Image: Malnourished Pakistani girl
Aaron Favila  /  AP
A malnourished Pakistani girl, Heleema, at a camp for displaced people in Sukkur, Sindh province, southern Pakistan.
msnbc.com staff and news service reports
updated 9/20/2010 9:40:56 AM ET 2010-09-20T13:40:56

Suhani Bunglani fans flies away from her two baby girls as one sleeps motionless while the other stares without blinking at the roof of their tent, her empty belly bulging beneath a green flowered shirt.

Their newborn sister already died on the ground inside this steamy shelter at just 4 days old, after the family's escape from violent floods that drowned a huge swath of Pakistan. Now the girls, ages 1 and 2, are slowly starving, with shriveled arms and legs as fragile as twigs.

More than 100,000 children left homeless by Pakistan's floods are in danger of dying because they simply do not have enough to eat, according to UNICEF. Children already weak from living on too little food in poor rural areas before the floods are fighting to stay alive, as diarrhea, respiratory diseases and malaria attack their emaciated bodies.

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Doctors roaming the 100-degree camp that reeks of urine and animal manure have warned Bunglani three times to take her children to the hospital, or they will die.

The mother says she knows they need help, but she cannot leave the tent without her husband's consent. She must stay until he returns, even if it means risking her daughters' lives.

"I am waiting for my husband," she says, still fanning flies from the sweating babies. "He is coming."

The floodwaters that swamped a section of Pakistan larger than Florida continue to inundate new areas, forcing even more people to flee. At least 18 million have already been affected, and nearly half of them are homeless. Many have been herded into crude, crowded camps or left to fend for themselves along roads.

But doctors warn the real catastrophe is moving much slower than the murky water. About 105,000 kids younger than 5 at risk of dying from severe acute malnutrition over the next six months, the United Nations Children's Fund estimates.

"You're seeing children who were probably very close to the brink of being malnourished and the emergency has just pushed them over the edge," says Erin Boyd, a UNICEF emergency nutritionist working in southern Pakistan. "There's just not the capacity to treat this level of severe acute malnutrition."

Setting himself on fire
On Monday, a father of four who lost his home in the floods, doused his body in gasoline and set himself on fire outside the home of Pakistan Prime Minister Yousuf Raza Gilani.

The Dawn newspaper reported that Muhammad Akram was caring for four children, a wife and two aging parents in Jeewan Wala village, some 100 miles west of Multan. They did not even have a tent for shelter.

Akram, who lost his job as a factory watchman last May, reportedly visited Gilani's home to ask for a job recommendation. The prime minister's security detail pushed him back and he set himself on fire, a relative said.

Slideshow: Pakistan: A nation in turmoil

The World Food Program alone has fed more than 4 million people since the crisis began, distributing monthly rations that include nutrition-packed foods for children. But the sheer geographic and human scale of the disaster is overwhelming, and U.N. Secretary-General Ban Ki-moon has called it the worst he has ever seen.

Even now, some families who refused to abandon their villages remain marooned on islands cut off from all transport. The lucky ones sprint and dive for supplies dropped by choppers hovering above. But not everyone is being reached.

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Inside the government-run Railway Hospital in the southern town of Sukkur, deep in Pakistan's agriculture bread basket, the aid group Doctors Without Borders has already converted one ward into an inpatient feeding center. Some babies weighing a fraction of what's normal wail and gasp on diarrhea-stained sheets, while others wince quietly as if trying to find the strength to cry. Some little cheeks are sunken in. Others have hollow eyes or bottoms that are merely bones covered by folds of scaly, wrinkled skin.

Their mothers sit on the beds beside them, spoon-feeding milk and pinches of Plumpy'nut, the sweet peanut butter-based nutritional paste dubbed 'chocolate' by the ward's doctors. Many of the women are unable to produce breast milk because they are weak and ill themselves. Some are already pregnant again in an area where illiteracy is high and girls often marry at 12 or 13 and produce back-to-back babies for years to come. Death, especially among newborns, is expected here where even before the floods a quarter of babies were born underweight.

Janat Khosa's 3-year-old grandson is one of the worst cases in the ward, with chopstick-thin arms and legs, along with suspected tuberculosis complicating his recovery.

Story: Pakistan floods: How you can help

"He was well. He was walking and running before the flood came," Khosa says. "After the flood he got diarrhea. He did not eat."

'They don't have milk'
Bunglani says her two baby girls have had little to eat since the Indus River jumped its banks and turned one-fifth of the country into a muddy lake. She was working in the field when the water began surging, leaving her just enough time to grab a baby under each arm and run to safety.

The military transported the extended family to the camp on the outskirts of Sukkur, where she said they typically receive one meal a day consisting of rice, vegetables or lentils. There is nothing for the babies, and the newborn simply was not strong enough to survive.

"They are getting bread. They don't have milk. She can eat rice," Bunglani says, pointing to Sughra, 2. "But the younger one cannot."

In the past day, Sughra has stopped eating altogether. She will not take rice or any other food, she just turns her head and shoves her mother's hand away.

The little one, Heleema, 1, cannot sit on her own without support, even though she should be getting ready to walk by now.

People from neighboring tents begin to gather, urging Bunglani to allow the doctors to take her children to the hospital. Finally, her brother-in-law arrives and gives the OK. Bunglani grabs both girls and begins walking to the truck, waiting on the road where their grandfather joins them. He will escort her, guaranteeing that her husband will approve of the decision.

"These kids are everything to me," Bunglani says. "I am worried about them, and everybody can see what condition they are in."

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Post-flood data are lacking, but farming families have been flushed from their homes, losing the vital crops and livestock that were sustaining them in one of the country's poorest areas.

