of the Back Pack Health Worker Team have become the solution.

Hauling patients in hammocks lashed to bamboo poles and hanging intravenous fluid bags off branches to treat the sick as they lie on beds of banana leaves on the forest floor, these local health workers share the precarious existence of their patients and flee with them as the Burmese military advances and attacks.

"Instead of setting up permanent infrastructure in this situation, the programme designed had to be more community-based, even though they are displaced or mobile," said Dr Cynthia Maung, a founder of Back Pack and of the 22-year-old Mae Tao Clinic for refugees and migrant workers in Mae Sot, Thailand. "The area where these people work is in conflict zones. They are like other villagers, vulnerable to be casualties to malaria and the same risks as people in the community."

Burma's ruling military junta has long waged war with the country's ethnic minorities, who for decades have sought autonomy. In the late 1990s the junta stepped up attacks, razing thousands of villages, displacing half a million people and laying landmines to prevent communities from returning to their land.

Established in 1998, Back Pack has recruited health workers from these communities, and brought them to Mae Sot – a sleepy Thai border town that serves as a base for Burmese refugee groups. There they are trained by technical experts from Johns Hopkins School of Public Health and the American NGO Global Health Access Program (Ghap). Loaded up with several 10kg packs of medical supplies, they are then dispatched across the Moei river into Burma for days-long journeys by foot back home.

What began as 32 teams of 120 health workers serving 64,000 people in eastern Burma has expanded to 80 teams – 254 medics, 645 traditional birth attendants and 360 village health volunteers – addressing the needs of a 190,000-strong population along the eastern and western borders.

Supported by groups including Burma Relief Centre, International Rescue Committee and Not On Our Watch, Back Pack handled 89,000 cases in 2009, on a budget of  about $550,000.

Each team leader receives just $33 per month, as a survival stipend to be shared with others in the field.

The medics are trained to treat 20 common illnesses, including diarrhoea and pneumonia, as well as malaria, which accounts for a quarter of all deaths in eastern Burma. They delivered 3,600 babies in 2009, and treated 55 gunshot and 17 landmine victims.

Since Back Pack's founding, nine of its medics and one traditional birth attendant have been killed by gunfire or landmines. The most recent fatality was last July, when soldiers burned down Thada Dae village in Karen state, and shot a Back Pack medic. Several Back Pack workers have been arrested by Burmese troops, though none are currently in detention.

Every six months, some 60 to 80 team leaders return to Thailand for a month. As most are not recognised as Burmese citizens and are stateless, they cross the border illegally, carrying epidemiological data and patient histories. At the Mae Sot headquarters, they are debriefed and updated on medical advances.

"In eastern Burma, which may have active conflict or may be unstable, clinic access may not be available," said Jen Leigh, Ghap's field director and one of Back Pack's many partners who graduated from the Johns Hopkins public health school. "We know the best practices, and we use the evidence to help decide what is the best intervention in this setting."

Back Pack has trained 1,300 health workers for its own ranks and community-based organisations such as the Burma Medical Association and Karen Department of Health and Welfare, which provide care in more stable areas.

Back Pack also mobilises to help elsewhere as need arises. After cyclone Nargis struck Burma's southern delta in 2008, they formed the Emergency Assistance Team to deliver food, water, shelter and health services. When people fleeing Burmese troops crossed into Thailand in June 2009, they created the Karen Community-Based Organisation Emergency Relief Committee.

"For myself, I understand that this is my task, these are my people, this is my community. When they are suffering, I have to solve this problem," said Mahn Mahn, Back Pack's secretary and one of the driving forces among the Mae Sot-based Burmese in exile. "When there is oppression beside you, you are not free. If someone needs help, is still suffering, you are not free."

Junta leader Than Shwe thought about spending $1bn on football club despite country being devastated by cyclone Nargis

The leader of Burma's military junta considered making a $1bn (£634m) bid to buy Manchester United football club around the time it was facing rising anger from the United Nations over its "unacceptably slow" response to cyclone Nargis.Than Shwe, commander in chief of the armed forces and a fan of United, was urged to mount a takeover bid by his grandson, according to a cable from the US embassy in Rangoon. It details how the regime was thought to be using football to distract its population from ongoing political and economic problems.

The proposal was made prior to January 2009; only months earlier, in May 2008, the Burmese junta had been accused of blocking vital international aid supplies after Nargis struck, killing 140,000 people.

Than Shwe reportedly concluded that making a bid for United might "look bad" at the time, but the revelation that the proposal was even considered is likely to fuel criticism of the regime's cruelty. The senior general instead ordered the creation of a new multimillion dollar national football league at the same time as aid agencies were reporting that one year on, many survivors of the cyclone still lacked permanent housing, access to clean water, and tools for fishing and agriculture.

The mooted price tag for Manchester United was exactly the same as the aid bill to cover the most urgent food, agriculture and housing for the three years after the cyclone, as estimated by international agencies including the UN. The proposal revealed that the regime, which is increasingly exploiting its oil and gas reserves, felt confident of finding such a sum. According to Forbes magazine's valuation of the club at the time, $1bn would have been enough to acquire a 56% controlling stake.

"One well-connected source reports that the grandson wanted Than Shwe to offer $1bn for Manchester United," said the June 2009 cable to Washington. "The senior general thought that sort of expenditure could look bad, so he opted to create for Burma a league of its own."

Than Shwe then reportedly coerced and bribed eight leading business and political figures to establish teams and ordered them to spend large sums on imported players and new stadiums.

