Pakistani authorities are struggling to stop their largest lake from blowing up its banks after desperate attempts to lower the water level have failed.
Lake Manchar in Sindh province is dangerously full after record monsoons that flooded a third of Pakistan.
Three breaches in the shores of the lake so far – to protect the areas downstream – have caused the displacement of 100,000 people.
But it could still overflow and rescue teams are rushing to evacuate many more people who remain at risk of drowning.
Floods in Pakistan affected an estimated 33 million people and killed at least 1,314, including 458 children, Pakistan’s National Disaster Management Agency said.
Estimates suggest that the floods caused at least $ 10 billion (£ 8.5 billion) in damage.
Sindh province produces half of the country’s food supply, compounding fears that many will face severe food shortages in a country already struggling with an economic crisis.
On Sunday, officials breached Lake Manchar after it flooded two rural towns in hopes that it would stop it from further flooding the levees and flooding more densely populated areas.
The move affected about 400 villages, for a total of 135,000 people. The decision to deliberately flood some villages is controversial: the lake straddles two districts, Dadu and Jamshoro, both of which inhabit hundreds of thousands of people and about 80% of the region is underwater.
Villagers affected by the deliberate violation were warned to evacuate. But local sources say not all of them were rescued in time: some did not want to leave their homes or livestock, a lifeline for many in rural communities, and there are few places to go.
The military has been called in to help with the evacuations, but most of the locals are helping each other.
Some of those who fled their homes in the last few days before the Manchar breach were taken to a nearby government-run facility that is used as a refuge for displaced people, but the conditions leave much to be desired.
Many displaced people live on the roadside without shelter, food or drinking water.
“We have nothing here, we try to find food for our children all day, some nights we sleep without food,” one woman told the BBC.
“We are afraid that the roof will collapse on us: it is damaged,” said another villager. “Our children are getting sick and we have been sleeping on the floor – there are no beds for many of us.”
Officials said just over a quarter of a million people are in shelters, a fraction of the 33 million Pakistanis affected. Rescue efforts cannot keep up with demand: there is simply too much need and too little resources.
Damaged infrastructure also hinders rescue and rescue operations. Some connecting roads in Sindh province have collapsed, are flooded or are blocked for days with traffic in a queue.
Pakistan is facing one of the worst climate-induced natural disasters in years, as record torrential rainfall and melting glaciers in the country’s northern mountains caused devastating flooding and submerged nearly a third of its territory underwater.
Meanwhile, the United Nations children’s agency Unicef said more children are at risk of dying from diseases in Pakistan due to a shortage of clean water.
The disaster also highlighted the large disparity between the countries that contribute most to climate change and the countries that are impacted by it.
Pakistan produces less than 1% of global greenhouse gas emissions, but its geography makes it extremely vulnerable to climate change.
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Further reporting by Zubaidah AbdulJalil