Children under 5 are the most vulnerable. Their tiny immune systems are not yet strong enough to fight off diseases. When essential vitamins and nutrients are severely lacking from their diets, they are left defenseless.

Feeding centers had to be established from scratch in most parts of Pakistan. Many organizations were slow to respond to the need, and filthy public hospitals are now overflowing with sick children stacked sometimes three to a bed.

"We are very, very deeply concerned," says Sylvain Groulx, project coordinator for Doctors Without Borders in Sukkur, who has teams canvassing 200 camps in search of malnourished children. "You can have some serious, serious physical consequences on their health and very long term, and it can reach death."

Once Bunglani finally arrives at the hospital, doctors quickly examine the babies. The youngest, who's been suffering diarrhea since the floods, weighs less than 8 pounds — about 2 pounds shy of where she should be. The older one weighs only 2 pounds more, about 4 pounds below her target weight.

Newsweek: Despite crises, Pakistan prevails

When a nurse hands Sughra a brown plastic cup filled with milk formula, she snatches it with both hands and gulps until every drop is gone. Then she reaches for more.

Some children are much worse off. They arrive comatose and severely dehydrated or covered in scabby skin that is ripe for infection due to a lack of protein and vitamins and minerals.

The ward itself is clean, air-conditioned and filled with colorful balloons and toys. It is a welcome break from life in the camp, and Bunglani's girls appear more alert within just a few hours.

They sleep side-by-side, sucking their thumbs, as their mother hovers over them on the bed. They, and the 22 others here, are the lucky ones. And for now, they are safe.

But Bunglani is already thinking about tomorrow and how she and her family will survive in the camp. She looks to the ceiling and lifts her open palms. Only God knows.

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Photos: Floods ravage Pakistan