The cable revealed that in January 2009, selected Burmese business people were told "that Than Shwe had 'chosen' them to be the owners of the new professional soccer teams. [The informant, a top executive at one of the sponsor companies] said the owners are responsible for paying all costs, including team salaries, housing and transportation, uniform costs, and advertising for the new league. In addition, owners must build new stadiums in their respective regions by 2011, at an estimated cost of $1m per stadium."

The Magway team was spending $155,000 a month on salaries while the Kanbawza team, linked to a bank, had budgeted $2m for the 2009 season. Rangoon United hired five players from Africa and Delta United recruited several Argentinians.

"When asked why the owners would participate in such an expensive endeavour, [an executive with one company sponsor] observed that they had little choice," the embassy reported. "'When the senior general asks someone to do something, you do it with no complaints,' he stated."

He added that several of the business people expected to receive incentives from the regime, such as construction contracts, new gem and jade mines, and import permits, which would more than offset their costs. The owners of the clubs in the Burma national football league, which launched on 16 May 2009, include "regime crony" Zaw Zaw, who also chairs Burma's football federation and drew up plans for the league with the senior general's grandson.

"Zaw Zaw hired Senior General Than Shwe's grandson to play on the team," a separate cable adds.

But according to the dispatch, "many Burmese businessmen speculate the regime is using it as a way to distract the populace from ongoing political and economic problems or to divert their attention from criticism of the upcoming 2010 elections".

Political football

From Sierra Leone to Iran, football is more than a sport for many governments.

Cables in June 2009 reveal Iran's fear that public unrest over a national football team loss "could add fire to the increasingly volatile political demonstrations" during the presidential election.

Such was President Mahmoud Ahmadinejad's political investment in Team Melli that spies were said to keep tabs on key players. He loaned the squad his presidential plane to travel to North Korea for a match after personally firing the coach Ali Daei when they lost to regional rivals, Saudi Arabia. But fans have rebelled, chanting "we don't want political soccer" at one game.

In Jordan, hooliganism at a match in July 2009 between Al-Wahdat (Palestinian fans) and Al-Faysali (Jordanian fans) revealed the "ugly side of Jordanian ultranationalism" as the Palestinian origins of both the queen and the crown prince were denigrated. One contact warned US diplomats that such extremism "would be difficult to contain now that it was publicly expressed".

Even in Azerbaijan, football clubs mean status for regime figures. The son of Kamaladdin Heydarov, the oil-rich nation's minister for emergency situations, owns Gabala football club: "a small-scale effort to replicate the Chelsea antics of Russia's Roman Abramovich".

"The Gabala squad is a virtual United Nations team, with players from across Europe, Latin America and Africa – the best team money can buy, at least for central Azerbaijan."

Meanwhile the US embassy in Sierra Leone believes the country's football manager, Mohamed Ahmed Sesay, may have used the job "to facilitate narcotics trafficking", after he was arrested during a cocaine trafficking investigation.

On Tuesday last week, a vigorous area of low pressure developed over a large part of the north-eastern US. This depression is believed to be one of the deepest on record across the interior US, with a central pressure of 955 millibars. The extra-tropical cyclone was of such huge proportions that it affected the weather from as far as the Rocky Mountains all the way to Hudson Bay.

It brought strong winds, heavy rain, spawned 24 tornadoes and further north, in north central Dakota, there was heavy snowfall of around 33cm. The storm caused chaos, with wind speeds gusting over 50mph, bringing down power lines, damaging homes and causing more than 500 flights to be cancelled at Chicago O'Hare Airport.

Meanwhile, on the other side of the Atlantic, Turkey was hit by torrential rain this week with Canakkale recording 83mm in just 12 hours overnight on Thursday. Flood waters rose to nearly a metre in Istanbul after rivers burst their banks, disrupting traffic and causing ferries to be cancelled between Yalova and Istanbul due to the high winds.

Typhoon Chaba developed over the Pacific Ocean on Tuesday, becoming the 14th tropical cyclone of the season. It reached Category 4 status on Thursday with wind speeds hitting 115mph. Nearly 40 flights were cancelled between the Okinawa and the Amami Islands. Residents of Japan's Kanto region braced themselves on Saturday, but the weakening storm remained out to sea.

• This article was amended on Tuesday 2 November 2010. The original said 995 millibars, and this has been corrected.

Aung San Suu Kyi does not stand alone. Let's show our support for Zarganar and the thousands persecuted by a brutal junta

Next Monday afternoon a small demonstration in Trafalgar Square will draw attention to the desperate situation of a talented writer with a wicked sense of humour lying sick and isolated in a cell in the northern part of his country, imprisoned solely for questioning and satirising his country's regime.

Not tempted to read on? Briefly imagine the prosecution and long-term imprisonment of the cartoonist Steve Bell or the comedy writer Armando Iannucci for satirical works, or the singer Billy Bragg for inappropriate activism, and you begin to grasp both the significance and madness of this situation.

Maung Thura, better known as Zarganar, is a Burmese writer, poet, activist and comedian, most recently arrested for leading a private relief effort to deliver aid to victims of cyclone Nargis, which struck Burma in May 2008. When it became clear that the government was obstructing international aid to the devastated Irrawaddy delta and surrounding areas, Zarganar led efforts to raise and distribute aid from private donors.

Despite assurances from the authorities that private donors would be given free access to cyclone-affected areas, he and at least 21 others were later arrested for their participation in the voluntary aid effort. Among his reported crimes was giving interviews to overseas radio stations and other media about his work and the needs of the people. He also ridiculed state media reports about the effect of the cyclone.

