"I have to do it or else they will die of thirst or even worse -- diseases," the elderly woman said in Akharaghat village in the north of the state, where rain and Himalayan snow melt has combined to flood half of the 38 districts.

Singh is one of 11.5 million people affected by floods in Bihar, many of them left with little food to eat or clean water to drink, and public health experts warn disease could follow as the waters recede.

Like the old woman, the entire village in the worst-hit Darbhanga district is now camping on a dirt road as they wait for food to arrive from state capital Patna, 125 kilometres (77 miles) to the southwest.

"We have not even seen a single relief official in the past one week," said Muneshwar Singh, the woman's husband.

More than a quarter of Bihar's 6,000-plus flood-hit villages are in Darbhanga. Relief has been limited for swathes of the 2.5 million people hit by floods in this stricken district.

The worst floods in 30 years have left some areas partially or totally submerged and unreachable by boat, officials say, and relief packets can only be airdropped there by army helicopter.

But even in villages reachable by road, many say they are going hungry.

"We have not received any relief or even a fist-full of grains in the past 15 days," said Shauki Sani in nearby Majhouli village.

"Our entire family is going hungry."

A long stretch of the highway to the capital is now dotted with clusters of new shanties housing cattle and families who fled their homes after rivers burst their banks and flooded farmland.

State officials travel with armed guards, apparently in fear of attack by desperate flood victims in the deeply poor state with an already entrenched reputation for lawlessness and crime.

Health experts also warned of the possibility of disease following the floods.

"There is a huge chance of an outbreak of disease when things of this magnitude happen," said A.K. Pande, head of the Patna Medical College and Hospital, the state's largest healthcare facility.

"Receding floodwaters leave behind sludge and debris, which becomes the breeding ground for epidemics."

But the state's disaster commissioner told AFP Monday the relief operation was "in full swing" and that 1.5 million kilograms (3.3 million pounds) of wheat and rice had been distributed so far.

"The waters are also receding and that is helping us to augment relief operations," said Manoj Kumar Srivastava from capital Patna.

"Our commitment is that we will reach everyone who has been left out."

Srivastava said about 4,000 non-motorised boats were delivering relief to areas reachable by water while four army helicopters were dropping supplies to villages that were cut off.

Darbhanga district official Upendra Sharma said that the situation was improving with the area once again linked to the state capital.

"Very soon we pray heavy vehicles carrying essentials will be able to reach us," Sharma told AFP.

For one old man, however, those supplies will arrive too late.

In the district of Muzaffarabad, due west of Darbhanga, a crowd milled around near the body of an old man who died of starvation on a pavement Monday.

Bystanders said the 75-year-old man had been abandoned by his fleeing family.

"He has been lying here for the the past three or four days and finally hunger seems to have finished him off," said a man who was part of the crowd.

"If things do not improve there will be riots for food."

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