Rescue teams battled to get drinking water, food and medicine to hundreds of thousands of disease-prone people caught up in Pakistan's worst flooding in decades even as a new cycle of monsoon rains threatened to spread the devastation to the country's south.
With massive devastation in north-west Pakistan leaving anywhere up to 1,400 people dead and affecting a further 2.5 million, according to the Red Cross, experts said there was a crucial need avoid the spread of cholera and other waterborne diseases spread. There have already been several reported outbreaks, as drowned livestock rots amid the slowly receding waters.
While rescue workers and troops dispatched by the government have used helicopters and boats to rescue thousands of people, officials say at least 27,000 are still stranded. Images from the affected areas showed scenes despair as groups of people gathered on higher ground, the roofs of buildings or fought to salvage their homes and belongings and to gather livestock that survived.
One of the worst affected areas is the north of the Swat Valley, once a tourist haven located 100 miles north of Islamabad that was controlled by the Taliban until a military operation forced them out last year. A relief worker with the charity Save the Children, who hiked with colleagues through devastated areas, said the main road through the valley had been destroyed and that up to 6,000 tourists were believed to be stranded in several towns.
Speaking from the valley's largest town, Mingora, the relief worker, who asked not to be named, told The Independent: "The last time there was anything like this was in 1929. The floods have affected the entire valley, although the north is the worst. People are using donkeys and anything else they can to carry supplies. The army's job really is to evacuate people in helicopters."
Officials say the extent of the flooding and its true impact in the Khyber-Pakhtunkhwa province, formerly known as the North West Frontier, had only recently become more clear. Roads, bridges and entire villages have been washed away. "The scale of this is a lot bigger than we thought even two days ago," said Nicki Bennett, of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) in Islamabad. "The biggest issue is still the lack of access. Around 27,000 people are still in areas that are cut off. While water is receding in the north, the problems could spread to other areas of the country."
Indeed, aid organisations said they were already preparing for a new round of flooding in southern Punjab and Sindh provinces in the south as the Indus river continued to swell with monsoon water. A state of emergency has been declared in five districts in Sindh while hundreds of villages have been affected in Punjab, the nation's most populated area.
More rain would only add to the problems. "It could cause massive flooding. The army has already been called out in these areas," said Ashraf Mall of the Tearfund charity.
While the priority for aid workers is to provide clean water, medicine and emergency shelter for hundreds of thousands of people, the government will soon also have to prepare to deal with mounting public anger. Reports from the frontline of the crisis, suggest there is a widespread belief among people that the authorities have not acted with sufficient speed or on an adequate scale.
In the vacuum, Islamist charities have again stepped in to fill the need for emergency aid. Falah-e-Insaniat Foundation (Foundation for the Welfare of Humanity), a group better known as Jamaat-ud-Dawa, a supposedly-banned group, said it had established more than a dozen relief and medical camps, and a dozen ambulances were providing emergency treatment for those who had suffered injuries. Several other Islamist groups are also said to be helping out with the relief effort.
"We have lost everything. We only managed to save our lives. Nobody has come to us," Mihrajuddin Khan, a school teacher in Swat Valley, told Reuters. "We are being treated like orphans, animals."
Money is already flowing in to help Pakistan's stretched aid efforts.
Yesterday, Britain's Secretary of State for International Development,Andrew Mitchell, announced £5m in new aid to pay for safe drinking water, hygiene kits, toilets, sewage clearance and waste removal. Over the weekend, the US announced it would provide $10m (£6.3m) in emergency assistance. It is also giving rescue boats, water filtration units, prefabricated steel bridges and thousands of packaged meals.
Some of the 30,000 Pakistani soldiers dispatched to help deal with the flooding have thrown these meals from helicopters to beleaguered survivors below.