The United Nations warned yesterday that up to 3.5 million children were at risk from water-borne diseases in flood-hit Pakistan and said it was bracing to deal with thousands of potential cholera cases.

Fresh rains threaten further anguish for millions of people that have been affected by Pakistan’s worst floods for 80 years and UN chief Ban Ki-moon has urged the world to speed up international aid urgently.

Described as the worst humanitarian crisis in the world today, the three-week disaster has affected 20 million people, and has destroyed crops, infrastructure, towns and villages, according to the Pakistani government.

The United Nations has launched an aid appeal for $460 million, but charities say the response has been sluggish and flood survivors on the ground have lashed out against the weak civilian government for failing to help.

Maurizio Giuliano, spokesman for the UN Office for the Coordination of Humanitarian Affairs (OCHA), feared that Pakistan was on the brink of a “second wave of death” unless more donor funds materialised.

“Up to 3.5 million children are at high risk of deadly water-borne diseases, including diarrhoea-related, such as watery diarrhoea and dysentery,” he said, estimating the total number at risk from such diseases at six million.

Typhoid, hepatitis A and E are also concerns, he said.

“WHO (World Health Organisation) is preparing to assist up to 140,000 people in case there is any cholera, but the government has not notified us of any confirmed cases,” the spokesman said.

“We fear we’re getting close to the start of seeing a second wave of death if not enough money comes through, due to water-borne diseases along with lack of clean water and food shortages,” he said.

Cholera is endemic in Pakistan and the risk of outbreaks increases with flooding, but the government has so far confirmed no cases publicly.

One charity worker, speaking on condition of anonymity, said that several flood survivors had already died of the disease.

The UN estimates that 1,600 people have died in the floods, while the government in Islamabad has confirmed 1,384 deaths.

Several hundred people yesterday blocked the main highway linking the breadbasket of Punjab province to the financial capital Karachi, calling for assistance and holding up traffic for more than an hour, witnesses said.

“We have no food and no shelter. We need immediate help,” shouted the protesters, who included women and children.

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