The stench of decay hangs over a makeshift camp in Pakistan's south, where hundreds of locals have sought shelter from the devastating monsoon floods that have put nearly a third of the country under water.
In Punjab province, dozens of tents are perched in the area around a small rural railway station — the only dry land on a horizon of water, reached only by a sliver of road.
The odour is a heady mix of rotting vegetation from drowned crops, leftover food scraps and garbage — as well as the accumulated excrement of the hundreds of people and livestock gathered there.
"There is no place for showering or going to the bathroom," said Zebunnisa Bibi, forced to flee with her family two weeks ago when floodwater inundated her village.
Similar tent camps have mushroomed across the south and west of the country. The worst flooding in the country's history has covered an area the size of the United Kingdom and affected 33 million people — one in seven Pakistanis.
A lack of functioning toilets at these camps is one of the biggest issues — posing a health hazard for all, but misery in particular for women and girls.
Rural Pakistan is home to extremely conservative Muslim communities, and many displaced women are having to live in close proximity to men who aren't relatives for the first time in their lives.
"We used to live behind the veil, but God has removed that for us," said Zebunnisa, referring to the strict segregation between the genders that is practised in rural Pakistan.
– 'Deeply ashamed' –
She said she was "deeply ashamed" at having to relieve herself in the open — especially after she caught a man watching her as she lowered her shalwar kameez behind a tree.
Shameen Bibi expressed similar sentiments.
"Where can I send my daughters alone? When we squat to relieve ourselves, we get scared that some man might come."
Swarms of flies and mosquitoes add to the misery, creating an environment ripe for a breakout of disease and infection.
Some women have stopped venturing into the floodwater to relieve themselves after many developed rashes.
Ehsan Ayaz, a volunteer doctor who arrived at the campsite in Fazilpur as AFP visited, said the lack of toilets was "the main reason" for the rise in cases of skin infections and stomach flu he treated.
Shameen and her daughters now drink as little water as possible during the day, preferring to spend hours in discomfort rather than be forced to relieve themselves where they can be seen.
When the sun sets and darkness descends on the camp, the women search for a secluded spot away from flickering campfires.
They take turns to keep watch and warn away any encroaching men.
"I don't know what we can even do if someone does decide to come and take advantage of us," said Shameen.
There is also another threat.
At night, said Shameen, "snakes and scorpions come out from the water".
UN preparing for worse to come in Pakistan floods
Geneva (AFP) Sept 6, 2022 –
The United Nations warned on Tuesday the humanitarian situation in flood-ravaged Pakistan was expected to get worse, a day after establishing an air bridge to deliver aid to victims.
More than 33 million people in Pakistan have been affected by the flooding, brought on by record monsoon rains amplified by climate change. The floods have caused at least 1,300 deaths and washed away homes, businesses, roads and bridges.
The UN's World Health Organization said more than 1,460 health centres had been damaged, of which 432 were fully wrecked, the majority of them in the southeastern province of Sindh.
More than 4,500 medical camps have been set up by the WHO and its partners, while more than 230,000 rapid tests for acute watery diarrhoea, malaria, dengue, hepatitis and chikungunya have been distributed.
Such diseases are already circulating in Pakistan, alongside Covid-19, HIV and polio, and "now all these are at risk of getting worse", WHO spokesman Tarik Jasarevic told reporters in Geneva.
"We have already received reports of increased number of cases of acute watery diarrhoea, typhoid, measles and malaria, especially in the worst-affected areas."
Jasarevic said it was still difficuly to get to areas hit hard by the floods, which have submerged a third of the country — an area the size of the United Kingdom
Mortality among newborn babies and severe acute malnutrition are at risk of increasing due to disruption of services.
"The situation is expected to worsen," Jasarevic warned.
The WHO has delivered $1.5 million in medicines and emergency stockpiles, including tents, water purification kits and oral rehydration sachets.
It is appealing for $19 million from donors.
UNHCR, the UN refugee agency, has launched an air bridge to deliver aid from Dubai.
The first four flights took off on Monday, said Indrika Ratwatte, UNHCR's regional director for Asia and the Pacific.
Six other flights are planned, with mattresses, tarpaulins and cooking utensils on board.
"The food insecurity is going to be huge because the crops are devastated, obviously, and the little they had in terms of livestock is also destroyed," he said.