By SIMON ROUGHNEEN for The Irrawaddy

SUKKUR, Pakistan—On the road in from the airport, the water shimmered under the moonlight as men, women and children sat in the dark, near the would-be lake shore. During the day, in the nearby river, dolphins can usually be spotted.

Idyllic, you might think. However, this dusty and ramshackle town is at the front-line of one of the world’s worst humanitarian disasters in living memory.

Usually there is no water lapping at the roadside, and the only people there would be those out for an evening snack. Ramadan fast. But since torrential monsoon rain sent the Indus River spilling onto towns and farmland across Pakistan, an area the size of Italy has been deluged.

In downtown Sukkur, I spoke to Ashraf, who said he had left his family at the outskirts, before coming into town to buy some food.

“We managed to gather up some of our possessions before the waters came, but we did not have much warning. Our home is under water completely. I have enough money to feed my children for another couple of days, that is all.”

Like a few more flood victims I encountered, he had to pay three times the normal price for a bus to the city, as opportunists capitalize on people’s desperation to make a quick rupee.

Nature’s unwitting cruelty is followed, here and there, by man’s calculated greed. The last time a natural disaster hit this country, 80,000 people died in 13 seconds when an earthquake rocked Kashmir. This time, the death-toll is much lower and the disaster is unfolding slowly over many weeks. However, the impact is vast—running the entire 1,976 mile length of the Indus River from the mountainous north of Pakistan, where that 2005 quake hit, to these flood-prone plains in the south.

Everywhere, there are cases of diarrhea, cholera, skin diseases, as well as malaria and dengue—with mosquitoes proliferating amid the flood waters. Almost 5 million people now have no access to clean water, an irony seemingly lifted from Coleridge’s line “water water everywhere and not a drop to drink.”

Seventeen million acres of land are under water and, out of the mind-boggling 20 million people thought to be affected by the floods—around 800,000 people remain beyond the reach of aid workers or the Pakistani army, cut off by the rising waters that dissolved bridges and submerged roads.

This disaster is as vast as the swollen country-long lake that the Indus River has become, but the real human suffering and loss can be obscured by or sanitized into mere statistics—with people’s lives traduced by the actuary-level numbers required to account for such vast destruction.

The name Sukkur is derived from the Arabic word for intense, according to some historical accounts that date the place-name to Umayyad conquerors who marched east to this region over a millennium ago. For aid workers trying to help the displaced who are now—for want of a better word—flooding the town, the epithet seems apt.

Brian Casey worked at the forefront of relief operations in Haiti after the recent earthquake and in Burma after the 2008 Cyclone Nargis with the Irish NGO, GOAL. He said that the extent of the slowly unfurling crisis in Pakistan comes close to these massive disasters: “people are hungry, people are getting sick, and we don’t know yet how much worse things will get as the water rises in places. And at the same time, we have to think about how to help people rebuild homes and farms once the waters recede.”

Outside the city, Nizam Ud Din Bharchood of the Pakistani charity, Hands, takes me to a string of ad-hoc campsites along the highway. At one, around 30 women and children lolled under trees in the dust-infused 40-degree heat.

“Some of these people are here almost three weeks, without shelter, without regular food or water”, he said. “The men have gone into the city to see if they can get work somehow.”

Hands has been helping out with food and medicine since the start of the flood, and is partnering with GOAL to reach more people. Back to numbers again, and these are rising in tandem with the still-swelling waters, in an odd sort of danse macabre.

Four million Pakistanis are now homeless, and another 600,000 are threatened down-river in this southern region, meaning they might have to flee as well with two more weeks of monsoon rains expected.

Mohammed Ramza had less than a day to pack up with his family, and move, along with all his neighbors, to the roadside outside Sukkur.

“Our homes were destroyed, we managed only to save a few animals,” he said, pointing to a half-dozen goats sitting in the shade, their ears tugged by a trio of giggling children, none of whom are more than five years old.

Ignoring maternal admonitions to leave the animals alone, they compete to play up to the foreigner’s camera, some temporary respite from their still-unfinished ordeal.

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Irrawaddy correspondent Simon Roughneen is in Sindh, southern Pakistan. He can be reached via his website www.simonroughneen.com