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ISLAMABAD (Reuters) - Only a small fraction of the six million Pakistanis desperate for food and clean water have received any help as the United Nations battled donor fatigue and appealed urgently on Tuesday for more funds.
With hundreds of villages marooned and highways and bridges cut in half by swollen rivers, food rations and access to clean water have only been provided to around 500,000 million flood survivors, the U.N. said.
The United Nations has warned that up to 3.5 million children could be in danger of contracting deadly diseases carried through contaminated water and insects in a crisis that has disrupted the lives of at least a tenth of Pakistan's 170 million people.
"We have a country which has endemic watery diarrhea, endemic cholera, endemic upper respiratory infections and we have the conditions for much much expanded problems," UNICEF Regional Director for South Asia Daniel Toole told a news conference.
"We cannot spend pledges. We cannot buy purification tablets, we cannot support Pakistan with pledges. I urge the international community to urgently change pledges into checks."
U.N. Food and Agriculture Organization (FAO) spokesman Ali Khan said Pakistan could face food shortages if its farmers miss the sowing season which is due to start next month.
Up to 1,600 people have been killed and two million made homeless in Pakistan's worst floods in decades. The United Nations has reported the first case of cholera, but only a third of the $459 million aid needed for initial relief has arrived.
"Only a limited proportion of food and water needs have been met. One of the major reasons for this is funding," U.N. spokesman Maurizio Giuliano told Reuters, adding the flood's slower unraveling compared to earthquakes and Tsunamis had dampened donor response.
"Floods do not come in 30 seconds ... but the humanitarian needs are greater than in Haiti."
Public anger has grown in the two weeks of floods, highlighting potential political troubles for President Asif Ali Zardari's unpopular government which is a major U.S. ally in the war against Islamist militancy.
"We left our homes with nothing and now we're here with no clothes, no food and our children are living beside the road," said protester Gul Hasan, clutching a large stick, in Karampur in the southern province of Sindh.
The World Bank will release $900 million to help fund relief efforts. Funds will come through reprogramming of planned projects and reallocation of undisbursed funds, but it did not say how it would be used to aid victims.
Some Pakistani flood victims blocked highways to demand government help and villagers clashed with baton-wielding police on Tuesday after opposition leader Nawaz Sharif tried to distribute relief in Sindh.
Hundreds of stick-wielding protesters blocked a main road with rocks outside Muzaffarabad city in Punjab, trying to snatch relief goods from trucks.
The damage and cost of recovery could shave more than one percentage point off economic growth, analysts say. Pakistan's High Commissioner to Britain, Wajid Shamsul Hasan, said the cost of rebuilding could be more than $10 to $15 billion.
Islamic charities, some linked to militant groups, have stepped in to give aid to victims, possibly gaining supporters.
Pakistan Foreign Minister Shah Mehmood Qureshi said it was dangerous to let the Islamists fill the vacuum.
"If a person is hungry, if a person is thirsty and you provide water, he'll not ask whether you are a moderate or an extremist," Qureshi told the British Broadcasting Corporation.
"He'll grab water from you and save himself and his children who were starved. So you have to be aware of this challenge."
US ambassador to Pakistan Anne Patterson played down concerns about the involvement of charities linked to Islamist militants in relief activities as "exaggerated."
Victims are relying mostly on the military, the most powerful institution in Pakistan, and foreign aid agencies for help.
Nevertheless, a military coup is considered unlikely. The army's priority is fighting Taliban insurgents, and seizing power during a disaster would make no sense, analysts say.
A trickle of food survivors were returning home.
"We've heard that the water is going down," said Gulam Hussain, who was driving a hired auto-rickshaw with his brother, his sister-in-law and three infants. Two rope beds were strapped to the sides, a fan crammed inside and bundles piled on the roof.
"I'm going back to my village because my home is there," said Hussain, who had been living under a bridge for days in Sindh.
Additional reporting by Robert Birsel in Karampur; Sahar Ahmed in Karachi and Alistair Scrutton and Zeeshan Haider in Islamabad; Writing by Alistair Scrutton; Editing by Michael Georgy