A 59-year prison sentence was later reduced to 35 years. Two years on, there are desperate worries about his health following a collapse in prison last April. He is said to be suffering from heart problems, jaundice and a stomach ulcer that predate his current imprisonment. Zarganar, winner of the inaugural PEN/Pinter prize for an international writer of courage, is one of several prominent journalists and leaders who have risked life and health to stand out against the brutal junta in Burma. He was first arrested in October 1988 after making fun of the government, but freed six months later. In May 1990 he impersonated General Saw Maung, former head of the military government, to a crowd of thousands at the Yankin teacher training college stadium in Rangoon.

Famous in his own country, Zarganar is virtually unknown here: one more faceless name doing good things far away. In Burma, only the country's imprisoned pro democracy movement leader Aung San Suu Kyi has broken through the barrier of indifference and information overload. She is rightly celebrated by leaders worldwide for her endurance, her calmness, her refusal to descend into violence, bitterness or compromise. Her personal story is tragic; her political story, inspirational.

But we would do well to remember that Suu Kyi is not the only one standing up against unimaginable repression. She is instead the leader and totemic representative of the 2,100 political prisoners incarcerated in Burma in 2010. Anyone concerned with freedom in general, and the situation in Burma in particular, should look beyond her image and peer into the crowd of brave people standing behind her – and then do what we can to support them.

• Free Zarganar! rally: Trafalgar Square, London, 2-4pm, Monday 3 May

Ruled by the world's last military junta, Burma is shunned by both governments and tourists. Yet its people are crying out for contact. So what's the ethical traveller to do?

On the boat to Mandalay the same thoughts kept turning in my mind. The red orb of a full moon ­appeared, casting streaks of gold across the placid water of the Irrawaddy river, but even this beauty failed to displace the questions that haunted our two-week stay earlier this month. Why were we in Burma? Was our trip giving comfort to the country's military dictatorship, by common consent one of the world's worst regimes?

Burma never has been a popular destination, and after the bloody ­suppression of the monks' protests in September 2007 and the government's delay in helping hundreds of thousands who lost everything in Cyclone Nargis the following May, the tourist trickle almost dried up. Only 47,161 people came from Europe last year, mainly from France and Germany, making Burma the country least visited by ­British people anywhere in Asia (with the exception of North Korea).

So was our party of visitors wrong to buck the trend? Not if you go by the number of people who eagerly ­approached us to practise their English and, after a tentative start, wanted to say what they thought of their rulers. "They're mad," one driver told us as he steered his creaking banger past a crush of Chinese bicycles and motorbikes, the commonest form of transport on Burma's rutted roads.

In decades of reporting I have ­generally stuck to journalism's rule number one: don't quote taxi drivers. But in a few places (Manhattan, Havana, and now Burma) you meet such a ­variety of characters forced to earn a living behind the wheel that their opinions offer a broad range of views. This driver had trained as a computer engineer before serving in a Burmese embassy in a western country. "Life is not improving here," he said. "Most people don't like the government. We have no legislative body. We have no democracy." (Apologies for breaking journalism's rule number two: don't use anonymous quotes if they are ­pejorative. In Burma, critical sources deserve protection.)

Another driver was making political comments within five minutes of our hiring him from Rangoon airport into town. Asked if it was our first trip to Burma, I said yes, and then added, "I see you call it Burma." "Burma good name, Myanmar new name," he replied mischievously. When we ­inquired what the attractive gardens were behind locked gates on the left, "That was the university. Now closed," he commented. "Because of the ­demonstrations, when we had ­demonstrations. They moved all the universities out of Rangoon. Now it's quiet," he added, before smiling ­sarcastically: "Good idea."

An intelligence officer, I wondered fleetingly, working at the airport to test arriving foreigners? If so, he wasn't much of an expert, since his only ­question, apart from whether it was our first trip, was where we came from. The one good thing he found to say of the ­regime was that it had ­allowed English to be taught again in primary schools. "For a time they stopped it. The army doesn't like ­English but now it's OK again." That certainly seemed to be true. ­Rangoon's main shopping street is brimming with cramped ­bookshops, full of English grammar and vocabulary manuals. Similar titles were laid out on the ­pavements alongside food stalls and fruit-drink stands.

In contrast to Thailand, where ­linguistic communication is a struggle and faces in public transport are blank and unwelcoming, Burmese friendliness is a delight. Burma is multi-ethnic and, until the military coup of 1962, was open to the world. For decades its elite spoke good English and even today most people in Rangoon and Mandalay have a smattering. Keenness for contact with foreigners is strong, for its own sake and as resistance to enforced isolation.

Of course, some friendliness is ­commercially driven. Vendors with bright smiles and the chat-up line "Where are you from?" can turn into leeches at some sites. But genuine ­curiosity is more common. In the hour before sunset, when tourists routinely climb the thousand or more steps to Mandalay Hill, young monks emerge to engage in conversation, especially delighted to meet someone who speaks "real English".

The regime itself uses English for a few publications. Who buys them is hard to say, except perhaps the diplomatic community. They offer a dreary diet of ministerial visits to new hydro­electric projects, with the one benefit of reminding you that Burma is the last country in the world ruled by a military junta: the minister for ­information is a brigadier-general; the minister for construction is a major-general. More bizarrely, so too is the minister for culture.

One copy of the government-owned newspaper New Light of Myanmar that I picked up showed the ministers of culture of Cambodia, Laos, Burma and Vietnam at a recent conference. In full military dress and medals, Burma's minister looked eccentric beside his three conventionally suited counterparts.

