Harsh Pakistan winter slows quake aid

A consortium of relief agencies, working with the military, has helped build more than 6,700 shelters like this in Allai Valley. The CGI sheets are provided free of cost, and the timber and stone are salvaged from old homes, keeping costs low.

Still, Mr. Wahab is one of the fortunate few. Logistical challenges, such as the road to Pashto, have meant that only 30 percent of required shelters have been built here, according to Army estimates. The International Organization for Migration (IOM) recently tried to send 3,200 CGI sheets, enough for about 320 shelters, to Bana, but landslides, snow, and ice prevented the delivery. "With snow and rain here, we're going to have an extremely hard time delivering goods," says Darren Boisvert, IOM's public information officer, adding that recent weather conditions have also grounded helicopter flights.

There are also concerns that many survivors are rebuilding their homes with heavy flat roofs and stone masonry, elements that made them deadly in the first place.

"They're building the old way. It's a problem," says Anna Pont, project manager for UN-Habitat, adding that A-frame structures and wood masonry are much safer. The next challenge for relief agencies, Ms. Pont and others say, is providing training to ensure that what survivors build doesn't simply collapse again.

For now, shelter is only part of the problem. The number of cases of pneumonia and acute respiratory infections are rising, according to doctors at a hospital in Bana run by Save the Children, a relief organization.

Access to medical treatment is also limited, with Save the Children's hospital and a Cuban medical camp the only full-time medical facilities in the Allai Valley. Army officers spoke of one man who carried his gravely ill infant daughter for miles to Pashto only to find no clinic. The girl apparently died on the return trip.

Conditions like this continue to push many survivors further down the valley, straining already overcrowded camps.

The Maira Relief Camp in Battagram, just south of Allai, is the largest in the quake zone. Steam hangs over its 2,300 tents, where stoves burn throughout the day, keeping more than 16,000 inhabitants warm. While the laughter of children resounds like a promising refrain, about 300 new survivors arrive here daily from Allai, threatening shortages.

The road to recovery this winter is thin and easily broken, like the road to Pashto. Weary men trudge its passes each day, carrying food and supplies on their backs. They are determined and there is hope, but also a sense of uncertainty.

"What I can say is that we are living paycheck to paycheck," says Mr. Vandemoortele of the UN, adding that the agency had received only $321 million in donations, about half of its appeal. "Cash and coordination are crucial."

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