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  1. A malnourished Pakistani girl named Khadija cries at the Railway Hospital in Sukkur, Sindh province in southern Pakistan on Sept. 13. According to UNICEF, more than 100,000 children are in danger of dying of starvation. (Aaron Favila / AP) Back to slideshow navigation
  2. A submerged strip of land is pictured from a Pakistani Army helicopter dropping aid in Khairpur Nathan Shah town, in the Sindh province, on Sept. 14. (Carl De Souza / AFP - Getty Images) Back to slideshow navigation
  3. Flood victims, trapped on a roof top, scramble for food rations dropped by a Pakistan Army helicopter during relief operations Sept. 14 in the submerged town of Khairpur Nathan Shah in Dadu district in Sindh province, Pakistan. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  4. Internally displaced Pakistani grandmother Janal holds the hand of her three-day-old grandchild at a camp in Sukkur on Thursday, September 9. (Adek Berry / AFP - Getty Images) Back to slideshow navigation
  5. An aerial view of flooded areas in Jampur, Pakistan on Friday, Sept. 10. (Mk Chaudhry / EPA) Back to slideshow navigation
  6. Villagers rush to board a small rescue boat operated by the Pakistani special forces Navy, north of Dadu, Sindh province, Pakistan, on Friday, September 10. (Carl De Souza / AFP - Getty Images) Back to slideshow navigation
  7. Flood victims scramble for food rations as they battle the downwash from a Pakistan Army helicopter during relief operations on Monday, September 13 in Sindh province, Pakistan. Over six weeks after flooding began, new devastation continues across the Sindh province of Pakistan, as flood waters, still on the rise, continue to overcome new villages. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  8. Pakistani flood affected children scramble to get gifts from women volunteers as they prepare to celebrate Eid, which ends the fasting month of Ramadan, at a camp setup for displaced people in Muzaffargarh district, Punjab province, Pakistan on Thursday, Sept. 9. (Aaron Favila / AP) Back to slideshow navigation
  9. The body of five-day-old Akash is carried by his uncle and accompanied by other relatives during his funeral in Pakistan's Muzaffargarh district on Monday, Sept. 6. The baby died five days after he was born in a flooded village due to lack of medical support, family members said.. (Damir Sagolj / Reuters) Back to slideshow navigation
  10. Flood victims and relatives of five-day-old Akash grieve over his body before his funeral. (Damir Sagolj / Reuters) Back to slideshow navigation
  11. A Pakistani woman displaced by flooding cooks at Motehin Camp organized by Qarshi Dawakhana NGO, in Sultan on Sept. 6. (Carl De Souza / AFP - Getty Images) Back to slideshow navigation
  12. A sick flood victim, Gulzar, 9, lies on his mother's lap in a private hospital converted into a flood relief camp providing free medical treatment at Sukkur, in Pakistan's Sindh province, on Sept. 5. (Athar Hussain / Reuters) Back to slideshow navigation
  13. A displaced Pakistani girl pumps water in an area which has been occupied by flood victims in front of the DPS thermal power station in Muzaffargah on Sept. 5. (Carl De Souza / AFP - Getty Images) Back to slideshow navigation
  14. Pakistanis wade through floodwaters to return to their home in Sujawat, Sindh province, in southern Pakistan on Sept 4. (Vincent Thian / AP) Back to slideshow navigation
  15. A Pakistani woman walks by dead cotton crops as floodwaters slowly recede at the mostly agricultural lands of Shah Jamal village, Muzaffargarh district, Punjab province, Pakistan. (Aaron Favila / AP) Back to slideshow navigation
  16. Children fly a kite from the roof of an abandoned building where their families found shelter in Pakistan's Muzaffargarh district of Punjab province on Sept. 4. (Damir Sagolj / Reuters) Back to slideshow navigation
  17. An aerial view shows Pakistanis displaced by floods taking shelter on higher ground in Retla area in Punjab province on Aug. 31. (Arif Ali / AFP - Getty Images) Back to slideshow navigation
  18. A woman, whose familiy was displaced by floods, sits on a makeshift bed on the higher ground of a bund on Aug. 29, in Thatta. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  19. Pakistanis affected by the floods carry a sick boy in Thatta on Aug. 29. (Pedro Ugarte / AFP - Getty Images) Back to slideshow navigation
  20. A young flood victim drinks from a tap as others fill containers with clean water to take back to their relief camp in Nowshera on Aug. 29. (Damir Sagolj / Reuters) Back to slideshow navigation
  21. Villagers affected by the floods walk through the water in Thatta on Aug. 29. Torrential monsoon rains have triggered massive floods that have moved steadily from north to south over the past month, engulfing a fifth of the volatile country and affecting 17 million of its 167 million people. (Pedro Ugarte / AFP - Getty Images) Back to slideshow navigation
  22. A farmer harvests crops as he restores agricultural land near flooded areas in Multan on Aug. 29. (Shabbir Hussein Imam / EPA) Back to slideshow navigation
  23. Children catch fish in flood water in Basera on Aug. 28. The United Nations has warned that up to 3.5 million children were at risk from water-borne diseases in the flood-hit country and said it was bracing to deal with thousands of potential cholera cases. (Shabbir Hussein Imam / EPA) Back to slideshow navigation
  24. People use a damaged railway track to cross heavy floodwater in Sultan Kot on Aug. 28. (Anjum Naveed / AP) Back to slideshow navigation
  25. Covered with flies, a two-year-old girl, who is suffering from diarrhea, lies on her mother's lap outside her family's tent in a village in Rajanpur district of Punjab province on Aug. 28. (Asim Tanveer / Reuters) Back to slideshow navigation
  26. A man pauses from the task of clearing shoulder-high sediment, left by floodwaters, from his shop in Margala on Aug. 28. (Tim Wimborne / Reuters) Back to slideshow navigation
  27. A man negotiates floodwaters with his chickens in the remote village of Ali Pur town in Muzaffargarh district, Punjab Province, on Aug. 28. (Aaron Favila / AP) Back to slideshow navigation
  28. Six-month-old Raja rests in a hammock while his mother cooks at an overhead bridge next to a flood relief camp in Sukkur on Aug. 28. (Athar Hussain / Reuters) Back to slideshow navigation
  29. A child waits for his turn to get food at a camp in Sukkur, southern Pakistan, on Aug. 28. (Anjum Naveed / AP) Back to slideshow navigation
  30. Boats carrying flood survivors arrive on higher ground after their evacuation from flooded areas of Jampur on Aug. 28. (Arif Ali / AFP - Getty Images) Back to slideshow navigation
  31. An army paramedic treats a flood-affected man at a medical center in Rajanpur District in the far south-western part of Punjab on Aug. 28. (Arif Ali / AFP - Getty Images) Back to slideshow navigation
  32. Four-year-old flood survivor Hajani drinks her morning tea while taking refuge with her family in a relief camp in Sukkur, in Pakistan's Sindh province on Friday, Aug. 27. Officials say as many as 20 million people have been affected by Pakistan's worst flooding in 80 years. (Athar Hussain / Reuters) Back to slideshow navigation
