When night falls in the refugee camp outside Karachi, Shanawaz Khoso worries about snake bites. The 38-year-old and his seven children sleep in tents alongside 5,000 other displaced villagers, partially exposed to the elements and to creatures that include scorpions and venomous snakes. When the sun rises, stifling heat and mountains of untreated sewage turn the camp into a breeding ground for disease. Fever and stomach pain are prevalent, but there are no doctors and there is no medicine.

"We are living here out of necessity,” Khoso says. "Nothing is coming here now. We’re terrified.”

With monsoon season fast approaching, Pakistan has already seen heavy rains and strong winds resulting in dozens of fatalities, hundreds of injuries and damage to roads, houses and farmland. This year, though, the rain is falling on a country still reeling. Just 10 months ago, severe flooding in Pakistan killed over 1,700, displaced 8 million and cost the economy more than $30 billion (¥4.3 trillion).