Floods are worsening in southern Pakistan, where up to 200,000 people have been forced to flee their homes in the past 36 hours.
River levels are still rising in some areas and rescue teams are struggling to reach those in need.
Many of the flood victims are still waiting for food, shelter and clean water.
From the air it looks like a country without any dry land. Thousands of people are packed onto levee banks and tiny strips of road that sit just above the water line.
A helicopter dropping hundreds of boxes of high-energy biscuits is the only thing keeping many people alive.
For a lot of the people in isolated areas, these helicopter flights are a lifeline to bring in food and also to evacuate those who need medical care.
But when the chopper finally touches down at a makeshift camp, there is no food left on board.
It is a dusty hell; ragged people push forward hoping to get something.
Ten-year-old Mumtaz Ali, who has a small brother to feed, counts himself among the many hungry men.
“Here the situation is very difficult. My life is very dangerous,” he said.
“I am a very hungry man. See my brother is a very hungry man. And give me food. You not give me food. Why?”
The helicopter crew give out medicine and bring several seriously ill children on board with their families.
But there are too many flood victims, not enough food and not enough helicopters to reach everyone.
The United Nations and aid groups say the more international donations they receive, the more people they can help.
Daryll Ainsworth, an Australian working with the UN World Food program, says he has never seen a disaster such as this.
“I was on the first helicopter out there just to check that everything was going alright,” he said.
“I’ve been a veteran of this sort of work for many years and it brought a bit of a lump to my throat to see these people there and the need is real.”
On the ground, Pakistani troops run along the tarmac, ready to load another helicopter with more food for the desperate people of the flood zone.
These choppers have been supplied by the Afghan military.
Mr Ainsworth says despite the troubles across the border, the Afghans have come to help
“I can’t say enough how much I think everyone should start helping,” he said.
“When you think that the Afghan government with their problems is prepared to send helicopter pilots and helicopters to help in this situation, I think for Australians and people throughout the world it is a small little thing to pay to help this organisation and get them back on the road again.”
Many flood victims are now totally reliant on air drops for their survival.
It could be up to a year before they are able to sow and harvest new crops and feed themselves again.
As talks on more flood aid get underway at the International Monetary Fund (IMF) in Washington, US officials say the international relief effort is coming together.
State Department officials say $784 million has now been pledged by UN member countries for the flood relief effort, with another $300 million promised outside the UN framework.
They say food has been delivered to over 2 million people and 1.5 million flood victims have received medical care.
The State Department’s Mark Ward says dozens of acute treatment centres have been set up across Pakistan to combat cholera and other health threats.
“Malaria is getting to be a concern so we’re providing 700,000 mosquito nets,” he said.