Pakistan reported 18 flood-related casualties on Wednesday as Prime Minister Shehbaz Sharif called for a "sustainable system" to cope with the challenges of climate change, which is seen as the primary reason that triggered unprecedented rains and floods in Pakistan this monsoon season.

Authorities have been struggling to respond to the floods given their unprecedented magnitude. The government has said 33 million people — 15pc of its population — have been affected.

A daily situation report by the National Disaster Management Authority showed on Wednesday that 18 more people had fallen victim to the deadly flood over the past 24 hours, taking the death toll since June 14 to 1,343.

The National Flood Response Coordination Centre (NFRCC) confirmed the tally in a separate statement, saying that 17 people were injured due to flash floods over the past 24 hours, taking the total number of injured reported so far to 12,720.

The statement added that rain/thundershowers were expected in parts of Khyber Pakhtunkhwa, Azad Jammu and Kashmir and Gilgit-Balstistan, as well as adjoining hills today, while the weather would likely remain hot an humid in other areas of the country.

This morning, the NFRCC Deputy chairperson Ahsan Iqbal and the forum's coordinator, Major General Zafar Iqbal, presided over a meeting of the forum to review the flood situation.

The flood situation in Sindh and Balochistan — two of the worst-affected provinces — and rehabilitation activities were the focus of the discussion, a statement issued after the meeting said.

The meeting was informed that digital mapping of affected areas would be carried out to prioritise the rehabilitation of communication infrastructure and population.

Ahsan Iqbal further directed the relevant authorities to complete the joint damage assessment survey on "war footing" so that rehabilitation activities could be focused on, including the repair of communication infrastructure.

'Trillions' needed for relief and rehabilitation: PM

Meanwhile, Prime Minister Shehbaz Sharif reached Dera Ismail Khan to review the ongoing restoration and rehabilitation work in flood-affected areas.

On the occasion, the premier emphasised the need for a "sustainable system" to cope with the challenges of climate change.

He said "trillions" were needed for relief and rehabilitation activities post floods.

"The country is grappling with an unprecedented situation, witnessing floods that have resulted in the loss of lives, infrastructure and crops," he said, adding that it was time to "rise above politics and demonstrate the spirit of service and welfare."

Revisiting the damage caused by floods in Swat, he regretted the construction of hotels and resorts alongside rivers, which he saw as the main reason behind floods in the district.

PM Shehbaz announced that a sum provided by a philanthropist for flood relief would be used for prefabricating 100 houses in DI Khan, each having two rooms and a toilet, to accommodate widows and orphans in the first phase.

He set a timeframe of two weeks for building the houses, saying that he would personally visit the site to assess whether the project could be replicated in other areas.

Moreover, announcing an earlier decision to increase the amount set aside for flood relief under the Benazir Income Support Programme, the premier said under this package, every flood-hit household would be given Rs25,000. "Besides, Rs1 million will be given in compensation to the relatives of the deceased."

He said the government had also ordered 0.2m tents for the homeless displaced by floods.

The prime minister lauded politicians, the local administration and the armed forces for "acting in unison while contributing to the rescue and rehabilitation" of flood-affected citizens across the country and expressed his gratitude to friendly countries for their support and assistance.

Earlier, the PM was briefed about the losses caused by floods, with the DI Khan deputy commissioner (DC) stating that heavy rains from August 17 to August 27 had wreaked havoc in the district, affecting 70 per cent of its population.

A National Highway Authority (NHA) official told the prime minister that the 600-kilometre-long N-55 DI Khan-Razmak thoroughfare was restored in two days, while the N-35 Karakoram Highway up to Kuchal Nullah towards Kohistan was restored by Frontier Works Organisation.

The prime minister also visited the Saggu Bridge during his trip and was told the bridge was swept away due to flash floods. The bridge is located on the N-50 National Highway, connecting DI Khan with Kuchlak.

PM Shehbaz was told that after the first spell of torrential rains and floods, the bridge was repaired in two days and following a second hit by floods, its reconstruction was underway.

He was informed that the Saggu Bridge in the first torrential wave was restored within two days, however, the work was in progress after the second hit by floods.

Water level recedes marginally in Manchhar Lake

The water level in Manchhar Lake on Wednesday recorded a slight decrease. According to official figures, the water level had dropped to 122.3 foot-reduced level (RL) at noon from 122.5RL at 6am.

Meanwhile, Indus River remained in high flood at Kotri barrage with around 58,3882 flowing downstream at noon against upstream discharge of 604,127 cusecs. Only a marginal drop was seen at upstream discharge at Kotri barrage on Wednesday.

According to Wapda chief engineer (water) Sukkur Naeem Qadir Mangi, flows in Main Nara Valley Drain remained the same with only slight recession in flows due to a breach at RD-10 on Tuesday.

Situation in Sindh

After causing widespread destruction in the country's north, floodwaters have converged in Sindh in the south, where the Dadu district has been particularly affected.