The junta wants to shed its anachronistic image. Elections announced for this year are ­intended to give the regime a civilian face, of a sort anyway. The new constitution provides for a presidential system with 14 regional governments. Sizeable blocks of seats will be reserved for the army, and the commander-in-chief will have extraordinary powers. Aung San Suu Kyi, the icon of the opposition ­National League for Democracy – which won the last elections in 1990 but was prevented from taking office – is of course still under house arrest. But even if she were not, this new consti­tution bars her from standing for ­president. The poll will be tightly ­controlled in other ways and opposition groups are unlikely to have much room to campaign, ­although election regu­lations have not yet been finalised.

While people's willingness to give foreigners their opinions was the biggest surprise of our trip, the amount of access people have to dissenting views also ran counter to our preconceived picture. The BBC's Burmese radio ­service is widely heard. An Oslo-based exile TV station, the Democratic Voice of Burma, can be picked up by satellites that are easily available. Rangoon and Mandalay have numerous internet ­cafes, which are invariably full. When I clicked on the BBC website in Burmese it came up promptly.

To resist this, the regime makes the feeblest of propaganda efforts. For a flavour, take the instructions that ­appear under the bizarre headline The People's Desire in newspapers and on occasional roadside hoardings: 1. Oppose those relying on External ­Elements, acting as stooges, holding negative views; 2. Oppose those trying to jeopardise the stability of the state and national progress; 3. Oppose foreign nations interfering in the internal affairs of the state; 4. Crush all internal and external destructive elements as the common enemy.

The fourth of these points encapsulates the junta's preferred strategy for handling criticism – repression. The country has around 2,100 political ­prisoners, including many of the monks who led the 2007 street protests from Rangoon's majestic Shwedagon ­Pagoda. Dozens were shot and killed during those protests, and public ­assembly is still severely restricted. The authorities are so determined to prevent crowds gathering that they have even fenced off a corner of the vast concourse, full of minor temples and Buddha statues, that surrounds the Shwedagon's golden stupa in Rangoon. This corner contains a monument to student demonstrators killed by the British in 1920, and the regime wants no parallels drawn or flowers placed in memory of more recent deaths.

Britain's long occupation

For British visitors, the monument is a useful reminder of Britain's long occupation of Burma, the most graphic account of which can be found in George Orwell's Burmese Days, a ­fictionalised memoir of the odious colleagues he worked with as an imperial policeman in northern Burma in the 1920s. The book is certainly an essential text if you want to understand the racism, brutality and violence which the ­British empire entailed, and another key text for any visitor to Burma is ­Amitav Ghosh's epic, The Glass Palace, covering three generations of two ­Burmese and Indian families. One of its most powerful sections covers the dilemma confronting Burmese nationalists during the second world war – whether to support the Japanese against the British Raj, or defend the very empire they had long sought to overthrow. The most prominent leader to face this agonising choice was Aung San Suu Kyi's father, General Aung San, who first joined the Japanese but came back to the British side.

One morning in Rangoon we tracked down his house, a rambling wooden building with delicately carved gables on a hillock in a northern suburb. It has long been closed to Burmese but, according to the guidebooks, foreigners could wander in and admire family photographs, some showing the young Aung San Suu Kyi. Not any more. "Only on 19 July," a gardener told us through the locked railings. That is the anniversary of the day Aung San, by then Burma's prime minister, was murdered by a political rival on the eve of independence.

Where there are faint signs of hope for Burma is in the aid field. Thanks to an international boycott, Burma receives less help than any other country in the world. This is one reason for the catastrophic rates of infant mortality and child malnutrition. But in recent months western governments have started to think again, since the denial of assistance hits only Burma's poorest. Foreign donors are stepping up develop­ment aid on top of the ­emergency grants supplied after Cyclone Nargis, which left an estimated 140,000 dead or missing.

The junta's initial reaction to the ­cyclone was to refuse international help. It carried on with a refer­endum on the new ­constitution, as though Nargis had not happened. This further blackened its image. But under pressure from governments in the Association of South-Eastern Asian Nations (Asean), the junta changed its line and inter­national aid agency officials now say the regime has been working well with the UN and Asean in agreeing programmes, priorities and relief projects, and allowing donor money to reach people. ­Foreign aid workers get permits to ­enter the ­affected areas in the ­Irrawaddy delta. Big western non-­governmental ­organisations such as Oxfam and Save the Children are well-established in Burma, with a network of local staff.

As tourists, we were allowed to spend a day in Twante, one cyclone-­affected area about 20 miles out of Rangoon. A driver whom we found ­independently invited us home to lunch where his wife and other women relatives were feeding two dozen monks, a gesture the family makes about twice a year, he said. The temples played a key role in collecting clothes, food and money for cyclone victims. Private companies funded the rebuilding of many houses and schools.

After the disaster, Burmese students and other young people poured into the area to help. Some were so moved that they later set up aid projects and small NGOs without government ­obstruction, we were told. As a result, according to a western aid worker who travels regularly to Burma, Cyclone Nargis has resulted in a broadening of independent civil society activity.

Suspend travel bans

Optimists argue that the institutional changes enshrined in the new consti­tution will also enlarge the space for progress. There may be a clampdown in advance of the poll, one observer said, but the fact that Burma will have legislative bodies at national and local levels for the first time in more than a generation gives scope for wider ­debate. The International Crisis Group, which often reflects the views of the liberal wing of the western diplomatic elite, takes a similar line. "Even assuming that the intention of the regime is to consolidate military rule rather than begin a transition away from it, such processes often lead in unexpected ­directions," it wrote in an analysis of the pre-election scene.

