At a charity clinic in a southern Pakistani village, dozens of people affected by relentless rains and floods crowd around the door waiting to talk to a volunteer doctor.
The village of Bhambro is in a poor district of Sindh province, hard-hit by record floods that have destroyed more than a million homes and damaged critical infrastructure including health facilities across the country.
Bhambro is surrounded by vast stretches of flooded farmland, its streets full of mud and strewn with debris and manure – conditions ripe for outbreaks of malaria, cholera and skin diseases such as scabies.
Tens of millions of people have been affected by relentless monsoon rains that have submerged a third of Pakistan and claimed more than 1,100 lives.
The rains that began in June have unleashed the worst flooding in more than a decade, washing away swathes of vital crops and damaging or destroying more than a million homes.
"Skin diseases are the main problem here because of dirty, stagnant water and unhygienic conditions," said Sajjad Memon, one of the doctors at the clinic, which is run by the charity Alkhidmat Foundation.
He used the flashlight on his mobile phone to examine patients, who were mostly reporting scabs and rashes.
Many had made their way to the clinic walking barefoot through filthy floodwater and mud.
"My child's foot is burning with pain. My feet too," said Azra Bhambro, a 23-year-old woman who had come to the clinic for help.
Abdul Aziz, a doctor in charge of Alkhidmat's clinics in the area, told AFP that cases of scabies and fungal infections were on the rise.
Scabies outbreaks are common in crowded places with tropical conditions – such as flood relief camps and shelters – and can lead to severe itching and rashes, according to the World Health Organization.
Memon told AFP that many of the patients at the clinic could not afford to purchase shoes.
Major health hazards
The millions of people affected by the floods face major health hazards including potentially deadly diseases such as malaria and dengue fever, the WHO warned in a statement on Tuesday.
Sindh province, in Pakistan's south, has been hit particularly hard, with vast swathes of land under water and many villagers forced to head to large cities for shelter, food aid and medical assistance.
The health threat is even greater in areas such as Bhambro, where health services were already limited, and for the tens of thousands who are taking shelter in crowded relief camps.
"Ongoing disease outbreaks in Pakistan, including acute watery diarrhoea, dengue fever, malaria, polio, and Covid-19 are being further aggravated, particularly in camps and where water and sanitation facilities have been damaged," the WHO said.
The UN appeals for $160 mn
Earlier this week, the United Nations and Pakistan launched an emergency appeal for $160 million, with the United States quickly offering $30 million.
The funds will provide 5.2 million of the worst-affected and most vulnerable people with aid including food, clean water, sanitation and emergency education, UN Secretary-General Antonio Guterres said, calling the disaster a "colossal crisis".
"Pakistan is awash in suffering. The Pakistani people are facing a monsoon on steroids – the relentless impact of epochal levels of rain and flooding," he said in a video statement before announcing plans to visit Pakistan next week.
The United States, the largest donor to Pakistan, said it was providing a fresh $30 million for urgent needs including food, safe water and hygiene.
Guterres branded the floods a "climate catastrophe", saying South Asia was one of the world's hotspots where people are "15 times more likely to die from climate impacts".
"It is outrageous that climate action is being put on the back burner as global emissions of greenhouse gases are still rising, putting all of us – everywhere – in growing danger," he said.
The UN's World Meteorological Organization said that Pakistan and northwest India have been witnessing an intense 2022 monsoon season.