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Cholera surfaces in flood-ravaged Pakistan as prime minister says 20 million left homeless

Pakistan Cholera

Aug. 13: Pakistani villagers wash themselves after digging out their belongings from the rubble of their houses in Aza Kheil near Peshawar, Pakistan. International aid for Pakistani flood victims is coming in slowly compared to other recent disasters despite the massive number of people affected and the potential for dire economic consequence. (AP)

ISLAMABAD (AP) — A case of the deadly, waterborne disease cholera has been confirmed in Pakistan's flood-ravaged northwest, and aid workers expect there to be more, the U.N. said Saturday. The discovery came as new flood surges hit the south and the prime minister said 20 million people had been left homeless by the deluge.

The flooding disaster has battered Pakistan's economy and undermined its political stability at a time when the United States needs its steadfast cooperation against Islamist extremism. The U.N. has appealed for an initial $460 million to provide relief to Pakistan, but has said the country will need billions to rebuild once the flood recedes.

In light of the crisis, Pakistan canceled celebrations Saturday marking its creation and independence from Britain in 1947. Government leaders were expected to spend much of the day visiting flood victims, and U.N. Secretary General Ban Ki-Moon also was expected to visit sometime soon, possibly over the weekend.

The floods have killed around 1,500 people, and aid workers have warned that diseases could raise that toll.

One case of cholera had been fully confirmed in Mingora, the main town in the northwest's Swat Valley, U.N. spokesman Maurizio Giuliano said Saturday. Other cases were suspected, and aid workers are now responding to all those exhibiting acute watery diarrhea as if it is cholera, Giuliano said.

Cholera is "an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae," according to the World Health Organization. It can lead to severe dehydration and death without prompt treatment, and containing cholera outbreaks is considered a high priority following floods.

The Pakistani crisis began in late July, when unusually heavy monsoon rains tore through the country from its mountainous northwest. Hundreds of thousands of homes have been destroyed. The economy's biggest industry, agriculture, has been severely hit, with an estimated 1.7 million acres (nearly 700,000 hectares) of farmland wiped out.

U.N. officials, citing government figures, have said around 14 million Pakistanis were directly or indirectly affected.

But in a televised address to the nation Saturday, Prime Minister Yousuf Raza Gilani said 20 million were now homeless. He did not elaborate, and it was unclear how many of those people were briefly forced to leave their homes and how many had lost their houses altogether.

Fresh flood waves swelled the River Indus on Saturday, threatening nearby cities, towns and villages in southern Sindh province, said Mohammed Ajmal Shad, a senior meteorologist. The Indus was already more than 15 miles (25 kilometers) wide at some points — 25 times wider than during normal monsoon seasons.

Authorities were trying to evacuate or warn people in Jacobabad, Hyderabad, Thatta, Ghotki, Larkana and other areas. Already, many flood victims are living in muddy camps or overcrowded government buildings, while thousands more are sleeping in the open next to their cows, goats and whatever possessions they managed to drag with them.

The damage to the Pakistani government's credibility, which was already shaky, may be even harder to repair, especially after fury caused by President Asif Ali Zardari's decision to visit Europe as the crisis was unfolding.

The prime minister defended the government's response to the flooding disaster in his speech Saturday.

"This natural disaster has caused destruction at such a huge level that the government help (to survivors) looks insufficient," Gilani said, adding that rescue workers are doing their best to reach all victims.

The United States has donated the most to the relief effort, at least $70 million, and has sent military helicopters to rescue stranded people and drop off food and water. Washington hopes the assistance will help improve its image in the country — however marginally — as it seeks its support in the battle against the Taliban in neighboring Afghanistan.

As President Barack Obama congratulated Pakistan on its Independence Day, which also marked the Muslim-majority nation's separation from India, he insisted the U.S. would not abandon the country in its time of need.

"We will remain committed to helping Pakistan and will work side by side with you and the international community toward a recovery that brings back the dynamic vitality of your nation," Obama said in a statement.