The group suggests western governments suspend their travel bans on junta members, resume normal contact and push the message that political prisoners must be released and election campaigning be allowed to go ahead freely. The Obama administration has also announced a shift in US policy on Burma towards engagement rather than isolation, though without ­specifying any concrete steps.

According to articles on the online opposition website Irrawaddy, Aung San Suu Kyi's party, the National League for Democracy, is involved in a tough internal debate over whether to take part in the elections. It might back certain candidates even if, as is ­assumed, it is barred from competing in its own right. Taking part would ­allow the party's supporters to revive their networks and contacts.

Meanwhile, the western investment boycott has left the field open to Chinese companies. They are especially visible in Mandalay, which has a large mall called the Great Wall Shopping Centre. "People respect the Chinese – they think they're cleverer than Burmese," said a young man who studied briefly in ­another Asean country. "They don't like Indians because Indians were the main agents of the British occupation. But the Chinese are taking over. They're close to the regime. Each side helps the other. It's like a mafia," he added.

Back, then, to the nagging question: should we have toured a country with so bad a regime and such little prospect of improvement? This young man had no doubt. "Bring in tourists who can spread the word from the outside world and also tell people in their own countries about Burma," he said.

In Britain, the Burma Campaign UK criticises tourism and investment and publishes a "dirty list" of firms that do business with Burma. This includes travel companies as well as the Lonely Planet guidebooks. The campaign's website contains a December 2002 quote from Aung San Suu Kyi: "We have not yet come to the point where we encourage people to come to Burma as tourists."

Two other exile lobbies, Voices for Burma and Free Burma Coalition, which used to support a tourism boycott now take the opposite view. Voices for Burma also enlists Aung San Suu Kyi, though its sourcing is flimsy. Its website says: "According to a close acquaintance, not yet identified but reportedly from her party, the National League of ­Democracy, Daw Aung San Suu Kyi has been quoted as saying that travel to her country can now be encouraged, provided arrangements are made through private organisations. She now believes that tourism might be beneficial, should the result of the visit draw attention to the oppression of the people by the military junta."

While favouring engagement, Voices for Burma and the Free Burma Coalition urge tourists to do as much as possible to help private Burmese citizens and not put money in the government's pocket, and in fact it is possible to do so now as a tourist. Some fees, such as the entrance ticket for the ruined city of Bagan, the visa charge and airport departure tax, cannot be escaped. But in 2003 the government dropped the requirement that every tourist change $200 at an official exchange place. ­Instead of going on a package or using a UK- or Bangkok-based tour company that inevitably has contacts with the Burmese government, visitors can travel on their own by picking one of the many family-owned Burmese travel agents that work from tiny ­offices in Rangoon. You make your ­arrangements either on the spot or by email in advance. There are also ­numerous family-owned guesthouses and restaurants and thousands of ­private souvenir-makers and sellers. Thanks to the web, details of how to plan your trip are readily available.

The big decision is whether to go at all. No one should imagine tourism is automatically going to make Burma a better place. But can anyone credibly argue the tourism boycott has made it better either?

Jonathan Steele is a regular Guardian columnist and roving foreign correspondent. He has written several books on international affairs, including books on South Africa, Germany, eastern Europe and Russia.

Environmental Justice Foundation report says 10% of the global population is at risk of forced displacement due to climate change

Global warming will force up to 150 million "climate refugees" to move to other countries in the next 40 years, a new report from the Environmental Justice Foundation (EJF) warns.

In 2008 alone, more than 20 million people were displaced by climate-related natural disasters, including 800,000 people by cyclone Nargis in Asia, and almost 80,000 by heavy floods and rains in Brazil, the NGO said.

President Mohamed Nasheed of the Maldives, who presented testimony to the EJF, said people in his country did not want to "trade a paradise for a climate refugee camp". He warned rich countries taking part in UN climate talks this week in Barcelona "not to be stupid" in negotiating a climate treaty in Copenhagen this December.

Nasheed urged governments to find ways to keep temperature rises caused by warming under 2C. "We won't be around for anything after 2C," he said. "We are just 1.5m over sea level and anything over that, any rise in sea level – anything even near that – would wipe off the Maldives. People are having to move their homes because of erosion. We've already this year had problems with two islands and we are having to move them to other islands. We have a right to live."

Last month, the president held a cabinet meeting underwater to draw attention to the plight of his country.

The EJF claimed 500 million to 600 million people – nearly 10% of the world's population – are at risk from displacement by climate change. Around 26 million have already had to move, a figure that the EJF predicts could grow to 150 million by 2050. "The majority of these people are likely to be internally displaced, migrating only within a short radius from their homes. Relatively few will migrate internationally to permanently resettle in other countries," said the report's authors.

In the longer term, the report said, changes to weather patterns will lead to various problems, including desertification and sea-level rises that threaten to inundate low-lying areas and small island developing states. An expert at the Institute for Sustainable Development and International Relations in Paris recently said global warming could create "ghost states" with citizens living in "virtual states" due to land lost to rising seas.

The UN's Intergovernmental Panel on Climate Change (IPCC) predicts sea-level rise in the range of 18-59cm during the 21st century. Nearly one-third of coastal countries have more than 10% of their national land within 5 metres of sea level. Countries liable to lose all or a significant part of their land in the next 50 years, said the EJF report, include Tuvalu, Fiji, the Solomon islands, the Marshall islands, the Maldives and some of the Lesser Antilles.