  33. Neighbors help each other rebuild homes destroyed by the floods after the waters receded enough for them to return to their villages in Sanawa, near Muzaffargarh, Pakistan on Thursday, Aug. 26. (Shabbir Hussein Imam / EPA) Back to slideshow navigation
  34. A young Pakistani girl, displaced from her home by flooding, helps prepare dinner for her family near Sukkur in Sindh province, Pakistan. The country's agricultural heartland has been devastated with rice, corn and wheat crops destroyed by floods. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  35. Pakistanis displaced by flooding sit outside tents at a temporary camp operated by the Pakistan Army, in Sukkar, Sindh province, southern Pakistan, Thursday, Aug. 26. (Kevin Frayer / AP) Back to slideshow navigation
  36. Pakistanis reach for food thrown by an aid volunteer outside a temporary camp operated by the Pakistan Army, in Sukkar, Sindh province, southern Pakistan, on Thursday Aug. 26. (Kevin Frayer / AP) Back to slideshow navigation
  37. Nasiba, 3-months-old, sleeps in a hammock while taking refuge from the flood with her family in a classroom in Sukkur, Pakistan, Aug. 25. (Akhtar Soomro / Reuters) Back to slideshow navigation
  38. People move to high ground after fresh flood warnings were issued in Jamshoro, Pakistan, Aug. 25. The United Nations has warned, that up to 3.5 million children are at risk from water-borne diseases in flood-hit Pakistan. the organization is preparing to deal with thousands of potential cholera cases. More than 1,500 people across Pakistan have been killed and hundreds of thousands stranded due to flash floods triggered by the ongoing spell of monsoon rains. (Nadeem Khawer / EPA) Back to slideshow navigation
  39. Allah Detta, 26, a flood affected villager suffering from high fever and spasms, receives medical treatment, Aug. 25, at the makeshift medical centre in the Sultan Colony Army flood relief camp near Muzaffargarh, Pakistan. The country's agricultural heartland has been devastated, with rice, corn and wheat crops destroyed by floods. The UN has described the disaster as unprecedented, with over a third of the country under water. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  40. Workers unload relief goods from a truck at an army relief camp at Sultan Colony in Muzaffargarh district, Punjab province, Pakistan on Aug. 25. Pakistan will have to demonstrate it can spend relief funds transparently and well if it wants more help in rebuilding after its massive floods, the U.S. aid chief said. (Aaron Favila / AP) Back to slideshow navigation
  41. Pakistanis displaced by floods reach out for milk during an aid distribution at a temporary camp in Sukkar, Pakistan on Aug. 25. (Kevin Frayer / AP) Back to slideshow navigation
  42. One and a half year old Mudasar, suffering from diarrhea, is consoled by his mother as receives treatment at the District Headquarters Hospital, Aug. 23, in Muzaffargarh in Punjab, Pakistan. Officials say as many as 20 million people have been affected during the region's worst flooding in 80 years. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  43. Pakistani flood-affected villagers wait to board an army boat as they evacuate Kamria village in the Sindh province, on Aug. 23. (Rizwan Tabassum / AFP - Getty Images) Back to slideshow navigation
  44. A Pakistani boy swims as he tries to keep his food dry in a flooded area near Basira village in Punjab on Aug. 22. U.N. agencies stepped up calls for donors to deliver on their pledges for Pakistan to prevent what UN chief Ban Ki-moon called a "slow-motion tsunami" from wreaking further catastrophe. (Pedro Ugarte / AFP - Getty Images) Back to slideshow navigation
  45. A Pakistan Army helicopter flies over the Garhi Khairoo, area near the new flood zone of Shahdakot, Pakistan on Sunday. (Paula Bronstein / Getty Images) Back to slideshow navigation
  46. A flood victim takes bath in a bucket while taking refuge at a relief camp in Sukkur in Pakistan's Sindh province Sunday. (Akhtar Soomro / Reuters) Back to slideshow navigation
  47. Flood victims travel through flood waters on Sunday in the village of Shah Jamaal west of Muzaffargarh in Punjab, Pakistan. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  48. A man and a woman displaced by floods, walk through flood waters on Sunday in the village of Baseera near Muzaffargarh in Punjab, Pakistan. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  49. A child receives medical treatment at a local hospital in Pakistan's Muzaffargarh district of Punjab province Sunday. (Reinhard Krause / Reuters) Back to slideshow navigation
  50. Flood victims line up for food distribution by the World Food Program (WFP) at a tented camp on Aug. 21 in Sukkur, Pakistan. (Paula Bronstein / Getty Images) Back to slideshow navigation
  51. People make their way through a flooded street on Aug. 21, in Jampur, Pakistan. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  52. A 7-year-old flood victim runs towards a food distribution truck while on the road with her family in Sukkur, Pakistan, on Aug. 21. (Akhtar Soomro / Reuters) Back to slideshow navigation
  53. U.S. Sen. John Kerry, left, talks to flood refugees as Pakistan President Asif Ali Zardari looks on in Jampur, Pakistan, on Aug. 19. (B.k.bangash / AP) Back to slideshow navigation
  54. A Pakistani family stands on its farm compound surrounded by flood water, near Bachel in Sindh Province, southern Pakistan, on Aug. 19. (Kevin Frayer / AP) Back to slideshow navigation
  55. A flood survivor hangs on to a hovercraft and waits to get relief food distributed by naval officials in Sangi Village near Sukkur in southern Pakistan on Aug. 19. (Shakil Adil / AP) Back to slideshow navigation
  56. Flood victims run after a truck that the Pakistan military was using to give away aid at a tent camp Aug. 19 in Sukkur, Pakistan. The country's agricultural heartland has been devastated, with rice, corn and wheat crops destroyed by floods. (Paula Bronstein / Getty Images) Back to slideshow navigation
  57. Lal Pir power generating station is submerged in flood waters, further increasing a power crisis in Muzaffargarh near Multan, Pakistan on Aug. 19. Islamist terrorists may exploit the chaos and misery caused by the floods in Pakistan to gain new recruits, the country's president said. (B.k.bangash / AP) Back to slideshow navigation
  58. People struggle to get relief foodstuffs distributed by volunteers at outside a camp for flood-affected people in Hyderabad, Pakistan on Aug. 18. (Pervez Masih / AP) Back to slideshow navigation
  59. The Pakistani army distributes food to stranded flood victims in Basera, near Muzaffargarh in Punjab province, Pakistan on Aug. 18. (Matiullah Achakzai / EPA) Back to slideshow navigation
  60. A helicopter provided by the United Arab Emirates fly food supply over flood infected areas in Pakistan's near Taunsa Sharif in Punjab province Aug. 18. (Asim Tanveer / Reuters) Back to slideshow navigation
  61. Pakistani flood victims sit in a packed a U.S. Navy MH-53E helicopter during a rescue and aid mission by the U.S. Marine Expeditionary Unit on Aug. 17 in Kalaam, Pakistan. (Paula Bronstein / Getty Images) Back to slideshow navigation
  62. Pakistanis displaced by flooding reach to grab a bag of food aid during a distribution on the road near the flood line outside of Sukkar, southern Pakistan, Tuesday. (Kevin Frayer / AP) Back to slideshow navigation
