"How can we break the fast, when we have nothing to eat," asks Sabhagi Khatoon, a mother of six camped out under open skies on the highway near a dirty canal -- the only source of water to quench one's thirst in the heat.

Millions of displaced and hungry Pakistanis who watched flood waters swallow up their homes and crops were likely to wake up hungry Thursday, when the dawn-to-dusk fasting month started in Pakistan.

Khatoon fled her village of Karampur to Sukkur, 75 kilometres (47 miles) away in the southern province of Sindh, after floods that UN officials say have made six million people dependent on humanitarian aid for survival.

"We have nothing to eat, nothing to live in. We've been starving for days, so the start of Ramadan doesn't bring any joy.

"We used to celebrate Ramadan in a big way in our village, but my children and I are already starving. We need food, so we're already fasting in a way."

Pakistan's government says 14 million people are facing direct or indirect harm because of floods. The United Nations has warned that children are among the most vulnerable victims, with diarrhoea the biggest health threat.

"Our village drowned. Our homes and crops are ruined by floods. We are fighting a war of survival," said Mohammad Parial, 55.

Living in the open along the highway near Sukkur, Parial is desperate for his six grandchildren who need urgent food assistance.

"It will be a great day when our children get food.

"I used to grow fruit and vegetables on my farm in Khanpur but now nobody is offering any help. Ramadan is a month of blessing, but no one is there to let us enjoy these blessings," he said with tears in his eyes. "All my memories seem to have been swept away by floods."

The government has admitted being unable to cope with the scale of the crisis and an outpouring of rage from survivors and the political opposition is pressuring President Asif Ali Zardari.

Authorities promise to provide cooked meals to flood victims during Ramadan and compensate families of those killed, but few on the ground expect much assistance.

Islamic charity Jamaat-ud-Dawa, which features on a UN terrorism blacklist and whose involvement in relief has raised concerns in the United States, has also promised to provide iftar meals to the victims.

Mohammad Jadam, 30, a labourer from Thul town, 120 kilometres north of Sukkur, says people feel betrayed by the government when they most need help.

"I never dreamt I'd be in such circumstances in the holy month. I fast for Allah during Ramadan but we're starving. The government is doing nothing to save our children from starvation."

Children also feel no excitement ahead of Eid-ul Fitr, the festival at the end of Ramadan traditionally celebrated with feasting, new clothes and cash gifts.

"We never celebrated with much joy because we're poor and can't afford expensive food, but at least we had food, shelter and water during Ramadan in the past," said 12-year-old Taj Mohammad.

"My father would bring us new clothes and shoes at Eid but not now. We left all of our belongings behind when our village flooded. It's difficult to survive, let alone celebrate."

"We're hungry and thirsty. My father and I tried to pick up labour in Sukkur but there are thousands like us on the streets hoping to earn something."

Sheltering in a school in the northwestern district of Charsadda, male nurse Wajid Ali can't imagine providing two meals a day and clean drinking water for his 15 relatives at the set times stipulated during Ramadan.

Ali, his parents, sisters, wife and two children lost their home in Aziz Khel village. They are living at a relief camp in the school, lacking gas, water or utensils along with hundreds of other people.

"Clean water is the biggest problem. All of us have stomach problems," he said, adding that camp administrators provided a cooked meal, but in a haphazard fashion.

"We can't cook for ourselves. We have nothing to cook with, only wood we can collect to make a fire."

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