International disaster response is a more complicated beast than many people think. A country may be hit hard by floods or an earthquake, but that doesn't give the green light for the United Nations and other aid agencies to come charging in to help with relief. First, they have to wait for a sign from the government in question that outside assistance is wanted.

Often, this takes the form of an official request for international help. But sometimes, it's less direct. Rather than asking for assistance, a government will simply say it welcomes it. This is what has happened with the floods that have affected up to 2 million people in southern Pakistan in recent days, leaving some 250,000 homeless.

"China and India often do the same," explains Andrew MacLeod, a senior adviser on relief and recovery to the United Nations in Pakistan. "The government can see what is offered by international agencies and that can be measured against what is needed." So far, Islamabad has accepted relief goods such as medicine, water purification equipment and food.

The reasons why governments shy away from asking for aid vary. Often it's to do with politics - they want to be seen to be capable of dealing with their own disasters. Or it may be because the extent of an emergency is unclear at the beginning.

MacLeod says that, while this approach can lead to a smaller amount of international aid, in some cases it improves the quality because unwanted relief can be rejected. He cites the cost of having to burn surplus clothing after the 2005 quake in northern Pakistan, when the government did issue a formal request for help.

In the case of floods, working out the damage can be a real challenge when roads and communications are cut off, as has been the case in southern Pakistan.

"It's been difficult to get a full assessment. But on the current data, the Pakistan government is largely able to meet needs," says MacLeod. "If more information comes out, or we get a large weather system coming in, things could get out of their control."

The forecast is for more rain in the worst-affected provinces of Baluchistan and Sindh over the next three to four days.

The United Nations is sending its own disaster assessment team into the flooded region to better understand what's happening on the ground, and in preparation for further bad weather. And it's also hoping to persuade the government to agree to a U.N.-led appeal for funds to support the work of international aid agencies, which could be issued in the next day or two.

Meanwhile, the International Federation of Red Cross and Red Crescent Societies (IFRC) has approved a grant of 250,000 Swiss francs ($206,400) from its Disaster Relief Emergency Fund for the emergency.

The Pakistan Red Crescent has just sent a six-person medical team to the badly hit district of Turbat, and water pumps and tanks have been provided for 800 families. In the coming days, IFRC plans to deliver 6,000 food packs in Baluchistan and 1,500 in Sindh - each containing a week of rations for a family of seven. Food prices have risen since the disaster, but shortages are starting to ease as some roads have reopened, and the military has stepped up efforts to bring in supplies by air and sea.

As is often the case with flooding, getting clean water to affected people is one of the biggest challenges, along with the prevention of water-borne diseases. The government has asked for anti-snake venom, to treat people bitten by snakes lurking in the floodwater. It also plans to procure 100,000 tents, as many homes have been destroyed.

"As just one example, in the village of Koshkalat near Turbat, 200 households have been completely wiped out, affecting 2,000 people," IFRC communications coordinator John Tulloch told AlertNet. "The problem is that many of the villages in that area are built on dry river beds, and houses are made of mud and thatch. They are not designed to cope with flooding, and the people are very vulnerable."

The damage wrought by this year's storms and floods will compound the region's already high levels of poverty. In Baluchistan, to complicate matters, there is a long-running conflict going on between the government and separatist militants, who are fighting for a greater share of political power and natural resource revenue.

Despite the government's flood relief operation and plans to launch a national appeal, there have been protests in Turbat over what local people see as a slow response to their plight. Aid agencies certainly need time to assess needs in the wake of a disaster, and where access is cut off, supplies may take days to reach affected areas. But Pakistan may also be struggling because its national disaster response capacity is relatively young.

When the 2005 earthquake hit the north, the military played a key role in distributing relief supplies. Thanks to that experience, the army has boosted its skills in humanitarian response.

But the National Disaster Management Authority, which was only set up at the end of 2006, has barely had time to find its feet. "It is still in the process of constructing itself, while having to deal with this (flooding) disaster," says MacLeod.

The NDMA is also mandated to work on measures to reduce the risk of disasters - and this year's floods are likely to underscore the importance of helping vulnerable communities protect themselves.

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