While the United States recovers from superstorm Sandy, away from the glare of the international media, five million Pakistanis are struggling to get by in the country's third successive year of massive floods.

Two years after the worst floods in Pakistan's history captured the world's attention, this summer's monsoon rains once again inundated huge areas of the Indus Valley, with rural parts of Sindh province the worst hit.

At the floods' peak in September, more than quarter of a million were in relief camps across the country. Many have now gone home, but in Sindh, 160,000 remain homeless.

Abdur Razzaq Mirali is among them. As hundreds of thousands of Americans wait for their electricity to come back on after Sandy, 55-year-old Mirali's ambitions are rather more modest.

"Look, this is my house," he told AFP, pointing to a small mudbrick building half-submerged in filthy brown water.

"I am waiting here for the water to recede so we can start our normal life again."

Mirali and his family have waited two months so far and still their village -- also called Mirali -- swims knee-deep in foul-smelling water polluted with human and animal waste, where snakes dart around.

The 80 families of the tiny hamlet in Sindh's Jacobabad district, around 500 kilometres (300 miles) north of the metropolis of Karachi, shelter in makeshift shacks on a patch of higher ground overlooking their waterlogged homes and fields.

The world has paid scant attention to Pakistan's flood victims this year. No blanket media coverage, no benefit concerts by pop stars, just foreign aid organisations doing their best on the ground with limited resources.

But among Mirali's flood victims there is no resentment of the global attention lavished on America's eastern seaboard, only gratitude for US help and a feeling of solidarity not always present in a country where anti-American feeling often runs high.

"We should not be jealous of them. They are very generous people who have always helped us. They deserve the attention now when they are in duress," said farmer Ghulam Ali, 26.

"What we just want is to be helped to restore our normal life."

In this remote rural area, foreigners are a rare sight and so all white aid workers are regarded as "Americans".

"It is really amazing to see these Americans are helping us here despite having a much worse storm in their own country," said Hashim Mugheri, dressed in a worn-out shirt and loincloth and sporting a grey walrus moustache.

"The Americans are helping us here and some of our people are still abusing and hating them," he said.

Pakistan's National Disaster Management Authority says five million people have been affected by this year's floods, three million of them in Sindh, and more than 1.1 million acres (450,000 hectares) of crops destroyed.

With so much farmland under water, there are fears for food supplies. The World Food Programme (WFP) is working to supply 1.2 million people with rations for and hopes to extend the scheme for 700,000 of the most vulnerable for a further two months.

"This three-month intervention will ensure continued unconditional food support as lands are inundated and crop planting remains unlikely in many areas," said Nicole Carn, WFP Emergency Response Coordinator in the region.

"While floodwater is slowly receding in many areas, food insecurity remains a major concern in the affected areas."

The NDMA says it has handed out more than 230,000 37-kg ration packs with rice, flour, lentils and other essentials -- more than 50,000 of them in Jacobabad district.

But food problems look set to continue. The floods mean the "rabi" crop -- planted in the winter for a spring harvest -- will be disrupted, threatening supplies next year.

NGOs are warning that more help is needed, and quickly, and Wahab Pandhrani, who heads local aid group Pirbhat said Islamabad had let its people down by not appealing for foreign assistance.

"The government committed a huge blunder by taking the disaster too lightly," Pandhrani said.

"There is still time to launch an appeal for international help as we could face a huge problem in food security and malnutrition shortly."

Stacey Winston of the UN Office for the Coordination of Humanitarian Affairs (UNOCHA) said nearly $170 million was needed to support families for up to six months with food, water, shelter and other necessities, particularly with winter approaching.