Many other countries, including Bangladesh, Kenya, Papua New Guinea, Somalia, Yemen, Ethiopia, Chad and Rwanda, could see large movements of people. Bangladesh has had 70 climate-related natural disasters in the past 10 years.

"Climate change impacts on homes and infrastructure, food and water and human health. It will bring about a forced migration on an unprecedented scale," said the EJF director, Steve Trent. "We must take immediate steps to reduce our impact on global climate, and we must also recognise the need to protect those already suffering along with those most at risk."

He called for a new international agreement to address the scale and human cost of climate change. "The formal legal definition of refugees needs to be extended to include those affected by climate change and also internally displaced persons," he said.

Behind Aung San Suu Kyi stand hundreds of lesser known writers and activists paying the price for speaking out

There was a powerful moment at the end of a recent vigil held to mark the 64th birthday of Aung San Suu Kyi and to call for an end to her decades long detention. One of the demonstrators pinned a photograph of General Than Shwe, the head of Burma's ruling military junta, to the doorway of the silent but watchful Burmese embassy, across the portal from a picture of Aung San Suu Kyi.

The juxtaposition of the two faces highlighted, far more forcefully than a dozen speeches or articles, the gaping moral gap between a regime responsible for brutal and systematic persecution and a profoundly human opposition.

Aung San Suu Kyi's dignity and beauty are undoubtedly powerful tools in the campaign against the junta and one of the many reasons that the ongoing campaign for democracy has supporters right up to the highest level, including our own prime minister who is said to telephone the UN's Ban Ki Moon, just returned from an apparently fruitless mission to Burma, twice a week to discuss the situation there.

But we must not forget the many hundreds of lesser known writers and activists who live in daily fear of assault or assassination or are wasting away for lack of medical help in some of the world's most notorious jails.

In some cases, there are only one or two photographs of them in existence – grainy snaps of their younger, more hopeful selves – for us to look upon and mobilise around.

That is why tomorrow, English PEN, with the help of comedian Jo Brand and poet Ruth Padel among many others, will be highlighting the situation of imprisoned and persecuted writers around the world.

Those like Mexican writer, Lydia Cacho, author of several books on the child pornography trade who lives in fear of having her throat slit by shadowy forces who want to stop her work. Or the Saudi Arabian author and journalist Wajeha al-Huwaider who has been arrested and harassed repeatedly for her human rights writing and activism.

The tomorrow's main focus will be on Burma. We will hear the words of Aung San Suu Kyi whose trial on trumped up charges begins again on Friday. But there will also be readings form the work of the Burmese comedian and poet Zargana who was sentenced last year to 59 years in prison, commuted to 35, for leading a private relief effort to deliver aid to victims of the Cyclone Nargis in May 2008.

Many other writers have been rounded up during recent crack downs; those like journalist Zaw Thet Htwe, sentenced to 19 years for helping Zargana in the relief effort or the Burmese musician and Win Maw, arrested in a Rangoon tea shop and charged with "threatening national security" after sending news reports and video footage to the Norway-based Democratic Voice of Burma radio station during the protests in August and September 2007. Win Maw is now serving six years in the infamous Insein prison in Rangoon.

It is for these brave individuals just as much as Aung San Suu Kyi, that we need far more decisive international action against the junta. Her global fame offers a level of protection.

The lesser known must live in fear of the worst fate of all; that they will become just one of the many faceless disappeared.

English PEN Writers in prison committee and JAM host Breaking Through the Silence. St Margaret's Church, Westminster Abbey, July 9, 7.30pm. Tickets from English PEN.

On 2 May 2008 Cyclone Nargis struck Burma, causing the worst natural disaster in the country's history. It caused the death of over 140,000 people and damaged the lives of a further two million, as well as destroying 85 per cent of seed stocks and two million livestock. Below, we publish survival stories from two people whose lives were changed forever by Nargis, and who are now receiving counselling set up by Medecins Sans Frontieres

Nyein Chan, 27, was married with five children and lived with his parents and extended family. When Cyclone Nargis struck he was widowed, and all but one of his children died. Following counselling, he is now working regularly, sleeps well, his mood has improved and his physical symptoms have subsided

Before Nargis, I had a happy family and enough income, but my family and possessions were all destroyed in a single night and I cannot come to terms with that.

During Nargis, my family members and I escaped from our home by boat. Unfortunately, our boat was destroyed by strong winds and waves and all my family members fell into the water. My children were crying and shouting for help. First, I carried my grandfather and two sons to a big tree, then I went back to get my wife and other children. On the way, I was hit by strong waves and was carried further away. I eventually came to a big tree and climbed up it. I had no longyi [traditional sarong] and I stayed in that tree the whole night.

The next morning, I went back to the place where I had left my wife and children the previous night, but there was nothing. They were all gone. Then I went back to the big tree where I had left my grandfather and two sons, but found my grandfather and only one of my sons. My other son was missing – he had fallen down into the water in the night.

I am very sad and upset because I could not save my family. After two days, I heard that my eldest daughter had not died but had been saved by one of our neighbours and was in Bogalay camp. I went to the camp but did not find her. She had died during Nargis.

After Nargis, I suffered from persistent abdominal pains and headaches. I could not sleep well at night and had no desire to eat. I went to Bogalay and Yangon hospitals and was treated for hepatitis.

I feel very sad because six members of my family died in Nargis. I lost my home, wife, daughter and sons. I had no desire to live or work. I had no interest in anything.

