Dusty, thin tents and shelters made of tree branches stretch off into the distance in the vast, unplanted fields of Raziq Binu village, in the Sindh Province of Pakistan.

Outside these makeshift shelters, children play with pieces of wood and trash. The onset of winter means that temperatures will continue to drop as low as five degrees Celsius at night. Still, the smiling dust covered faces distract from the children’s bare feet and lack of warm clothes.

Six months ago, Raziq Binu village, three hours drive north of Karachi, was devastated by floods that washed away houses, crops, animals and livelihoods.

Asma Mahreen, her husband and their six children finally made it back to their home village, after five months of moving between different camps in Sindh and Balochistan provinces.

"Like most of the people in our village, our home has been washed away. We found nothing when we went back," she said while making lunch in a cramped makeshift shelter, a few steps away from where the family keeps their cattle.

"We just built this shack last week using whatever material we could find in the woods. But it is getting very cold lately and we are suffering, especially our children."

This family is just one of many in Sindh, whose houses were swept away when the July 2010 floods wreaked havoc throughout Pakistan. As the temperature continues to drop, MSF teams race to provide up to 2,000 transitional shelters for people in and around Jamshoro and Johi districts.

"My children have been complaining about the cold but we are simply helpless. We have nowhere else to go and no means to make things better. As parents, it hurts us to be helpless, to see our children suffer and not be able to give them what they need," said Musdaq Ali, Asma’s husband as he waited to receive the MSF shelter set.

Each set contains bamboo frames, plastic sheeting, wall and roof mats, as well as insulation material. The transitional shelter is designed to last for one year, which will hopefully give floods survivors some time to rebuild their lives after their homes and livelihoods were destroyed.

In addition to providing these sets, MSF teams also show villagers how to construct their transitional homes. For the safety of the families and the durability of the shelter, it is important that the shelter is put together properly. 

Attending the demonstration, Saleem Bushk, 45, tied down the last branch on the roof to one of the vertical bamboos that made up the walls and shared his story.

"Even before the floods, as a casual labourer, I could barely support my wife and our eight children. Now without a job, and not enough food to eat, all I can think of is to find a way to keep my family from starving, let alone to give them a home."

The situation is not without hope; six months after the floods, seasonal crops have started to sprout again, yet the road to recovery for flood survivors remains challenging.

"Six months after the floods, too many people are without anything, not even food or a way to earn a living. The good news is that we are helping them put a roof over their heads, a place to call their own and somewhere to keep their families safe," said Kamran Khan, a member of the MSF shelter team.

As he loaded the supply set onto his donkey cart, Musdaq Ali smiled and said, "I can now build a home for our family. I have asked our neighbours for help, and Inshallah, within a few days, it will be ready and my children will be warm and safe at night."

Since the start of the floods in Pakistan MSF has distributed 68,903 relief item kits and more than 17,000 tents; performed 96,656 medical consultations; screened more than 43,000 children and pregnant and lactating women and treated more than 5000 malnourished children; distributes 7.6 million litres of safe water per day; built 843 latrines, 280 shower sites and 130 hand-washing points, and constructed over 1000 transitional shelters.
 
Since 1988, MSF has been providing medical assistance to Pakistani nationals and Afghan refugees suffering from the effects of armed conflicts, poor access to health care, and natural disasters in Khyber Pakhtunkhwa, Balochistan, Punjab, and Sindh provinces, as well as the Federally Administered Tribal Areas and Kashmir.
 
MSF does not accept funding from any government for its work in Pakistan and chooses to rely solely on private donations.