There are already early signs of nutritional deficiencies in remote mountain areas hit by the October 8 quake and weakened people will fall prey to disease, the UN agency's emergency coordinator Michael Jones told AFP.

"In one month's time we will start to see malnutrition-related diseases and we will start to see people dying, they will say from hunger or starvation but it will be from weakened bodies," Jones said.

The WFP on Friday more than doubled the number of people it said needed food aid including vitamin-enhanced wheat flour, saying it now had to get supplies to 2.3 million before snow starts to fall in mid-November.

United Nations officials have repeatedly warned that the death toll of more than 55,000 in Pakistan will soar unless wealthy nations give more cash to provide shelter, food and medical aid over the next six months.

The WFP says it needs another 100 million dollars.

Food was already a problem in the quake zone before the quake hit, with around 60 percent of children there being chronically malnourished before the earthquake and 10 percent affected by wasting of the body, Jones said.

A recent WFP assessment of the worst-hit area showed that more than half of rural households surveyed lost all or most of their grain stocks and a quarter of the livestock was killed.

Large numbers of children were found to be suffering from diarrhoea or respiratory illnesses, "suggesting that a rapid increase in cases of acute malnutrition could be imminent", the WFP said in a statement.

About 20 percent of mothers with children aged under two had stopped breastfeeding, either because of illness or inadequate breast milk, it added.

"Unless there is regular supply and nutritional balance you start having deficiencies. That reflects itself in anaemia, goitre, night blindness, then the body's defence mechanism breaks down," Jones added.

"You lose your immunity to waterborne disease, communicable disease, airborne infection, even TB, and we start to lose people just from a weakened body. Also the body is not protected against the cold because you don't have the calories."

Aid groups also had to improve distribution to ensure women and children do not lose out, Jones said.

"It is the strongest and biggest who are going to be fed...for cultural reasons the women cannot go out and fight for their food when it is thrown off the back of a truck," he added.

Tents to protect survivors from the Himalayan winter have been the main focus of the aid drive so far but food is now becoming a priority, said WFP spokesman David Orr.

"People have been saying shelter, shelter, shelter but there is no point having a tent if you are cold and hungry inside," Orr said.

related report
Quake killed 17,000 schoolchildren in Pakistan: UNICEF Islamabad (AFP) Oct 31 - At least 17,000 Pakistani children died when their schools collapsed in the giant October 8 earthquake and the trauma for survivors is worse than after the Asian tsunami, UNICEF's chief said Monday.

"We are estimating that at least 17,000 pupils were killed in schools, that's the one number that we have some estimate on," UN Children's Fund executive director Ann Veneman told reporters in Islamabad.

According to UNICEF estimates some 1.6 million to 2.2 million children have been affected by the earthquake, which has killed more than 55,000 people and made 3.3 million homeless.

Veneman said that even those children who have survived were traumatised.

"The trauma that these children have experienced I think has been particularly even worse than other tragedies like the tsunami, because so many of these kids were in schools," she said.

"They were in school at that time when so many of the school buildings came down. The ones that survived, many have injuries, many lost friends, they lost teachers, they lost important people in their lives."

The UNICEF chief repeated warnings about a "second wave" of deaths if children are not provided with proper health care, clean drinking water and immunisation against disease.

"We are concerned about the possibility of a second wave of loss of life if children don't get the right interventions," she said. A UNICEF statement quoting Pakistani government estimates said that 6,700 schools have been destroyed in North Western Frontier Province and another 1,300 in Pakistan-adminstered Kashmir.

The agency was addressing the psychological needs of teachers as well the requirements of nearly 20,000 children "who will have physical impairments after this tragedy due to injuries and amputations," it said.

"This figure may increase as more villages are reached," it said.

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