  63. A flood victim walks on a damaged railway track while crossing floodwaters to reach his village in Sultan Kot, about 31 miles from Sukkur in the Sindh province, on Tuesday, Aug. 17. The World Bank will release $900 million dollars to help fund relief efforts for Pakistan's flood disaster as international agencies warned millions of people were at risk from disease. (Akhtar Soomro / Reuters) Back to slideshow navigation
  64. Flood victims wait as doctor Zahid Uall treats a girl at an emergency medical center in Charsadda, in the northwest Khyber-Pakhtunkhwa province, on Aug. 17. (Tim Wimborne / Reuters) Back to slideshow navigation
  65. A flood victim holding her sibling cries after having her donated rice snatched from her by passing vehicles, along the roadside in the Muzaffargarh district of Punjab province on Aug. 16. (Adrees Latif / Reuters) Back to slideshow navigation
  66. Flood victims hang on to the back of a truck while evacuating from Pakistan's Muzaffargarh district of Punjab province on Aug. 16. (Adrees Latif / Reuters) Back to slideshow navigation
  67. Flood victims fight for relief food distributed by volunteers in Shekarpur on Aug. 16. Angry flood survivors blocked a highway to protest slow delivery of aid and heavy rain lashed makeshift housing. (Shakil Adil / AP) Back to slideshow navigation
  68. A World Food Program worker sleeps on top of flour sacks in a hanger at an airbase in Pakistan's northwest Khyber-Pakhtunkhwa province, as poor weather prevents U.S. military helicopters from delivering aid to flood victims on Aug. 15. (Tim Wimborne / Reuters) Back to slideshow navigation
  69. Children are reflected in a window at a camp for people affected by floods in Nowshera, Pakistan on Aug. 15. (Aaron Favila / AP) Back to slideshow navigation
  70. Pakistani boys displaced by floods stand in the smoke as health workers spray against diseases at a camp in Nowshera on Saturday, Aug. 14. Pakistan's Prime Minister Yousuf Raza Gilani said 20 million people had been affected by the worst floods in the country's history as the United Nations confirmed the first cholera case. (A Majeed / AFP - Getty Images) Back to slideshow navigation
  71. A Pakistani flood victim sleeps on a hammock in a flooded area of Shah Jamal village on Friday, Aug. 13. Water levels receded in Pakistan but survivors of record floods endured grim conditions in makeshift tent cities, as the UN appealed for millions of dollars in urgent foreign aid. Pakistan's government says 14 million people have been affected by the floods. (Arif Ali / AFP - Getty Images) Back to slideshow navigation
  72. A combination of satellite images shows Nowshera, Pakistan, and the surrounding area on Oct. 7, 2007, on the left and on Aug. 5, 2010, on the right, after flooding struck the region. (DigitalGlobe satellite / Reuters) Back to slideshow navigation
  73. Flood-affected people wade through water for higher ground in Muzaffargarh near Multan on Aug. 13. (K.M. Chaudary / AP) Back to slideshow navigation
  74. Pakistani flood affected villagers wash themselves after digging out their belongings from the rubble of their houses in Aza Kheil near Peshawar on Friday. (Mohammad Sajjad / AP) Back to slideshow navigation
  75. Pakistan army soldiers distribute food among flood survivors to break their fast on the first day of the Muslim fasting month of Ramadan in Muzaffargarh on Aug. 12. The normally festive time is marked this year in Pakistan by misery. (K.M.Chaudary / AP) Back to slideshow navigation
  76. People dodge an army truck carrying relief supplies through floodwaters in the Muzaffargarh district in Punjab province on Aug. 11. (Adrees Latif / Reuters) Back to slideshow navigation
  77. Villagers displaced from their homes travel through flood waters on the back of a truck Aug. 11 on the outskirts of Muzaffargarh in Punjab. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  78. Pakistani flood survivors catch water bottles distributed by a military helicopter in Bssera village near Muzaffargarh on Aug. 11. (Arif Ali / AFP - Getty Images) Back to slideshow navigation
  79. A refugee from Afghanistan removes debris from her flood-destroyed house in Nowshera. (A Majeed / AFP - Getty Images) Back to slideshow navigation
  80. Mohammad Omer stands with his belongings on a road near his village Karam Pur, 43 miles from Sukkur in Pakistan's Sindh province, as he flees rising flood waters. (Akhtar Soomro / Reuters) Back to slideshow navigation
  81. U.S. Army and Pakistani soldiers sit on the cargo bay ramp of a CH-47 heavy-lift helicopter while flying over a flooded area in the Swat Valley on Aug. 10. The United States has sent helicopters and naval ships to deliver supplies and rescue people. (Behrouz Mehri / AFP - Getty Images) Back to slideshow navigation
  82. Flood victims wade through waters to get to higher ground on Aug. 9, near to Kot Addu in the Muzaffargarh district in Punjab. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  83. Flood survivors receive donated food at a relief camp established by volunteers on the outskirts of Sukkur on Aug. 9. (Asif Hassan / AFP - Getty Images) Back to slideshow navigation
  84. Children jostle for relief food in Nowshera, northwest Pakistan, on Aug. 9. (B.k. Bangash / AP) Back to slideshow navigation
  85. Grandmother Miru Mai smiles as she adjusts a blanket of newborn twin grandchildren, as mother Zada Perveen lies covered up after being rescued by Pakistan soldiers during air operations Aug. 9 in the village of Sanawan in the Muzaffargarh district. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  86. Navy soldiers attempt to distribute food to stranded flood victims in Pannu Aqil, Sindh province, on Aug. 9. (Nadeem Khawer / EPA) Back to slideshow navigation
  87. Villagers wade through floodwaters with their livestock while looking for higher ground in Sukkur on Aug. 8. (Akhtar Soomro / Reuters) Back to slideshow navigation
  88. Pakistani children wait as donated food is handed out at a relief camp set up by volunteers on the outskirts of Sukkur on Aug. 9. (Asif Hassan / AFP - Getty Images) Back to slideshow navigation
  89. Flood victims flee Pannu Aqil in Sindh province on Aug. 8. (Nadeem Khawer / EPA) Back to slideshow navigation
  90. A police officer uses a baton to control flood victims looting donated food from a bus in Azakhel on Aug. 8. (Anjum Naveed / AP) Back to slideshow navigation
  91. People check an unconscious baby, who had been bitten by a snake inside her flooded house, after being rescued by a naval boat in Sukkur, Pakistan, on Aug. 8. Pakistani navy boats traveled through miles of flood waters to rescue people stranded in a disaster that has angered many over the government's response. (Akhtar Soomro / Reuters) Back to slideshow navigation
  92. Pakistani villagers stand on the remains of a bridge washed away by heavy flooding in Bannu on Aug. 8. (Ijaz Mohammad / AP) Back to slideshow navigation
  93. Marooned flood victims looking to escape grab the side bars of a hovering Army helicopter which arrived to distribute food in the Muzaffargarh district of Pakistan's Punjab province on Saturday, Aug. 7. (Adrees Latif / Reuters) Back to slideshow navigation
  94. Afghan families, also hit by the floods which have devastated Pakistan, work to rid their homes of mud, on Aug. 7 in the south of Kabul, Afghanistan. More than 500 hundred families have been forced to evacuate their homes due to flooding, which originated on the country's border with Pakistan. (Majid Saeedi / Getty Images) Back to slideshow navigation
