Foreign donors have stumped up just half of a UN appeal target of $1.93 billion, sparking fears for 6.8 million who need emergency shelter as winter sets in, while farmland could remain flooded for another six months.
But officials say efforts to rebuild 1.6 million homes are being compromised by infighting between federal and provincial authorities, and express amazement that a $58.5 million prime minister's fund remains entirely unspent.
Shabbir Anwar, a spokesman for Prime Minister Yousuf Raza Gilani, said plans for the money were still being finalised as part of a national recovery plan.
"The government has prepared a national strategy for rehabilitation and reconstruction. The details are being finalised by the financial division," he told AFP.
But a top official said "malaise" at the heart of government was to blame for inaction, as thousands of families remain camped out on roadsides in makeshift tents.
"Once a decision is taken at the highest level it must be done, but it doesn't get done," he told AFP on condition of anonymity.
‘Nobody has helped us’
Huge swaths of Sindh province in the south remain underwater. From the air all that can be seen in the worst-affected parts of Dadu province are the tips of trees jutting above inland lakes.
Just outside Gul Muhammad Chandio village, families languish under tents overlooking fields submerged in water, clamouring for the relief that they say has failed to arrive in the months since the disaster.
Villagers returning from relief camps by donkey found homes still flooded or destroyed. A chair balanced on a rubber ring was the only way to ferry people across a flooded street.
"We're very worried about our income because our land is under water. Nobody has helped us," said 45-year-old Mohammad Khan, who returned to his home with seven children to find a pile of rubble.
"Please rebuild our homes. We're worried, we don't have anything."
Lack of support
UN officials have complained about a lack of international financial support for Pakistan.
The World Bank has put the overall figure for flood recovery at $9.7 billion.
The federal government insists on doling out the money itself to rebuild schools and hospitals, and has asked donors to contribute only to a cash fund, rather than offer infrastructure assistance.
Under a cash compensation scheme, 1.6 million of the worst-off families should each receive more than Rs85,450 rupees to rebuild their homes using an electronic card system.
The United States has been quick to endorse the fund, with US envoy Richard Holbrooke telling a development conference in Islamabad that its aid could be fast-tracked into the scheme.
But the World Bank has refused to back the scheme until the fund is made more transparent and accountable, and there have been widespread reports of problems with the cash card system, said Oxfam media officer Amil Khan.
"We have reports of people not knowing how to use the cash cards, machines not having any cash, not having any power. There have been issues of access... it's a significant issue," said Khan.
Reconstruction and rehabilitation
Head of the National Disaster Management Authority that coordinates flood relief, General Nadeem Ahmed, said he has "strong reservations" over the plan because there is no system in place to oversee the home rebuilding.
Of the 1.6 million homes earmarked for construction, he said 400,000 needed to be built elsewhere to avoid flood plains and fault lines in the earthquake-prone country.
"People are making houses and schools in the river beds," said Ahmed.
"We want to make sure that whatever reconstruction we do must make use of the opportunity to build back better."
USAID officials met Pakistan's National Accountability Board last week to discuss allegations of misuse of American money by aid organisations, a Pakistani official said on condition of anonymity.
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