Fears for six million flood children

The UN estimates up to a quarter of the country has been affected by the worst flooding in a generation, which struck two weeks ago and spread south through thousands of small villages.

Amid warning that dams in the Sindh province could still burst in the coming days to bring further floods, doctors are warning that stagnant flood plains in densely populated, poverty-stricken urban areas will become breeding grounds for cholera, mosquitoes and malaria.

The United Nations has launched an appeal to raise 293m for the country, with an estimated seven million people in need of emergency assistance, including food, clean water, shelter and medical care. A US Navy ship carrying helicopters and 1,000 Marines reached Pakistan's southern coast yesterday to boost relief efforts,

Mohammed Qazilbash, Save the Children's spokesman in Islamabad, said: "Outbreaks of cholera and malaria are a big concern. In southern Punjab and Sindh there are vast numbers of people living right along the water, some in makeshift houses.

"Children are drinking, washing in and going to the toilet in the same river water. If this sanitation crisis is not tackled now, in six months time millions and millions of children will be suffering potentially deadly diarrhoea and other diseases."

In southern areas of Pakistan, the flatter, hotter terrain means water can stand for long periods, making the flood plains a breeding ground for mosquitoes and malaria. Doctors working in northern areas of Punjab and Swat Valley have reported sharp increases in patients suffering from water-borne diseases, including diarrhoea, food poisoning, vomiting and fever.

Mark Bulpitt, head of emergencies for World Vision UK, said: "As we continue to reach those most affected by this flood, we must also focus on the longer-term recovery, prioritising livelihoods and education to ensure more of Pakistan's children do not become victims of child labour.

"Schools have been washed away so education will need to be prioritised, houses and health centres are unusable and then there is the emotional fallout of living through a disaster as devastating as this one."

President Asif Ali Zardari, who has been sharply criticised for visiting Europe as the floods began, made his first visit to victims of the disaster yesterday and toured one of the dams. Prime Minister Yousuf Raza Gilani, also visiting flood-hit areas, said more helicopters were needed to assist in relief.

"We will try our best to reach millions of people to ensure that they get food and other basic items during and after the month of Ramadan," he said.

Yesterday also saw the start of the holy month and what is normally a festive, social time was marked instead by misery and widespread fear for the future. Damage to crops, roads and bridges has caused food prices to triple in some parts of the country.

"Ramadan or no Ramadan, we are already dying of hunger," said Mai Hakeema, 50, who sat alongside her ailing husband in a tent outside the city of Sukkur. "We are fasting forcibly, and mourning our losses."

Muslims fast from dawn to dusk each day for the month to control their desires and show empathy for the poor. While millions of flood-affected people were fasting, a top religious scholar said victims dependent on charity could miss it and perform it later in the year.

n To make a donation to the DEC Pakistan appeal, call the 24-hour hotline on 0370 60 60 900, visit www.dec.org.uk or donate over the counter at any post office or high street bank, or send a cheque made payable to DEC PAKISTAN FLOODS APPEAL and post to DEC PAKISTAN FLOODS APPEAL, PO BOX 999, LONDON, EC3A 3AA

People can also donate 5 by texting the word GIVE to 70707.