  95. A woman and her baby wait for food handouts with other flood victims as they take refuge at a make-shift camp in Sukkur, Pakistan on Aug. 7. (Akhtar Soomro / Reuters) Back to slideshow navigation
  96. A man walks through a flooded house in the Muzaffargarh district of Pakistan's Punjab province on Aug. 7. (Adrees Latif / Reuters) Back to slideshow navigation
  97. Afghan families, hit by the floods which have devastated Pakistan, work to rid their homes of mud, on Aug. 7, in the south of Kabul, Afghanistan. (Majid Saeedi / Getty Images) Back to slideshow navigation
  98. Children, whose families have declined to be rescued, wade in rising flood waters on Friday, Aug. 6 in the village of Panu Akil, near Sukkur, Pakistan. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  99. Flood-affected people jostle for food relief in Nowshera in northwest Pakistan on Aug. 6. Stormy weather grounded helicopters carrying emergency supplies to Pakistan's flood-ravaged northwest Friday as the worst monsoon rains in decades brought more destruction to a nation already reeling from Islamist violence. (Mohammad Sajjad / AP) Back to slideshow navigation
  100. A Pakistani man carries a small boat on a donkey-cart to rescue people trapped in flooded areas in Sukkur on Aug. 6. (Asif Hassan / AFP - Getty Images) Back to slideshow navigation
  101. A paramedic vaccinates a child at a medical camp on the outskirts of Peshawar on August 4. (Mohammad Sajjad / AP) Back to slideshow navigation
  102. In this image released on Aug. 6, severe flooding continues in northwest Pakistan. (Merlin NGO via Reuters) Back to slideshow navigation
  103. Pakistani army soldiers in a helicopter rescue families stranded by flood watesr in Sanawan near Multan in central Pakistan on Thursday, Aug. 5. U.S. Army choppers flew their first relief missions in Pakistan's flood-ravaged northwest on Thursday, airlifting hundreds of stranded people to safety. (Khalid Tanveer / AP) Back to slideshow navigation
  104. Volunteers search for victims after a passenger bus plunged into the flooded Jhelum river in Pakistani administered Kashmir on Thursday. At least 22 people were killed. (Nasiruddin Mughal / EPA) Back to slideshow navigation
  105. Families set in for the evening in their makeshift tent homes located on a median strip on Tuesday, August 3, in Pabi. Rescue workers and troops in northwest Pakistan struggled to reach tens of thousands of people affected by the region's worst floods since 1929, according to officials. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  106. An army personnel carries a flood victim to a helicopter in Sanawa, a town located in the Muzaffar Ghar district of Pakistan's Punjab province on Thursday. (Str/pakistan / Reuters) Back to slideshow navigation
  107. Residents salvage valuables from their destroyed home on Wednesday, August 4, in Pabbi near to Nowshera, Pakistan. Rescue workers and troops in northwest Pakistan struggled to reach thousands of people affected by the region's worst floods since 1929, according to officials. Residents are bracing themselves for the worst as more rains are expected. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  108. Flood survivors jostle for relief food on the outskirts of Peshawar, Pakistan on Aug. 3. Relief work has been hampered by submerged roads, washed out bridges, and downed communication lines. (Mohammad Sajjad / AP) Back to slideshow navigation
  109. People wait to cross a flooded road in Bannu, northwestern Pakistan on Aug. 3. (Ijaz Mohammad / AP) Back to slideshow navigation
  110. Residents scramble to recover water bottles dropped from a Pakistan Air Force helicopter on Monday, Aug. 2 in Nowshera, Pakistan. Rescue workers and troops in northwest Pakistan struggled to reach thousands of people affected by the region's worst floods since 1929. (Daniel Berehulak / Getty Images) Back to slideshow navigation
  111. Vehicles are stuck in a traffic jam because of a demonstration by flood-affected people demanding the government provide aid to victims in Nowshera on Monday. (Anjum Naveed / AP) Back to slideshow navigation
  112. A bridge is washed away following flooding in the Swat region of Khyber-Pakhtunkhwa Province on Monday. The United Nations and the United States announced $10 million in emergency aid for Pakistan on Sunday. (W. Khan / EPA) Back to slideshow navigation
  113. People camp along railway tracks on Monday after their homes were destroyed by flooding in Nowshera. (Mohammad Sajjad / AP) Back to slideshow navigation
  114. Army soldiers carry the body of a flood victim to higher ground on July 31. (Adrees Latif / Reuters) Back to slideshow navigation
  115. Flood-displaced residents take shelter in a school at the Mohib Bhanda area in Nowshera on July 31. (A. Majeed / AFP - Getty Images) Back to slideshow navigation
  116. A man tries to cross a makeshift bridge to escape his flooded home in Nowshera on July 31. (Adrees Latif / Reuters) Back to slideshow navigation
  117. Pakistani soldiers carry an injured Chinese engineer in Manshera, Pakistan, on July 31. The main was rescued from a hydropower plant in a flood-hit area of Dubair. (Strdel / AFP - Getty Images) Back to slideshow navigation
  118. Stranded Pakistani villagers wait for rescue helicopters on their house in Nowshera, Pakistan, on July 30. (Mohammad Sajjad / AP) Back to slideshow navigation
  119. Flash floods were triggered by heavy monsoon rains in river Neelum in Pakistani administered Kashmir on July 30. Hundreds of people across Pakistan have been killed and thousands stranded in the ongoing spell of monsoon rains with most of the casualties caused by falling roofs and walls or electrocution. (Nasiruddin Mughal / EPA) Back to slideshow navigation
  120. An elderly man crosses part of the Islamabad - Peshawar tollway which washed away due to heavy floods in Charsadda, part of Pakistan's Northwest Frontier Province on Friday, July 30. Over 400 people have been killed by flash floods in the last week, with the country's northwest and Baluchistan provinces bearing the brunt of the storms. (Adrees Latif / Reuters) Back to slideshow navigation
  121. Residents take shelter on high grounds from floods in Risalpur,in Pakistan's Northwest Frontier Province on Friday, July 30. (Adrees Latif / Reuters) Back to slideshow navigation
  122. Residents use buckets to scoop water from their house after it was destroyed by floods in the outskirts of Peshawar, July 30. (Fayaz Aziz / Reuters) Back to slideshow navigation
  123. Pakistani residents stand by flood water that entered a residential area of Muzaffarabad on July 30. (Sajjad Qayyum / AFP - Getty Images) Back to slideshow navigation
  124. An aerial view of flood-hit areas on the outskirts of Dera Ismail Khan, on July 30. (Saood Rehman / EPA) Back to slideshow navigation
  125. Pakistani local residents cross a flooded street on the outskirt of Peshawar on July 28. (A Majeed / AFP - Getty Images) Back to slideshow navigation
  126. Flash floods fill the streets after a heavy downpour in Peshawar, July 28. (EPA) Back to slideshow navigation
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Explainer: U.N.'s Millennium Development Goals

