I have just met a young boy who spent 9 hours in the flood – he’s not spoken since.

I’m at Sabzi Mandi Camp in Hyderabad in Sindh, originally a vegetable market now filled with tents and people who are unable to go home because their villages remain under water. The boy stands close to his father and as his father moves around the boy mirrors him but makes no eye contact with anyone – it’s like he’s sleepwalking. His father tells me that it could be six to twelve months before his son recovers – he shows me a note from a psychiatrist supporting this.>/p>

Stress and worry

I’m here following up on what people did with a cash grant Oxfam distributed through local partner BHS (Bhandar Sangat) a few weeks ago. Several people I spoke to have spent a lot of the money on similar health care for their children.

Khalil Ahmed’s 16 year old son is also deeply affected, When the flood came he was out with the livestock…”we heard people shouting ‘Water is coming.Water is coming. Run. Run.’ All three buffalos he was with were washed away. Now he just sits in the tent staring at nothing. We don’t know what we can do. He is our oldest son.” The stress and worry is deeply etched on their faces.

Mohbat Khatoon (below) tells me she spent most of her money on treatment for her 15 year old daughter who wakes up crying in the night and in desperation tries to leave their tent. Worried about her daughter’s safety Mohbat Khatoon used more of the money on transport so her daughter could go and stay with an aunt so she could be with people she knew.

Most people report they have spent the money on food and warm clothes for their children as the days and nights are getting colder. Others are also using the money to repay transport costs, which they incurred when escaping the flood.

Cash has helped, but it’s not enough

Whilst this small injection of cash has helped to make peoples lives a little easier for a few weeks it is not enough.

For people in the camp the future is uncertain. Most of the people I meet are tenant farmers who have left behind decimated fields and homes, lost livelihoods and increasing debt that they don’t know how they will ever be able to repay.

Mohammed Hassan Brohi (right) explains that there is little chance of them returning home to restart their lives for quite a while, “It’s a water logged area because the water table is high…that’s why we grow rice…and it’s hard for the water to go and now that it’s winter it’s going to be even harder… It might take 6 to 12 months before the water has gone.” In the meantime everyone is looking for work as daily labourers. But as Khalil Ahmed points out this work is uncertain, “I sometimes get daily labouring work…but the contractors don’t know us and so are reluctant to employ us.”

Soni (right), whose name means Golden, tells me they sent most of the money to their landlord to help repay their debt. Their landlord had rung her husband to say, “If we get this money we should pay him, if not we should go for daily labouring work and repay him…because he had lost everything in the flood and needed the money.” Soni and her husband don’t have a tent and are sleeping on a mat on a concrete floor. Though under a roof, there are no walls or protection from the cold as winter descends.

Millions still in emergency conditions

As the focus of the international community shifts towards recovery and reconstruction, we must not forget that millions of people are still in emergency conditions. Large parts of southern Sindh remain under water, and will likely remain so for months to come. More than a million people remain displaced, unable to return to their homes either because their land is under water or because infrastructure and basic services are yet to be restored. Across Pakistan, 2m people are without basic food assistance, and almost 7 million are without emergency shelter. As the winter approaches, the situation is becoming increasingly desperate. Malnutrition – already at emergency levels prior to the floods – is deteriorating.