When I missed my family, I took to drinking alcohol heavily. I could not save all my family members. I have only one son now. Everyone else is dead. I was very upset and felt depressed. I did not stay in my old village, I moved to my elder brother's village. Now my only surviving son and I live with my brother's family.

I sometimes dream about my wife and children. When I do, I can no longer sleep so I wake up to smoke and drink. I want to live with my family as we were living before Nargis but I've lost everything.

Sabai, 35, was married with five children when Nargis hit. She lost three of her children and all of her property. After counselling, Sabai's strange dreams have subsided and she believes that her children have finally reached a good place – but she is worried about the upcoming monsoon season because she fears that another cyclone might hit

During Nargis my family and I stayed in the water the whole night. I had five children and the waters washed three of them away. I lost all the property we had before the cyclone.

I feel very sad for my dead children and I don't sleep well. I don't like eating and I am not interested in doing any work. I suffer from pains like headaches, backaches, general body pains, and loss of concentration.

When it is windy I don't eat anything and cannot sleep.

I get angry very easily and quite often. I do not like leaving home or seeing my neighbours or other villagers. I keep thinking about my dead children and cry a lot. When I think about the cyclone I get very upset and cry. The neighbours started to gossip that I was either pretending to be or actually was crazy and this made me even more angry.

After the cyclone, I had very strange dreams of my children. I dreamt that my children were asking me to follow them. I got very scared. My husband tried to get me to sleep, and supported me throughout the night. I felt like I was in hell.

Most days I go to the graveyard to mourn my children. I am worried they did not go to a good place and this makes me less interested in my remaining children, my husband and my business. I went to a fortune teller and he told me that the children will go to a good place because they are innocent, but I still get unusual and strange dreams.

• During the last year Nyein Chan and Sabai have benefited from mental health programmes set up by Medecins Sans Frontieres in Bogalay Township, in the Delta

How the UK Department for International Development has helped people rebuild their lives in the areas devastated by Cyclone Nargis a year ago

Kyaw Kyaw Min is 16, and the sole provider for his two younger siblings since he lost both parents to Nargis. He and other child orphans tell their story

Fears for half a million people ahead of monsoon season

A year after the devastating cyclone that laid waste large swaths of Burma, more than half a million people are still living in makeshift shacks which are unlikely to withstand the imminent monsoons, according to Save the Children.

Sea water has inundated wells throughout the Irrawaddy delta and turned almost 2m acres (800,000 hectares) of Burma's most fertile rice paddies into salt-contaminated wastelands.

Aid coordinators say 240,000 people in remote villages still rely on drinking water that is delivered by boat in large rubber bladders. In some places diesel-powered filtration plants work around the clock, turning brackish estuary water into drinkable water.

When cylone Nargis hit Burma on 2 May last year, killing at least 138,000 people and devastating the lives of millions more, the refusal of the ruling junta to allow foreign aid into the affected area left observers pessimistic about the future of those living there.

For more than three weeks after the­disaster Burma's generals refused to grant visas to foreign relief workers and blocked aid from reaching the delta, the worst-hit region.

The government eventually agreed to allow emergency teams into the delta after intervention by the UN secretary general, Ban Ki-moon, but scepticism remained about whether aid really would reach the 2.4 million people severely affected by the cyclone.

Nevertheless, a year on from the disaster foreign NGOs working on the ground say the relief effort has gone far better than they dared hope.

"What has been achieved over the last year has much exceeded what anybody predicted would be possible," said Paul Sender, Merlin's country director for Burma, based in Rangoon. "There was initially a lot of concern about whether anybody would be able to work here, or monitor where the aid was going, but we have found that the aid has been getting through to the people who need it."

Sender, who is also head of the UN's "health cluster" in Burma, said that the predicted outbreak of malnutrition and disease had not happened. "Figures from the clinics show there hasn't been a significant increase either, in the past year, which reflects the fact that there are health provisions in place." .

Dan Collison, director of Save the Children's emergency programme in Burma, said: "Not one Save the Children truck was stopped from reaching its destination, and in those first few weeks we reached 160,000 people, even when we weren't supposed to. We have no evidence at all that the regime confiscated or misappropriated aid, even in the early days."

This optimistic view is not shared by everyone. A report from Johns Hopkins University in the US this year, which collated information from interviews by local researchers working undercover in the delta, found "systematic obstruction of aid, wilful acts of theft and sale of relief supplies, forced relocation, and the use of forced labour for reconstruction projects, including forced child labour".

Sender said: "My biggest frustration working here is that there looks as though there will not be nearly enough money to continue our service provision. The recovery plan for health for the next three years is predicted to cost $54m (£37m), but so far all that has been made available from donors is $6m."

And despite the broad optimism among aid workers, there is no sign that Burma is moving towards democracy – as was underlined by the EU's decision in April to renew sanctions against Burma.

Numerous human rights abuses continue to be documented. In November Zarganar, a popular comedian active in Burma's democracy movement, was sentenced to 45 years in jail after being found to have violated the Electronics Act, which regulates electronic communications. He was detained last year for criticising publicly the government's slow response to cyclone Nargis.

Rappers, journalists and comedians have discovered a new crime in Burma – helping people devastated by cyclone Nargis

This year's Burma human rights day was commemorated by the launch of an international petition campaign to free political prisoners in Burma. Led by the Assistance Association for Political Prisoners and the Forum for Democracy it was supported by around 170 civil society groups with events from Dublin to Tokyo.

Inevitably this launch and most of the publicised activism occurred outside Burma, with former prisoners and activists rallying concerned folk globally; and inevitably the notion that the petition should be aimed at those who hold the keys to the cells of the more than 2,100 prisoners of conscience is not even considered.

