Corpses covered in flies lie outside city morgues. Inside, bodies up on bodies are piled high.
Hospitals are overwhelmed, relying on volunteers and donors for ice, water and even spare beds.
By Thursday, the death toll from the oppressive heat wave in Sindh province topped 1,000, officials told CNN.
But even without the numbers, the full extent of the misery isn't hard to gauge.
At the Jinnah Post Graduate Medical Center in Sindh's capital, Karachi, heat stroke victims are wheeled in daily, swelling the numbers well beyond capacity.
The overwhelmed doctors and nurses do what they can.
But with supplies limited, the government-run hospital is relying on volunteers and donors for even the basic necessities, they say.
Family members tend to many of the patients, wiping their brows with sponges and keeping them cool with wet, grimy towels.
"I felt so hot, I was vomiting," an elderly man told CNN. "I felt weak and my heart sank."
At the Edhi morgue, the largest still operating in Karachi, the picture is even more dismal. A charity runs the facility, but it's struggling.
The stench of death is felt even before visitors reach the gates.
A handwritten sign outside says the morgue is filled to capacity, while bodies lie outside.
Daily power outages, as the city tries to keep up with the demands of 16 million residents, mean the cold storage unit that houses bodies is hot and sticky.
The dead, it seems, are denied the dignity they deserve.
The city is used to baking in the heat around this time of the year, just before the monsoon rains arrive as welcome relief.
But this year's heat wave has been particularly brutal.
It began Friday. On Saturday, temperatures reached 44.8 degrees Celsius (112.64 degrees Fahrenheit) -- the highest-recorded temperature in the country in the last 15 years.
Sunday's temperature dipped slightly to 42.5 Celsius (108.5 F).
Cooler temperatures are expected to arrive later in the week.
The heat wave comes at a time when this predominantly Muslim country's citizens are observing Ramadan. During the holy month, the faithful fast from sunup until sundown.
This means that, amidst these scorching temperatures, Pakistanis are forgoing food and water.
Clerics are reminding residents that they can forego fasting if they feel the soaring temperatures are life-threatening.
"My son had a high temperature and then he had a fit," one woman told CNN
Asked if she had water and electricity, she replied, "Nothing. We have none of those things."