The death toll from twin earthquakes in Venezuela last month has risen to 3,889, the government has said, as regional health agencies warn of an increased risk of disease.

National Assembly President Jorge Rodrigues said on Thursday at least 16,740 people had been injured and 17,907 displaced.

The Pan American Health Organization (PAHO) warned that displaced people across Venezuela’s northern coast, the area most affected by the tremors, are at risk of disease because of limited access to clean water and regular medical care.

“In the coming weeks, the greatest health risks may stem not only from injuries caused by the earthquakes, but also from disruptions to health services, overcrowded conditions, deficiencies in water and sanitation and reduced access to vaccination and routine healthcare,” PAHO’s director Jarbas Barbosa said.

The agency is working with Venezuela’s health ⁠ministry to improve vaccine access and trace any outbreaks of respiratory or digestive illnesses, especially in shelters set up for those who lost their homes.

The United Nations has launched an appeal for roughly $300 million to assist 1.3 million people in urgent need of aid.

“It is clear at displacement sites that, particularly after two weeks, that people are turning up because they haven’t been able to get their other treatments,” UN relief chief Tom Fletcher told The Associated Press during a visit to Venezuela.

“So, they’re not turning up with just the fractures now, they’re turning up with those longer-term health needs. And it’s vital that we’re there for them.”

Doctors treating people in the northern state of La Guaira’s Catia La Mar community on Thursday reported an increase in skin conditions and diarrhoea, as well as of requests for medications for the treatment of chronic illnesses including diabetes and high blood pressure.

The emerging diseases are linked to crowded living spaces and poor water and sanitation conditions, which in many communities predate the earthquakes.

Much of the assistance on the ground is being delivered by local groups that have partnered with global humanitarian organizations.

Until recently, nongovernmental organisations were targets of government repression. When President Delcy Rodriguez was serving as vice president to former President Nicolás Maduro, NGOs were repeatedly accused of anti-government activities and the UN local human rights office was shut down. Now NGOs says there has been increased cooperation with government departments since the earthquakes.

“When you have a crisis of this magnitude, people put the politics to one side and are able to focus on saving as many lives as possible, and that’s what I’m seeing so far in this response,” Fletcher said.