LONDON (AlertNet) - A typhoon that smashed across Vietnam last week may have spared their lives but it destroyed their homes and livelihoods. Now disease and hunger loom as flood waters stagnate and thousands of people remain cut off from help.

Surviving in these conditions is a new test for thousands in Vietnam after Typhoon Ketsana hit the country's central coast, killing at least 163 people and displacing 150,000.

"Families are just glad to be alive. The floods came in the middle of the night so they fled from their homes to higher ground and when they returned, there was nothing left," said Nguyen Van Gia at Save the Children after returning from one of the affected regions, Quang Tri.

"They escaped with their lives but now they face a struggle to survive."

Some 19,000 families have not yet received any aid, most of them in flooded mountainous areas cut off by landslides, said the relief group.

Aid workers say they have seen carcasses of dead animals in flooded areas and many hectares of destroyed crops.

"The flood water is going down but is still up to eight metres in some places near the sea," Nick Finney at Save the Children wrote in a blog on Monday.

"A man in one of the local search and rescue teams was killed yesterday. He drowned whilst trying to rescue an old lady who was trapped on her corrugated iron roof."

Cases of diarrhoea, malaria and other diseases have risen and some clinics are running out of medicines.

The survivors urgently need clean water, sanitation and food. Some families send their children to catch fish in streams as food supplies are scarce.

The poor, especially those that live off the food they grow, have been hit the hardest and will take the longest to recover.

Typhoon Ketsana first smashed through the Philippines where it killed nearly 300 people and forced about half a million from their homes before sweeping through Vietnam, Cambodia and Laos.

Nguyen Hungha with the Red Cross related the story of Le Thi Hong's family he had met in Quang Ngai province of Vietnam.

"They are a young couple with four children and are very poor. They did not have much before the typhoon, now they have almost nothing."

He added that the local authorities had promised to give the family up to $600 for a new home. "That is good but only half of what they need. He is unlikely to raise the rest himself, as this is a huge amount for a poor fisherman with four children."

The aid worker also met an elderly woman whose house had been badly damaged and would likely have to be knocked down.

"She was not crying, but I could see the sadness on her face as she walked around her scattered belongings in what had been her home for many years."

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