The weak civilian government has faced an outpouring of fury over sluggish relief efforts, while officials are warning the country faces ruinous economic losses of up to $43 billion, ahead of IMF talks this week.

The month-long floods have killed 1,500 people and affected up to 20 million nationwide, according to official tallies, with the threat of disease ever-present in the miserable camps sheltering penniless survivors.

“We are right now trying to protect Shahdadkot town, which is threatened by the rising floodwaters,” Sindh Irrigation Minister Jam Saifullah Dharejo said.

He said an embankment built to protect the city was under pressure from the waters and “we are trying to save the city from the unprecedented flood.”

Dharejo said the Sindh government had already escorted most of Shahdadkot’s 100,000 population to safety.

“But there are still some people stranded in these villages (around Shahdadkot) and we are making efforts to rescue them,” he added.

Dharejo, however, stressed there was no threat to Hyderabad, the second-largest city in Sindh and Pakistan’s sixth biggest overall.

“There is nothing of the sort... Hyderabad is so far safe despite the growing pressure from floodwaters. We have strengthened embankments around the city,” the official said.

Streets were deserted and all markets shut in Shahdadkot town and some people were seen loading their belongings into a private vehicle before leaving their homes. Millions of flood survivors in desperate need of food, shelter and clean drinking water meanwhile require humanitarian assistance to survive, as concerns grow over potential cholera, typhoid and hepatitis outbreaks. The world has given or pledged more than $800 million to help Pakistan cope with the flood devastation, the foreign minister said Sunday. Pakistan is grateful for the international assistance, which came after the United Nations appealed for $460 million in aid for the deluged country, Foreign Minister Shah Mahmood Qureshi said.

“The total commitments and pledges that Pakistan has got so far are $815.58 million,” he told reporters in Islamabad. “In these circumstances, when the West and Europe and America are going through a recession ... this kind of solidarity for Pakistan, I think, is very encouraging.”

Pakistan can ill afford the crisis. The South Asian country’s economy was already being kept afloat by billions of dollars in loans from the International Monetary Fund, and the cost of rebuilding after the floods will likely run into the billions.

The IMF said it will meet with Pakistani officials this week to discuss the floods and what the country must do to cope.

“The IMF stands with Pakistan at this difficult time and will do its part to help the country,” said Masood Ahmed, director of the IMF’s Middle East and Central Asia department.