Quotes of the Day

Matt George, one of the tens of thousands of aid workers who headed to Pakistan after it was struck on Oct. 8 by its worst recorded earthquake, is accustomed to harsh conditions. But the American ex-surfer, who took up full-time volunteer work with the International Organization for Migration after he participated in relief efforts following the Asian tsunami and Hurricane Katrina, has found his work especially frustrating in the devastated Neelum Valley, located in the Himalayan mountains in the Pakistani-held portion of disputed Kashmir. After the quake, George, 49, became a familiar figure in the remote valley as he walked trails leading processions of porters toting pickaxes, shovels, bales of wire and plastic tarpaulins—the tools needed to build improvised shelters for survivors whose homes had been shaken into rubble. In late November, he went to check up on five widows for whom he had built lean-tos on a steep mountainside above the city of Muzaffarabad, not far from the quake's epicenter. To his dismay, George discovered that the structures had been torn down and the widows were gone.

"What happened?" he asked. None of the villagers answered. George later located one of the women, who was living under a splintered door propped against a boulder. She explained that village men had stolen the plastic tarps and metal sheeting that formed the walls and roofs. "The men were going to beat us, so we ran," she wailed. Outraged by this injustice, George cajoled villagers to collect fallen timber and started building a new shelter that should help her survive a brutally cold winter. "Not what I'd call a deluxe chalet," he said after completing the structure. "It's more Hobbit-esque."

Now, as the freezing weather closes in on the Neelum Valley, which climbs to 2,425 m above sea level, George and legions of other relief workers are worried that their efforts won't be enough. The earthquake that ripped through Pakistan and India killed more than 75,000 and injured more than 128,000. It also left some 3.5 million people without livelihoods, food or homes. Short on supplies, and with time and nature working against them, aid workers are struggling to protect those survivors and prevent further deaths. "This is a perfect storm of relief obstructions," says Thomas Miller, chief executive of Plan International, an aid agency helping children. "You have landslides, snow and no roads to reach the people way up in the mountains." Further complicating relief efforts is the danger that militant Islamic groups operating from camps in Pakistani-controlled Kashmir could resume their long-simmering war for control of the region, where an uneasy cease-fire has held since 2003.

Because winter snows and heavy rains make many of Kashmir's roads impassable, the U.N.'s World Food Program (WFP) reckons that helicopters are the only means of bringing food to 400,000 quake victims stranded in remote mountain villages. While nearly a dozen governments, led by the U.S. and Saudi Arabia along with the World Bank and other financial institutions, have pledged more than $5.4 billion in funding for the long-term reconstruction of Pakistan, aid organizations say they aren't getting the backup they need. Private aid agencies complain that donors are tired of digging into their pockets after a string of disasters—from the 2004 tsunami to Hurricane Katrina. Action Contre la Faim, a French agency with branches worldwide, says that in the three weeks after the tsunami, it raised $475,000 in cash from American donors. In the same period after the Pakistani quake, it collected only $47,000. So far, donor nations have contributed just $85 million of the $181 million the WFP says it needs for emergency airlifts this winter.

That WFP estimate covers only the cost of food to ward off starvation (the quake destroyed the villagers' regular winter stores). Helicopters cost up to $16,000 an hour to operate, and much more money is needed to rebuild homes and schools and to provide medical care for the sick and injured. The weather has been relatively dry so far. But with temperatures in areas above 1,500 m now dipping to -8°C, shelter is an immediate concern. There aren't enough tin sheets, a construction staple, to go around. At higher elevations, only about 10% of residents have them, says Sardar Rafiq of the U.K.-based NGO Islamic Relief. Many do have tents—the Pakistani government has distributed more than 245,000 of them—but they will be "useless," says Rafiq, "in the case of snow and rain. People cannot warm themselves in them."

