The fourth in a four-part series on Pakistan's flood disaster. Click here for part one, here for part two and here for part three.

NOWSHERA, Pakistan -- "I wonder if humanity exists in other parts of Pakistan."

Salma Begum 32, fumes when asked what the government and international community have done for her family in the weeks since the disastrous flooding here. The only support she has seen comes from the local branch of the Ummah Welfare Trust, a U.K.-based Islamic charity.

Many in Pakistan are in the same position, but the people in the Ummah camp are especially furious, as their tents sit right next to a much better-provisioned camp that has received extensive U.N. and government help. Other camp residents speak of a federal government relief operation just 15 minutes down the road that has been set up as something of a Potemkin village, used for tours to show celebrities and top-ranking nongovernmental organization (NGO) officials.

Meanwhile, the Ummah camp had yet to even see World Food Programme (WFP) rations at the time of a ClimateWire visit, some two months since this city was first drowned in the floodwaters. Each morning, said the displaced here, they scour the city in search of water for drinking and cooking the food Ummah workers give them. The only time Begum talks to her government representatives is when the police stop to ask her if there are any Islamic extremists living in the camp.

"Such ridiculous inquiries really make my blood boil," she said. "We don't want to be a bother to anyone, as we are already discriminated. They can just assist in providing cement and bricks, and we will build our houses ourselves."

Ummah officials said they have managed so far mostly through soliciting donations from other Nowshera residents hit less by the flooding, and with support from their London networks. Though the camp they have set up is highly visible, lying beside the main road, U.N. and international agencies have ignored them.

Government and U.N. officials say the 2010 flood crisis in Pakistan was partly caused by climate change, though the vast extent of the flooding has also exposed how the human activities in the developing world are making it more vulnerable to extreme weather events.

At the same time, the spotty relief and recovery operation in Pakistan provides a glimpse of how greater frequency of such natural disasters -- something predicted by many climate scientists -- could fray the capacity of the world to cope.

With some 20 million people affected and at least 7 million left homeless, aid workers from Pakistan and abroad are now openly saying that it is unlikely everyone will get enough support. Many will be left to completely fend for themselves, though exactly how many is unknown, experts admit.

The recovery effort in the north also lays bare the limitations that large international aid groups may face when responding to future crises in relatively unstable countries.

Providing aid and ducking security threats

Though foreign aid workers are seen everywhere in Haiti, they are nearly invisible in Nowshera and large parts of Pakistan, especially in Khyber Pakhtunkhwa province, as they duck security threats, leaving the Pakistan Army and local NGOs to do much of the heavy lifting.

By far, the Pakistan Army is seen as the driving force behind the flood relief efforts. It, and to a lesser extent U.S. forces, receives the most praise from not only the people in the camps but also private citizens active in organizing their own campaigns.

Meanwhile, the civilian government has come under heavy criticism for its demonstrated weakness in the wake of the disaster, fueling speculation of an impending coup as the Army restores its prestige.

"Political parties, they just want to buy influence. They say, 'Will you vote for me? Or I'll let you die,'" said Jassim Ubaid, a software entrepreneur in Islamabad who has organized help to the Swat Valley and northwestern regions. "Political parties aren't doing a good job, but the Pakistan Army and U.S. Marines are doing an unbiased job."

For the U.N. agencies and large NGOs, the picture is mixed.

Late last month, WFP officials in Nowshera estimated that food aid was reaching about 26,000 people a day in the camps. Much of the food was slow to reach affected populations, since WFP stockpiles prepositioned in Nowshera washed away in the flooding. But since then, officials believe, at least 5 million through Pakistan have received food aid.

A representative at one distribution point set up by the U.N. High Commissioner for Refugees (UNHCR) said that more than 1,700 packages of non-food items had been handed out by his small team by the end of September.

But the U.N. bodies themselves are staying mostly behind the scenes as the actual work on the ground is farmed out to local nonprofits.

In one section of Nowshera, for instance, WFP food assistance was being managed by the Community Research & Development Organization (CRDO), a charity based in nearby Peshawar. Mubarak Shah, the CRDO coordinator at the distribution point, gave a tour in which he explained how his group was helping WFP to set up an online-based system of registering families in need, to disburse aid in a more organized fashion.

Across the country, many other U.N. agencies and groups, including the U.S. Agency for International Development (USAID), Save the Children and Islamic Relief, have been conducting projects through the Rural Support Programmes Network (RSPN). The coalition of 10 regional support groups normally runs development and training projects but has now completely shifted to flood relief, helping the international community to navigate Pakistan and get help to areas most in need.

"When the scale of a disaster is so large, we have to mobilize a large amount of resources to create a new presence in new areas," said Ayesha Amina Askari, a program officer at RSPN's offices in Islamabad. Mobilizing disparate NGOs into the post-flood response makes sense, as "they already have a presence there; they have links with the local communities as well as the local government," she said.

Shortfalls of shelter and food

Though RSPN, deemed the largest local NGO network, is active throughout the country and is the beneficiary of generous support from large donors, it still is not enough, Askari said. In an interview, she complained of a massive shortfall in shelters available for the newly homeless, even in the north, where the devastation was more tightly concentrated.