Dadu DC Syed Murtaza Ali Shah estimates that over 1.2 million people have been affected by rains and floods since July 7 in the district.

He told Dawn.com on Wednesday that 201 relief camps had been set up in the district, where flood-affected people were being provided meals twice a day. Hundreds of others, he said, were living in the streets and they, too, were being provided food.

The DC added that teams of doctors were visiting the relief camps and flood-hit areas in the district to provide medical treatment.

However, he continued, "we face a shortage of tents and we have written to the government for more supplies".

The shortage of tents was also highlighted by MNA Rafique Ahmed Jamali, who has been elected from Dadu's NA-235 constituency.

He said there was an "urgent need" for 100,000 tents, adding that they were needed to provide shelter to flood-hit individuals and families "living in the streets and on trees".

The MNA expressed the resolve to stand by the people in the current "emergency situation".

The Flood Forecasting Division's website showed that the River Indus was in a high flood at Kotri on Wednesday morning and the situation had remained the same till the afternoon.

Reuters' drone footage of Sindh from yesterday showed agricultural and residential areas completely submerged in water, with just the tops of trees and buildings visible.

Rice fields resembled massive lakes of several miles in diameter, aerial video footage by the Pakistani military showed.

Yesterday, the water level in Sindh's Manchhar Lake had registered a slight decline after persistently rising for a day, with recently made cuts on its dyke allowing the outflow of water that resulted in the inundation of a section of the Indus Highway, lying between Sehwan to Bhan Saeedabad.

A bridge near the Sehwan toll plaza was also damaged by the torrents, while a 30-kilometre stretch of the highway was closed for traffic.

Motorway Police official Saqib Ahmer told Dawn that barriers had been installed on the road and commuters had been advised not to use this route.

According to the Dawn report, water from Manchhar had submerged the employees' colony and lounge of Sehwan airport on Tuesday while building pressure at the Aral Wah embankment, the final lifeline of Sehwan city and Bhan Saeedabad.

The water is affecting villages in UCs Bubak, Arazi, Jaffarabad, Paka Channa and Wahur, while as many as 300 big and small villages in Sehwan taluka have been flooded by water from the Manchhar Lake, the report said.

Meanwhile, Reuters reported that authorities were scrambling to widen a breach in Manchhar to prevent it from overflowing.

"Till yesterday there was enormous pressure on the dykes of Johi and Mehar towns, but people are fighting it out by strengthening the dykes," DC Murtaza Shah told Reuters, adding that 80 per cent to 90pc population of the towns had already fled.

The floods have turned the nearby town of Johi into a virtual island, as a dyke built by locals holds back the water.

EU coordinating incoming aid offers

Separately, the European Union (EU) said it was coordinating incoming aid offers to help the country face the ongoing emergency at the request of Pakistani authorities.

"The European Civil Protection Mechanism is deploying one liaison officer to help coordinate the arrival of further aid," it said in a statement.

Offers received so far from EU member states include 300 family tents from Belgium and another 300 from Sweden; 83 mobile water pumps, 200 family tents, 1,000 ground sheets, 200 kitchen kits, 400 hygiene kits, a team of eight doctors and four technicians and one bailey bridge from France; a water purification team from Denmark; and 400,000 antigen tests and 10,000 examination gloves from Austria.

The assistance comes on top of 2.15 million euros in EU humanitarian funding released over the past weeks to support families affected by flash floods and new humanitarian funding of 200,000 euros for the disaster response emergency fund released on Tuesday.

Commissioner for crisis management, Janez Lenarcic, said that the dramatic scale of the flooding emergency in Pakistan and the rapidly deteriorating humanitarian situation had triggered immediate EU support.

“We stand in solidarity with Pakistan and reaffirm our commitment to support people affected by these devastating floods,” he said.

Impending health crisis

As Pakistan reel from floods, the United Nations has appealed for $160 million in aid to help tackle what it said was an “unprecedented climate catastrophe” and nations have been extending financial and moral support with promises for more.

The federal cabinet also approved yesterday the decision to enhance the cumulative compensation amount for flood-affected families under the Benazir Income Support Programme from Rs28 billion to Rs70bn.

Meanwhile, large-scale displacements and countries limited resources have led to fears of an impending health crisis.

The World Health Organisation (WHO) issued yet another warning of a worsening humanitarian crisis in Pakistan in the wake of floods, with its spokesperson Tarik Jasarevic expressing alarm over a rise in the cases of various diseases in recent days.

“The situation is expected to worsen,” he warned, as it was still difficult to get to areas hit hard by the floods.

According to the WHO, over 1,460 health centres have been damaged due to floods across the country, of which 432 have been fully wrecked, mostly in Sindh.

Sindh Health Minister Azra Pechuho highlighted similar problems yesterday during a press conference, particularly stressing the need for more female doctors in flood-hit areas.

Earlier, Federal Health Minister Abdul Qadir Patel said over 1,200 medical relief camps would be set up in more than 20 flood-hit districts this month to provide medical assistance to affected citizens.

Additional input from Reuters