ISLAMABAD, 25 July 2007 (IRIN) - Over a million children are at risk of infectious diseases in Pakistan's flood-affected provinces of Balochistan and Sindh after last month's devastating cyclone Yemyin, which left nearly 300 dead and close to 400,000 homeless.

Of the 2.5 million people affected by the floods, three-quarters were women and children, with upwards of 500,000 children under five being particularly vulnerable, the UN Children's Fund (UNICEF) is now warning.

"Diarrhoeal diseases are our biggest concern," Bill Fellows, UNICEF's senior water, sanitation and hygiene (WASH) adviser for South Asia, told IRIN in Islamabad. He said typhoid, salmonella and acute watery diarrhoea were particular areas of concern.

Skin diseases due to poor hygiene such as general rashes, scabies, as well myriad eye diseases, including conjunctivitis, were also on the rise.

"In terms of sheer numbers, the skin diseases dwarf everything else, but they are infrequently fatal," Fellows said. "It's very hard to scratch yourself to death."

Drinking water "most pressing issue"

His comments come as the humanitarian community expands its activities in the flood-affected areas, less than a week after the UN issued a flash appeal of US$38 million to bolster the efforts of the Pakistani government to address the key humanitarian needs of the affected population over the next three months, with priority on shelter, water and sanitation, health and early recovery activities.

"The most pressing issue that people feel is the lack of safe drinking water," Fellows said, adding that between 200,000 and 500,000 inhabitants in the vast, but sparsely populated, area do not have access to safe drinking water at the moment.

"There is no shortage of water at the moment, but they don't have access to clean water," the WASH expert reiterated, adding that the short-term goal was to provide chlorine or disinfectants to purify the water they did have access to, or alternatively to tanker in safe drinking water to them, while simultaneously working on the restoration of water supply networks damaged by the disaster.

According to initial assessments, a large number of mechanised, gravity and windmill-based drinking water systems and wells had been damaged or contaminated due to flooding, while at the same time people had also lost essential household items used for fetching and storing water.

Damage assessments

In Balochistan, the local authorities say that with UNICEF's support they have succeeded in assessing the damage. Of the 288 damaged water schemes in the province, 50 have already been repaired, with another 50 now under way, they say.

Meanwhile, in Sindh province, assessments to the actual damage to the water schemes were still continuing.

"The flood is still working its way through Sindh," Fellows said, adding that several non-governmental organisations (NGOs), supported by UNICEF, were getting clean water to those in need by tanker.

Sanitation, hygiene

And while the water supply part was almost the simplest part of the emergency, the issue of sanitation and hygiene was proving more complex.

"First of all, there is the lack of soap," he said. "And that has to be replaced."

"Virtually all diarrhoeal diseases are faecal-oral so it's really a question of breaking the faecal-oral cycle," the UNICEF specialist said, through safe drinking water, hand washing, and sanitation and excrement disposal.

At present, the water and sanitation conditions in the affected area remain poor, he said. But quick, temporary pit latrines were being built – something particularly important for women in this largely conservative area.

"A particular concern for us is to ensure that women have some sort of latrine that is a safe environment they can use," he said, citing protection issues.

As part of last week's flash appeal on 18 July in Geneva, UNICEF has requested $6.3 million, of which approximately half is for WASH.

On 24 July the Australian government said it would contribute $1 million to UNICEF for immediate water and sanitation needs, and the Belgian government announced a contribution of nearly $600,000 for UNICEF's WASH activities in the flood-affected area.

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