The monsoon spell that started in the second week of July 2022 caused widespread flooding and has led to extensive human and infrastructure damage across many parts of Pakistan. According to the National Disaster Management Authority (NDMA), Monsoon Situation Report, which was published on August 30, 2022, 1,162 people have died and 3554 are injured in the country. Around 1,057,388 houses were damaged (including 324,386 fully and 733,002 partially damaged). In addition, around 5063 kilometres of roads have been washed away, 243 bridges have collapsed, many shops have been destroyed and 730,483 animals have died. Moreover, Sindh province is affected most adversely by heavy rainfall and resultant flooding in Pakistan. The Provincial Disaster Management Authority (PDMA) Sindh reported 405 deaths and 1074 severe injuries. Around, 896,084 houses have been damaged. Moreover, 2328 kilometres of roads and infrastructure has vanished, bridges have collapsed, and 15,435 livestock perished in the province. Sindh is Pakistan’s second-largest province but remains one of its poorest. An estimated 10 million people have been affected by the floods. Presently, these affected people are in desperate need of shelter and emergency medical assistance. The situation is similar in the restive southwestern Balochistan province. Recently, I had a chance to visit several districts of Sindh during this monsoon spell. Near the city of Khairpur, thousands of mud homes were sunk underwater. For miles, all that was visible were treetops. Where the water level was slightly lower, thatched roofs creep out from underneath the water. Nearly all of the country’s crops, along with thousands of livestock and stores of wheat and fertiliser, have been damaged – prompting warnings of a looming food crisis. Nearly all of the country’s crops, along with thousands of livestock and stores of wheat and fertilizer, have been damaged – prompting warnings of a looming food crisis. I visited several villages in Khairpur Mirs, Ghotki, Shiekparpur and Sukkur, the people were desperate for food, and shelter and importantly children were having waterborne diseases, particularly skin diseases. I remember I was having a mobile truck of cooked food and scores of people immediately ran towards it. Children carrying other children made their way to the long queue. One 12-year-old girl said she and her baby sister had not eaten for a day. “No food has come here from the government and from any organization, and even my sister is sick, she has been vomiting,” the girl said. The desperation was evident in every community. People ran towards car windows to ask for help and food. Seriously I felt helpless. This flood water gave rise to a serious health crisis, with thousands displaced by deluges and now being inflicted by various diseases, mainly water-borne. According to the Sindh provincial health department, some 71,398 people were logged by authorities to have arrived for treatment at the various medical camps set up across the province, with complaints largely linked to waters that have stagnated in the aftermath of the floods. Of the thousands of people who were tended to, a disproportionately high number of acute respiratory infections – 13,989 – were mentioned in official Sindh health department data. Some 12,777 people complained of diarrhoea, 13,672 skin diseases, 8,515 suspected malaria, with 415 confirmed, and 33 had dengue. Another 22,413 were ill with other ailments. Cumulatively, more than three million displaced people have received treatment since July 1. While talking with Sughra Solangi Chief Executive Officer Marvi Rural Development Organization said at the moment in Sindh priority needs are shelter and food followed by potable water and sanitation services, Non-food items including Menstrual Hygiene Management items for women, health services and livelihood opportunities. She said MRDO organised 50 free medical camps in District Khairpur and Sukkur in which more than 2000 patients have been treated and provided free medicines. She further said this flooding is the worst and deadliest in Pakistan’s 75 years of history, and there are multiple reasons for that. Despite having experienced similar catastrophes in 2007, 2010, and 2012, the government was not prepared to deal with a major flooding event. This time the lack of unpreparedness and proper planning increased the disaster’s impact, which will further escalate unless the water accumulated in flood-hit areas dries up. More children and women vulnerable to infectious diseases are likely to suffer. The government still doesn’t have the plan to rehabilitate or at least settle these displaced people in temporary shelters – many are living on their own on roadsides under the open sky. Resettling 33 million people remains a daunting task for the current government. During my visit to Northern and Southern Sindh, I found that many people live in unsanitary conditions in temporary shelters, often with limited access to basic services, compounding the risk of a major public health crisis. Moreover, pregnant women are being treated in temporary camps. On the other side, national and international NGOs are continuing their assistance through activities, including food, dignity kits, medical camps, non-food items, water, sanitation and hygiene support. I really want to appreciate the teams of the US Government for going into the communities and providing relief material and emergency lifesaving assistance to the most affected communities in Sindh and Balochistan. The US Government is providing Emergency Shelter Kits, Kitchen Kits and dignity hygiene Kits in the three District of Balouchistan, including Jhal Magsi, Naseerabad and Jafferabad and in the six districts of more affectees cities of the Sukkur, Kashmore, Jacobabad, Dadu Larkana and Shikarpur districts of Sindh. Moreover, Save the Children is also doing every bit for rehabilitating and establishing schools within the affected communities so that the children can continue their studies. Hereby, I want to highlight and appreciate the efforts made by Samr Trust, IOM, Oxfam and HRDN in providing relief material and services. Lastly, I want to conclude that the needs are enormous and more support is needed due to the scale of the catastrophe. The writer is a social and political activist based in Lahore. He can be reached at salmanali088@gmail.com, and tweets at Salmani_salu.