  • At the start of the new millennium, world leaders pledged to tackle poverty, disease, ignorance and inequality. They went beyond generalities and committed themselves to eight specific goals to be met by 2015.

    A decade later, some progress has been made, but many countries are still struggling to meet the 2015 target.

    Secretary-General Ban Ki-moon invited leaders of the 192 U.N. member nations to a three-day summit in New York starting Monday to review what has, and what hasn’t, been achieved.

    But recent reports show that the world's poorest countries, especially in sub-Saharan Africa, have made little headway in eradicating poverty. Africa, Asia and Latin America have seen a lack of progress in reducing mother and child deaths, boosting access to basic sanitation and promoting women's equality.

    In his report in preparation for the summit, Ban said the world possesses the knowledge and the resources to achieve the goals. “Our challenge today is to agree on an action agenda."

    See where things stand with the development goals and vote on what you think should be the world’s top priority.

  • Goal 1: Eradicate extreme poverty & hunger

    Image: A family cooks a meal in a city square where they are living under a makeshift tent in downtown Asuncion
    Jorge Adorno  /  Reuters
    A family cooks a meal in a city square where they are living under a makeshift tent in downtown Asuncion, Paraguay, Sept. 8, 2010. According to official data some 38 percent of the 5.6 million Paraguayans live below the poverty level. 

    Goal: To halve the number of people living below a poverty line of $1.25 a day and halve the number of people going hungry.

    Where things stand: Overall, the world is on track to halve the numbers of people in extreme poverty, though some critics say it's mainly because of tremendous improvements in China and India.

    The proportion of people living on less than $1 a day in developing countries fell from 46 percent in 1990 to 27 percent in 2005 and should reach the target despite the economic crisis. Even so, the U.N. said, about 920 million people will still be living on less than $1.25 a day in 2015.

    The world is not on track to halve hunger by 2015, mainly because of setbacks caused by record food price increases in 2008. In 1990, the share of hungry people was 20 percent; by 2005 it had dropped to 16 percent, but rose to an estimated 19 percent in 2009.

  • Goal 2: Achieve universal primary education

    Image:
    Jerome Delay  /  AP File
    Malawi schoolchildren listen to the teacher from their outdoor classroom in the village of Chiseka, outside Lilongwe, Malawi.

    Goal: Ensure that by 2015 children everywhere, boys and girls alike, will be able to complete primary school.

    Where things stand: Primary school enrollment rose from 83 percent in 2000 to 89 percent in 2008 – but 69 million children worldwide are still out of school, according to UNESCO.

    According to World Bank data, 50 poor countries have achieved universal primary education and seven more are on their way. Still, 38 countries, mostly in Africa, are off track and unlikely to achieve the full-enrollment target.

    That pace of progress is not sufficient to ensure the goal of universal primary education by 2015.

  • Goal 3: Promote gender equality and empower women

    Image: Sierra Leone academic year begins
    Ahmed Jallanzo  /  EPA
    A teacher instructs students in English at a school at the border town of Jendema, Pujehun, Sierra Leone in September 2010.lliteracy rates in West Africa are the highest in the world, cramping development and weakening citizens' power to effect socio-economic and political change, say education agencies, who are calling on governments and donors to establish literacy and education efforts.

    Goal: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015.

    Where things stand: Gender equity remains an elusive goal in many parts of the world, but there have been some gains.

    Between 1990 and 2005, all regions except Europe and Central and East Asia saw an increase in the number of women in national parliaments, according to the U.N. Development Fund for Women. The percentage of women with paid jobs outside agriculture also grew from 35 percent in 1990 to 40 percent today, according to the U.N.