In the south, where larger swaths of land were flooded, there is still an acute shortage of other non-food items like clean water and sanitation facilities, she said.

International aid workers attribute their low-key approach to security concerns.

"Operationally, security is a key concern in KPK [Khyber Pakhtunkhwa], and to a lesser extent in Sindh," said Ben Pickering, a program officer with Oxfam. "There will be areas that are unsafe for international staff to go to, and we are cognizant of that, and we have developed security guidelines and procedures as a result."

International staffers from Oxfam, World Vision and other charities face strict curfews in the north, where they are forbidden to travel at night. Other areas are off limits altogether. Pickering said that Oxfam has permanent foreign workers in places like Sukkur and Mardan but not in the Swat Valley. He said the need to "strike a balance" between giving to the needy and protecting workings will necessarily add a burden to efforts under way in Pakistan.

To help augment disaster relief capacities in Pakistan, local NGOs, USAID and other actors are working hard to strengthen the federal National Disaster Management Authority (NDMA), a body set up in 2005 in the wake of the devastating Kashmir earthquake.

Some five years since its inception, NDMA has proved largely ineffectual in the emergency response, instead leaning heavily on a nonprofit called Strengthening Participatory Organization (SPO) for advice and training. SPO advocates for disaffected populations but has also been busy setting up disaster early warning systems in various parts of the country, mainly to protect vulnerable areas from cyclones.

"NDMA still has no capacity to respond to disasters," said Noor Bakhsh Baloch, manager of SPO's humanitarian response efforts. "We have trained staff and skills, and ... have the most experience with responding to natural disasters."

Baloch has been working to change this but admits it's been a hard slog. His relationship with NDMA leadership has only recently improved, he said. He and other Pakistani NGO officials complain that NDMA changes staff too often, leaving no institutional memory and no well-established system to drive its efforts. The problems became acute during a 2009 episode when 2.5 million people fled the Swat Valley to escape intense fighting between the Army and Taliban insurgents.

Who is doing what, and where?

"This time, again, the NDMA doesn't know who is doing what, and where," Baloch complained. "A lot of NGOs are working in the field, but again, they [NDMA] don't have information about the NGOs, what we are, how many human resources we have and what we are doing."

Privately, Pakistani aid workers complain that many of their international sponsors are being too cautious, limiting the relative effectiveness of the entire relief effort. But the organizations say they have no choice, especially in light of recent, deadly attacks on WFP and World Vision offices by militants.

"The last thing we would want is to not be cognizant of those risks, expand as much as we can and get as many staff as we can out to those locations, and God forbid, an incident happens," Oxfam's Pickering explained. "It would have repercussions for the whole international community, and in a worst-case scenario, agencies would downscale their activities."

Stacey Winston, a public information officer in Islamabad with the U.N. Office for the Coordination of Humanitarian Affairs said the Ummah Welfare Trust camp hadn't received aid because it was considered a "spontaneous" camp not officially recognized by the government.

"UNHCR, through local implementing partners, is mapping the needs of these spontaneous camps and will do a needs assessment accordingly," Winston said.

Deedar Khan, UWT's Nowshera camp coordinator, is convinced fear and bias are behind the cold shouldering. He suspects the word "Ummah" triggers negative attitudes.

"Just because I have a beard, that does not make me a Taliban, yet foreigners lump us all in same category," Khan said bitterly. "Allah forbid, our religion does not recognize terrorism, fundamentalism and the acts of these militants at all, but the international community does not want to think broadly. It's happy with this disgusting status quo and relieves itself from caring about the majority of Khyber Pakhtunkhwa."

'Not everyone will be reached'

Winston denies that the U.N. fears militancy in the Ummah camps. And other relief officials with more experience working with international agencies are more forgiving than Khan.

"This disaster is at a scale where, unfortunately, not everyone will be reached, and you just have to take that for granted," said RSPN's Askari. "It's too massive. No nation, no U.N. agency, no NGO can reach all of these people."

The Pakistan government is now putting the final touches on a comprehensive Damage and Needs Assessment that has been under way for weeks. Yesterday, the World Bank and Asian Development Bank released figures that put total damage to homes, property, transport infrastructure and agriculture from this summer's flooding at $9.7 billion.

Billions of dollars has been promised to help Pakistan rebuild. Ummah camp residents, meanwhile, say they are tired of hearing promises of more basic assistance left unfulfilled.

"We are tired of this disgusting treatment; it's like the government does not really want to wake up," said Qamar Begum, a diabetic 57-year old pushed out of Nowshera. He said residents are getting so desperate that there's talk of keeping their children out of school, so they can work and provide for their families instead.

"We don't want anything except jobs for our men and some money to rebuild our damaged homes," he said. "We have lost everything in these floods, including our dignities."

Saadia Haq contributed to this report.

 Reprinted from Climatewire with permission from Environment & Energy Publishing, LLC., 202-628-6500