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Every day or two, Mira Abou Meghwar deposits her children in her shelter, takes a few steps across the road, and descends into the water: five paces and it is up to her shoulders. If she is careful, following the path she knows is there below her in the murk, she can keep her head above the water the whole way.

She walks a couple of kilometres back to the place where her house once stood. What remains of it lies beneath the still, sage-green water, but by rummaging around in its vicinity and looking in the branches of the thorn bushes that are inundated but still in place, she sometimes finds treasure: a piece of child's clothing; a metal cooking pot; a wooden box that once stored spices. She puts all this on her head, and wades slowly back to the stick-and-scrap tent where she now stays with her husband and their eight children, on the high ground of the main road.

They have been here for more than a month, since the night they awoke in their homes – hundreds of kilometres from the sea, a day's walk from the river – to the sound of water rushing all around them. Torrential monsoon rains, and catastrophically bad management of drainage and irrigation channels, caused a massive series of floods throughout Sindh, the southern province of Pakistan, and in neighbouring Baluchistan as well.

Some nine million people are now affected by widespread flooding in Pakistan; many have lost their homes, their possessions, and their livelihood for the foreseeable future as polluted water pools on the land they used to farm. These floods come one year after the largest natural disaster in Pakistan's history, late-monsoon floods that submerged one-fifth of the country's land mass and affected 20 million people. Many of those left homeless by the latest rains had already been displaced by the flood of 2010 and had yet to go home or were only just rebuilding when disaster came again.

The night the water hit the farming community of Jio Kaloi, Ms. Abou Meghwar and her husband gathered up their children and ran first to the local road, and when that began to be inundated, to the main road, and there they have remained.

"What do you think, that we could have saved anything in this water?" she demands after one of her afternoon salvage expeditions. "I saved my head, I saved my children's heads, and I saved my husband's head. That's it."

Yet the response of the Pakistani government has been fitful or entirely absent, the displaced people say, while the international community, weary of the perpetual litany of disaster from this country, has been equally slow to offer help.

Every major road in southern Sindh is now lined with shelters like the Abou Meghwars' – in a few places there are thick canvas tents pitched on the asphalt; most are homemade affairs, an old sari or a plastic tarp stretched over bamboo poles. Toddlers play a few inches from transport trucks that thunder past on the road from Karachi. There are no sanitation facilities. And while there is water in every direction, the lack of water safe to drink is perhaps the most urgent crisis facing the displaced. As they drink, bathe, water livestock and relieve themselves in the surrounding water, outbreaks of diarrheal disease are imminent. The only medical assistance the people of Jio Kaloi have received was a visit by Pakistan army medics who gave everyone in the community a jar of cough syrup.

Here in Sindh, an agricultural state where the feudal system is alive and well, the flood has been something of a leveller. At the homes of prosperous landlords, carved wooden four-poster beds are stacked on the roof; graceful gardens and farm equipment are under water.

But the bulk of the displaced are people such as the Abou Meghwars, who had very little before the flood and now have even less. They survived sharecropping a handful of the landlord's acres. The flood came just two days before they were to harvest their crops of cotton and chilies; everyone in their community had borrowed from the landlord to buy the seeds to plant. "We grew enough to eat," Ms. Abou Meghwar said. "Never to save."

Her neighbour, Hani Patian, borrowed 100,000 rupees this year, or $1,200 – for seeds and fertilizer, and to pay for her daughter's marriage. Now she is in a near-panic about what they will do. "The situation is more critical than you might think just looking at us. Because we have these debts, the landlord will not let us leave to look for work somewhere where there is no water," she explained. "We must return here every night. Everyone has a debt because we borrowed money from the landlord and the crop was ready to harvest."

Monsoon rain in the southern half of Pakistan this year is 270 per cent above normal. "There isn't any controversy any more, it's definitely climate change," said Iftikhar Khalid, associate country director for the aid agency Oxfam in Pakistan, about the freak weather patterns over the past two years. But the Pakistani state is not strong enough to manage the impact, he added. "There is a need for government to invest seriously in disaster management – how many times will the international community come to help you?"

Oxfam has helped the people of Jio Kaloi put in a water tank and has provided emergency hygiene kits of soap and buckets and sanitary napkins. It isn't much, but international help for this crisis is minimal. The United Nations humanitarian co-ordinator in Pakistan, Timo Pakkal, said this week that confirmed donor contributions to a UN rapid-response plan amounted to $9-million (U.S.) – just 3 per cent of the funds required.

Mr. Khalid said the government was late to ask for help, insisting it could manage the crisis itself, while international donors are numb to news of disaster from Pakistan. "Donors believe Pakistan has become a black hole: 'Money goes in and nothing comes out,' " he said.

Weak governance lies behind much of this flood disaster, he noted. Pakistan's system of canals and drains was in an advanced state of disrepair all over Sindh and Baluchistan, and people were given no warning of a potential breach. Much of the flooded territory was inundated by water from the Left Bank Outfall Drain, a megaproject built by the World Bank in the early 1980s to collect excess irrigation water, rainfall, saline groundwater, industrial effluent and municipal wastewater through a series of canals and deliver it to the sea. Instead, the heavy rainfall overflowed the canals and sent toxic water spilling over thousands of hectares of farmland.

"Some people say God caused this, but I think it is the government," villager Malouk Mangherar said. "Mismanagement of the canals and the LBOD caused the breaches and overflow."

There was no warning. "There had been some rain. There was some standing water around but not in the houses," Pathani Sharif said. "When we awoke we had only time to run. If we had noticed we might have saved our things." She lost her livestock, a buffalo and some chickens; Ms. Patian lost 400 kilograms of wheat saved for reseeding.

The confirmed death toll in the flood is about 430, although thousands of people are missing. The bulk of the flood-related deaths will start now, Oxfam's Mr. Khalid noted, from water-borne disease, particularly the diarrheal illnesses to which children are particularly susceptible. The older children of Jio Kaloi are still intrigued by the novelty of their flooded surroundings and dive off the road, swimming out around their former houses. But the babies already show the effects of a month without regular food or clean water. They are listless and alarmingly quiet.

"It will be at least six months before this water goes – when it goes we will go and look for labour," Ms. Patian said. "Until then, we will beg."

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