YANGON (Reuters) - Myanmar held a rare election to approve a new army-drafted constitution on Saturday while many of the 1.5 million survivors of a devastating cyclone waited in vain for a concerted aid effort to bring them food and medicine.

Though nervous voters were under orders to vote "yes" to a constitution that will enshrine a dominant role for the ruling military, it was the first real election in the former Burma in nearly two decades.

Army-controlled MRTV ran a final Burmese-style "get the vote out" propaganda blitz featuring jaunty actresses singing "Let's go voting" and "Come along for voting" to a boppy disco beat.

While the junta relentlessly focused on the poll, thousands of survivors of the cyclone that hammered Myanmar a week ago waited for food, medicine and shelter.

Ten thousand hungry and bedraggled refugees have turned up in Myaung Mya, west of Yangon, and their numbers were swelling by the day despite a lack of food and shelter, an aid volunteer said on Saturday.

The government has provided no help and the town cannot cope, residents say. "We have 900 people here but we only have 300 lunch boxes. We gave it to the women and children first. The men still have not had any food," the aid volunteer told Reuters.

PROTESTS AGAINST REFERENDUM

Protesters in Japan, Malaysia and Thailand denounced the junta for holding the referendum in disregard for the suffering of what the United Nations has estimated to be 1.5 million "severely affected" cyclone survivors.

"People are dying and they still want to go on with this artificial democracy," said Than Tun Aung, a refugee who led the protest in Kuala Lumpur.

Even before Cyclone Nargis hit on the night of May 2, groups opposed to military rule, and foreign governments led by the United States, had denounced the vote as an attempt by the military to legitimize its 46-year grip on power.

The government's feeble response to the disaster has only fed cynicism about the junta's determination to proceed with their "roadmap to democracy" leading to multi-party elections in 2010.

The Bush administration on Saturday sidestepped directly criticizing the constitutional vote and instead said the focus of the junta should be on relief efforts.

Questioned by reporters, White House spokesman Gordon Johndroe declined to repeat stiff criticism the United States has leveled against Myanmar's leaders for a vote seen as solidifying the military's grip on the country.

"Our position on the referendum is well-known," Johndroe told reporters. "Our focus now is on getting assistance to the people of Burma and we would certainly hope that is the focus of the Burmese government as well."

The United Nations appealed for $187 million in aid, even though it is still not confident the food, water and tents flown in will make it to those most in need because of the junta's reluctance to admit international relief workers.

Health experts warned that a "second disaster" loomed from diseases such as diarrhea and malaria, even if survivors do manage to find food and shelter.

"This is the second disaster," Greg Beck, Southeast Asia program director for the International Rescue Committee, told Reuters. "First was the cyclone and the surge of water, the second will come if there is no access to food, water and shelter. They will start dying," he said.

Official Myanmar media on Saturday revised the death toll to 23,335 people dead and 37,019 missing.

The generals approved one U.S. aid flight, due to arrive as soon as Monday carrying water purification systems and supplies to ward off waterborne diseases, U.S. officials said.

The U.S. Navy is sending four ships on exercises in Thailand towards Myanmar. France said it was sending a naval ship carrying heavy-lift helicopters and 1,500 tons of aid, which would arrive by the middle of next week.

The Americans say they are preparing the same kind of assistance they provided after the 2004 Asian tsunami and the 2005 Pakistan earthquake. But the air bridge the U.S. military set up during the tsunami is unlikely to be replicated.

"FOREIGN INTERFERENCE"

Myanmar has long been suspicious of the outside world, which the junta fears could bring in destabilizing ideas and values, such as Western concepts of democracy and human rights.

The junta has brutally suppressed any sign of dissent. At least 31 people were killed when troops crushed monk-led pro-democracy protests last September.

While impervious to Western economic sanctions, the generals have avoided total isolation by using Myanmar's vast natural gas reserves to befriend energy-hungry China and India.

Myanmar's top General Than Shwe made his first public appearance since the cyclone, casting his ballot in the new capital of Nyapyidaw. Voting in cyclone-devastated areas, including Yangon, has been postponed for two weeks.

State-run TV warned of "foreign interference" in a broadcast message urging people to vote yes for the constitution.

Most people were expected to do just that. Of the 20 people Reuters interviewed near polling stations in Hlegu, only two admitted to voting no. Even then it was in a whisper and with a nervous glance over the shoulder first. (Additional reporting by United Nations, Geneva and Washington bureau; Writing by Bill Tarrant; Editing by Richard Balmforth)