"Therefore, despite all out efforts by the government, all available aid seems to be inadequate. I would appeal to the world community to extend a helping hand to fight this calamity." 

'Help is coming'

Islamabad has faced criticism over its response to the crisis, but Shah Mahmood Qureshi, the country's foreign minister, defended the government's actions on Saturday.

He told Al Jazeera that the international community is waking up to the crisis and therefore, there is no need to declare a state of emergency.

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"We don't have to declare an emergency to mobilise people. We have now mobilised people and government agencies and international help is coming," Qureshi said.

The United Nations estimates that the floods have destroyed $1bn worth of crops in Pakistan but Qureshi said that Pakistan has enough wheat supplies to avert a food crisis, and the issue was access and not food supply.

"The reason people are finding it difficult to access food is because many of the bridges were swept away. We can only access them by air, and we have a shortage of helicopters," Qureshi said.  

His comments came after Asif Ali Zardari, the country's president, made his second trip to flood-affected areas in the country. Zardari, who came under criticism for failing to cut short a visit to Europe last week at the height of the disaster, pledged to do more to help those affected.

"I promise to you that ... your houses will be built. All those who have had everything washed away will be helped. We are with you, Pakistan is with you, the people of Pakistan are with you, and we will stand together."

Cholera confirmed

Meanwhile, rains continue to fall in parts of Pakistan, and another surge of water is expected to reach Sindh province by Saturday night.

threat of disease
Health authorities are worried about the possible spread of several diseases.Cholera: An intestinal disorder that causes vomiting and diarrhoea. One case has been reported. Malaria: A parasitic liver infection that leads to fever, headache and vomiting. Dengue fever: A mosquito-borne virus that causes high fever, joint pain and bleeding. Gastroenteritis: An inflammation of the stomach and intestines caused by tainted food. Also known as gastric flu.

Waters have been rising at the Kotri barrage along the Indus river and threatening to overrun the river's embankments. Flooding at Kotri could threaten the city of Hyderabad.

The floods have sparked fears of disease in the country, and the United Nations has confirmed at least one case of cholera in northwestern Pakistan.

The cholera case was reported in Mingora, the main town in the northwestern Swat valley, which has seen some of the most extensive damage.

Maurizio Giuliano, a spokesman for the United Nations Office for Humanitarian Affairs, said on Saturday the world body had stepped up its efforts to contain cholera.

Giuliano said doctors will give cholera treatments to 36,000 people in northwest Pakistan who suffer from diarrhoea, which is one of the main symptoms of cholera.

"Given that there are concerns about cholera, which is a very deadly disease, what we've started to do instead of testing them for cholera is to treat everyone for cholera," he said.

Unsanitary conditions and a lack of safe drinking water have created the potential for serious disease outbreaks, according to medical workers.

Manuel Bessler, the head of the UN office for Co-ordination of Humanitarian Affairs, told Al Jazeera that many parts of the country are only accessible via helicopter, making it difficult to provide drinking water.

"The only means to bring in clean water is tankering, having trucks to reach the area," he said. "But the major challenge is access. In a lot of areas, particularly in the north, we have no access, with all the major bridges that lead over the Swat river washed away."