The number of political prisoners – which has doubled since 2007 – is perhaps the most debilitating of issues for any chance of reconciliation or democratic progress in Burma; internment, and the fear that this breeds in those not detained, castrates society, depriving it of viable leadership and dialogue and leadership. It eradicates many of the most original and inspiring voices from the nation's life.

Perhaps the most vindictive prosecutions are those carried out against people for helping the victims of cyclone Nargis. Last week Min Thein Tun was sentenced to 17 years in jail for co-ordinating relief via the internet. He will join Eint Khaing Oo, a young award-winning journalist, on the list; her "crime" was the simple act of interviewing a victim.

While democracy is referred to like a brand, its principles – namely freedom of speech and association – are feared by the regime, to the extent that even actions that are not conspicuously anti-government in any form are ruthlessly suppressed. Ideas and actions of the slightly humanistic or questioning are painfully at odds with the notions of politics that are held by the junta.

Despite "showboating", as the journalist Larry Jagan calls government human rights PR, the numbers show no sign of diminishing. The "showboating" incident was a release of more than 6,000 prisoners, of whom a mere 20 or so were political – and, according to Bo Kyi of the Assistance Association for Political Prisoners, these had served lengthy sentences already. Indeed, if the release of such a large number of genuine criminals is not bad enough, it has been suggested that the clear-out was to free up cells for incoming politicals.

If that is the case it could well be because of next year's supposed election. Which is set to be a strange affair, as the constitution on which it is based is a charter that explicitly legitimates military rule, is illegal to campaign against and was "voted" in by a staggering 98% of the vote – a result that is indicative of the ridiculousness of the whole charade, as the UN constitutional expert Yash Ghai noted: "The cynicism with which the regime held the referendum and manipulated the results was on a par with the cynicism and coercion by which the draft was prepared."

Of the younger groups joining older generations of activists, perhaps most notable is Generation Wave. The youth group has undertaken graffiti and leafleting campaigns, and among its members is the now detained rapper, Zayar Thaw, one of the most popular musicians in Burma and founder of the band Acid. After his trial for "dealing in foreign currency" and belonging to an "illegal organisation" an attempt has been made to arraign the judges before the international criminal court. The rapper was allowed no time in private with legal representatives and prosecution "witnesses" were not cross-examined.

At roughly the same time that Zayar Thaw was receiving his sentence the government slapped a savage 45-year sentence on Zarganar, the renowned satirist. His plight was sealed by a single interview with the foreign press about cyclone Nargis.

In their decades behind bars these political prisoners will face rape and torture and be deprived of food. And many are put in prisons far from their families, who are often their only source of decent nutrition and medicines. The denial of healthcare is routine even to those suffering from conditions such as heart disease. Within the crowded cells reading and writing is forbidden, and news is gleaned from the scraps of old newsprint used in the making of Burmese cigarettes, cheroots. Communication between cells is done through painstaking versions of Morse code.

There is very little room to manoeuvre within Burma for activists, yet the immense struggle continues clandestinely – just this week a campaign to deface banknotes began with slogans inside Burma as a way of supporting the international petition calling for the release of political prisoners.

• First independent research into disaster details host of abuses
• Study urges junta be referred to international criminal court

International aid for cyclone victims in Burma was deliberately blocked by the military regime, the first independent report into the disaster has found.

The junta's wilful disregard for the welfare of the 3.4 million survivors of cyclone Nargis – which struck the Irrawaddy delta last May, killing 140,000 people – and a host of other abuses detailed by the research may amount to crimes against humanity under international law.

The teams of Burmese volunteers and experts from a US university that conducted the research urged the UN security council to refer the regime to the international criminal court.

The report After the Storm: Voices from the Delta outlined how the Burmese authorities failed to provide adequate food, shelter or water for the survivors.

The storm surge coupled with intense winds swept away homes, fields, livestock and rice stores, leaving little or nothing for survivors.

But the military regime, which was at the time preparing for a national referendum on its plans to hold elections in 2010, insisted it could cope with the disaster despite its scale and shunned most international relief for weeks.

Researchers from Johns Hopkins University in the US and Burmese volunteers from the Emergency Assistance Team (Eat-Burma) spent months interviewing survivors and relief workers about the cyclone's aftermath.

Their study found that the Burmese army obstructed private cyclone relief efforts even among its own concerned citizens, setting up checkpoints and arresting some of those trying to provide help.

Supplies of overseas relief materials that were eventually allowed into Burma were confiscated by the military and sold in markets, the packaging easily identifiable.

"I went to some of the markets run by the military and authorities and saw supplies that had been donated being sold there," a former Burmese soldier who fled to Mae Sot across the border in Thailand told the researchers. "The materials were supposed to go to the victims. I could recognise them in the market."

The researchers were repeatedly told that surviving men, women and even children were used as forced labour on reconstruction projects for the military.

"[The army] did not help us, they threatened us," said one survivor from the town of Labutta. "Everyone in the village was required to work for five days, morning and evening without compensation. Children were required to work too. A boy got injured on his leg and got a fever. After two or three days he was taken to [Rangoon], but after a few days he died."

Professor Chris Beyrer, director of the centre for public health and human rights at Johns Hopkins, said the Burmese regime's response to the disaster violated humanitarian relief norms and legal frameworks for relief efforts.

The systematic abuses may amount to crimes against humanity under international law through the creation of conditions where basic survival needs of people are not met, "intentionally causing great suffering, or serious injury to body or to mental or physical health", he said.