The cold is already taking a toll, as hundreds of enfeebled men, women and children flock to medical camps each day complaining of chest colds, flu and other seasonal ailments. "The quake destroyed the entire private set-up of village doctors and paramedics," says Faisal Edhi, trustee of Karachi-based NGO the Edhi Foundation. "There is a shortage of doctors and nurses, so people now have to travel far to get to the doctors in makeshift medical camps." Because people have no money for fuel, they can't cook meals, adds Rana Khurshid Amed, a Neelum Valley forestry official, "so they look to the government and to God for help. It's only God who is there. Let's see how many people survive the snow."

If they do, it will be thanks not only to divine intervention but to an extraordinarily wide-ranging effort on the ground. Scattered in some 75 camps throughout Kashmir is an eclectic mix of professional aid workers, foreign volunteers, Islamic extremists and soldiers (Pakistan alone has committed about 40,000 troops to relief efforts). In some cases, old adversaries have set aside their enormous differences, at least for now. Before the quake, the mountain valleys of Pakistani-controlled Kashmir were off-limits to outsiders. Called Azad Kashmir (Free Kashmir) by the Pakistanis, the area was cordoned off by the army because, in the decades-long conflict with India for control of Kashmir, Azad was an unofficial war zone. The bus stations and grungy hotels of Muzaffarabad swarmed with secret police on the prowl for unwelcome strangers such as journalists, foreign diplomats and Indian spies.

Meanwhile, shadowy Islamic groups ran clandestine camps that trained jihadi volunteers in guerrilla warfare and slipped them across the Line of Control—the unofficial border between the Pakistani and Indian areas of Kashmir—to ambush troops, Hindu civilians and politicians on the Indian side. President Pervez Musharraf, under pressure from the U.S. after 9/11, says he closed the camps in Azad Kashmir. But as recently as last August, according to sources in the militant groups, bands of guerrillas were still crossing over the Line of Control, dodging Indian land mines and patrols.

But the quake has changed everything. The necessity of coping with the devastation in Azad Kashmir has strengthened the precarious cease-fire and forced the Pakistanis to open up. On the mountainsides where thousands of refugee tents have sprouted between collapsed buildings, the U.S. military is delivering drinking water to camps run by "Axis of Evil" nemesis Iran; U.S. and NATO soldiers flirt with Cuban nurses. But the most surreal partnership of all is between the U.S. military and Islamic militants from groups like Lashkar-e-Toiba, branded by Washington as terrorists. Bemused to find himself at daily briefings in Muzaffarabad with U.S. and NATO military commanders, one Pakistani militant leader, Haji Javed ul-Hassan, remarks: "This is not a battlefield, it is a battle of relief."

Yet the three main Kashmir militant groups—Lashkar-e-Toiba, Hizbul Muja-heddin and Jaish-e-Mohammad—have also used the earthquake to stage a comeback there. Ex-guerrillas now deploy their motorized rubber boats, on which they had trained for commando maneuvers, to ferry passengers across the Neelum River where bridges have collapsed. Immediately after the quake, militants were first on the scene in many villages, getting there far quicker than the Pakistani army, and they applied their expertise in first aid to save injured people pulled from fallen buildings. Their knowledge of the saw-backed ranges along the Line of Control has made it possible for them to reach quake-struck hamlets bypassed by the big aid agencies.

A few diehard guerrillas are still crossing over the Line of Control to battle Indian troops, several militants say. It's possible they will redouble their attacks once the emergency has passed. Others fear that support for the militant cause will be boosted by the well-publicized success of their relief work. Ryan Crocker, U.S. ambassador to Islamabad, has noted his "concern" over the renewed strength of the jihadi groups, which may now find it easier to attract recruits and to wield political influence among ordinary Kashmiris. Still, the militants worry about another crackdown by Musharraf. As Lashkar-e-Toiba spokesman Yahya Mujahid told TIME, "We fear the government will toe the American line and curb our humanitarian work." And if that happens, says Mujahid, "The Kashmiris will die of hunger."

Meanwhile, the frantic efforts of relief workers like George continue. But with blizzard season setting in and supplies short, he feels increasingly helpless. "There's just not enough aid getting up the mountain," George says. "And we're running out of time."

• Tim McGirk | Neelum Valley
• Pakistan's earthquake survivors face an ominous winter as undersupplied relief workers race to keep them fed and sheltered