    Violent crime against women continues to be a serious problem, with rape and other attacks being used as a weapon of war in some violence-torn countries. But according to the U.N. agency for women, there has been some progress. In 2002, only 45 countries had specific laws on the books about domestic violence. By 2006, the number of countries had risen to 60.

  • Goal 4: Reduce child mortality

    Image: LIBERIA-HEALTH-WOMEN-MORTALITY
    Georges Gobet  /  AFP/Getty Images/ File
    A sick child awaits treatment on his bed at the Phebe hospital near Gbarnga, Liberia. 

    Goal: Cut by two-thirds deaths of children under age 5.

    Where things stand: Only about one-fourth of developing countries are on track to reach this goal.

    Each year about 8 million children die before they are 5, largely from preventable causes. Some 38 percent of the deaths occur in the first month of life due to infection, low birth weight stemming from poor maternal nutrition, or birth asphyxia.

    Nearly half of the deaths are from preventable and treatable illnesses such as pneumonia and diarrhea.

  • Goal 5: Improve maternal health

    Image:
    Felicity Thompson  /  AP
    Yaumu Sesay, 40, looks on as her two-day old baby boy, Allasane, is held by his grandmother at Princess Christian Maternity Hospital in Freetown, Sierra Leone on Sept. 10, 2010. Despite success stories in the battle against maternal mortality, the troubling reality is that hundreds of thousands of pregnant women still die unnecessarily every year. 

    Goal: To reduce by three-quarters the maternal mortality rate and achieve universal access to reproductive health.

    Where things stand: There has been a big drop in the number of women who die giving birth, but the progress falls short of the goal.

    Globally, more than half of all maternal deaths are concentrated in six countries: Afghanistan, the Democratic Republic of Congo, Ethiopia, India, Nigeria and Pakistan.

    The number of deaths decreased by 34 percent from an estimated 540,000 two decades ago to 358,000 in 2008, according to a U.N. report — an average annual decline of just 2.3 percent, or half of what is needed.

    In the U.S. and other industrialized countries, 24 women die for every 100,000 live births, but that number soars to as high as 1,400 in Afghanistan and 1,000 in some of the other poorest corners of the globe. 

  • Goal 6: Combat HIV/AIDS, malaria and other diseases

    Image: -
    Tony Karumba  /  AFP/Getty Images
    A south Sudanese woman lays on a bed at a health clinic in Terekeka, Sudan, where the population is exposed to malaria, a vector-borne, infectious parasitic disease that is a leading cause of death of infants and children in Africa.

    Goal: Halt and begin to reverse the spread of HIV/AIDS; by 2010 provide universal access to treatment for HIV and AIDS. Halt and begin to reverse the incidence of malaria and other major diseases.

    Where things stand: The goal of halting and reversing the AIDS epidemic is unlikely to be met. The number of people living with HIV/AIDS has risen from 8 million in 1990 to an estimated 33 million people in 2008, according to the United Nations AIDS program, or UNAIDS.

    While the number of new infections has fallen from a peak of 3.5 million in 1996 to 2.7 million in 2008, UNAIDS said five people are becoming infected for every two who start treatment. Two million AIDS-related deaths still occur every year.

    Sub-Saharan Africa remains the region hardest hit by HIV, accounting for 67 percent of all people living with the virus worldwide, 71 percent of AIDS-related deaths and 91 percent of all new infections among children.

    But African nations whose populations have been devastated by AIDS have made big strides in fighting HIV, with new infections down 25 percent since 2001 in some of the worst-hit places, according to a UNAIDS report released ahead of the summit.

    African countries with the biggest epidemics, including Nigeria, South Africa, Zambia and Zimbabwe, are leading the decline, thanks to better use of prevention methods and greater access to life-preserving drugs, UNAIDS said.

    Although the number of new HIV infections is steadily falling or stabilizing in most parts of the world, the report said major problems still exist in certain regions and among particular high-risk groups.

    Eastern Europe and Central Asia have rapidly expanding HIV epidemics — the disease is spreading in that region at a rate of 500 new infections a day — and in several high-income countries there has been a resurgence of HIV infections among gay men.

  • Goal 7: Ensure environmental stability

    Image: Women carry tubs of water on their heads
    Issouf Sanogo  /  AFP - Getty Images
    Women carry tubs of water on their heads at a drinking water collection site on Aug. 10, 2010 in Abobo, a poor neighborhood in Abidjan, Ivory Coast. Women from various parts of the country's economic capital often spend the night lining up to get potable water.

    Goal: Integrate sustainable development into national policies and reverse environmental losses; reduce the rate of loss of biodiversity by 2010; halve the number of people living without safe drinking water and basic sanitation.

    Where things stand: According to the U.N., a decisive response to climate change is still urgently needed. Deforestation shows signs of decreasing but is still alarmingly high, the U.N. says.

    There has been much greater progress on expanding access to safe drinking water. Between 1990 and 2008, more than 1.6 billion people in developing countries gained access to improved sources of drinking water, raising the proportion of population with access to 84 percent from 72 percent.

    Still, half the population of developing regions lives without sanitation, according to the U.N.

  • Goal 8: Develop a global partnership for development

    Goal: To address cooperation in aid, trade, debt relief and access to technology and essential drugs.

    Where things stand: Aid has remained constant at about $38 billion a year since 2008, falling short of promises, according to the IMF.

    Countries have failed to conclude the latest round of global trade talks despite repeated pledges to reach a deal.

    There has been progress in writing off the debts of most of the world's poorest countries.

  • Vote

    What do you think should be the U.N.'s top goal?

  • Sources

    The Associated Press, Reuters, UN, World Bank, IMF

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