Poor communities providing refuge to tens of thousands of people uprooted from their homes due to fighting in northwest Pakistan are themselves struggling to cope and desperately need help to support those they are sheltering, say aid agencies.

Some 1.5 million people have fled the former tourist region of Swat Valley in recent weeks after the Pakistani military launched a major offensive against Taliban militants.

Hundreds of thousands of exhausted, traumatised people have been streaming into towns in the North West Frontier Province (NWFP), seeking food, water and shelter.

While about 20 percent of those displaced by the fighting have been accommodated in camps, many are living with family or friends or with local Pashtun communities who have opened their doors to them.

But as the army intensifies its offensive and more people flee, the additional burden being placed upon these host communities - who are known for their culture of hospitality - is beginning to take its toll.

Aid workers say the huge numbers of displaced are putting a strain on the limited resources of their low-income-earning hosts, who are not only providing rooms in their homes for scores of people, but also sharing their food, water and other items.

"Those who have been displaced are living in very difficult circumstances within the host communities," said Patrick Parsons, operations controller for Merlin aid agency in Pakistan.

"In many cases, there are up to 25 people - men, women and children - crammed into one room and the families whom they are living with are trying to share whatever they have, but it's putting a big strain on them and this is not sustainable."

Relief groups add that the additional burden is also putting pressure on water and power supplies. In some cases, people are living with no electricity and limited access to toilets.

'SHOCK ABSORBER'

Given the vast numbers of people who have been arriving daily to districts such as Mardan, Swabi, Peshawar and Nowshera, most aid agencies have been primarily focusing on meeting the needs of those in the camps.

But humanitarian organisations say it is time to focus on those outside of the camps who have been largely neglected.

"It would be a total disaster if we did not have the support of the host communities as they have been a shock absorber given the mass exodus of people that we have seen in recent days," said Kilian Kleinschmit, assistant country representative for the United Nations refugee agency (UNHCR) in Pakistan.

"But we have a situation where very poor people are being taken in by a very poor host community and this makes for a very poor mix... We must now reach out to them."

The U.N. World Food Programme says the province is already food insecure and they have started distributing food to people outside of the camps.

But aid workers say non-food items such as bedding, cooking utensils and water and medical services need to be provided to those living with host communities as well as those renting accommodation and sheltering in schools and colleges.

They also suggest that monthly cash allowances be given to those displaced and livelihood building programmes initiated.

There are concerns that if pressure is not relieved on the host communities soon, already stretched systems will break down completely and hundreds of thousands of people will be forced to move into camps.

But in order to avoid this, aid workers say more funds are required and are appealing to international donors to come forward.

The head of UNHCR, Antonio Gueterres, has warned of the consequences if nothing is done soon to help those uprooted by the war and the tens of thousands of host families trying to care for them.

"Leaving this population without the support they need - with such massive numbers - could constitute an enormous destabilising factor," he said.

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