Hamida likes her job, but she's doesn't know how much longer she can practice it. The 26-year-old is a "lady health visitor," a clinic-based paramedic tasked with providing reproductive and family planning assistance to the women of her community Dherai in the Swat Valley. "The situation was good until recently," she says, "and then last week somebody blew up the school."
Throughout the interview, Hamida is shrouded in her flowing cream dupatta, its green horizontal stripes firmly fixed over her hair, mouth and nose. She is covered up despite the fact that she is indoors, away from windows, and there are no men present. "If it gets more dangerous, I can't come to work," she says. "The security level is high now." The doe-eyed mother of two requested that TIME use only her first name. Her co-worker Falak, a bespectacled mother of four, makes the same request. She also keeps her beige dupatta firmly fixed over her face throughout the interview. "The Taliban's requirements are to cover yourself," says Falak, 30. "I think that because we are properly covered we shouldn't feel a threat from the Taliban. If we are going to come to work, I know to not look around or laugh on the streets but to just mind my own business. That way they won't say anything."
The Pakistani military last year claimed to have pounded out the Taliban threat in these soaring, craggy green slopes. But now the Tehrik-e-Taliban Pakistan have openly claimed responsibility for destroying the boy's school Hamida referred to, just a few hundred meters north of Dherai in the village of Koza Bandai. It also said it was behind the killing of a member of Dherai's anti-Taliban peace committee a week before that. (On Friday, in the town of Darra Adamkhel, about 40 miles south of Dherai, the Taliban appear to have bombed a mosque, killing 45 people.) The insurgents have not disappeared. Now, with the military diverting manpower toward flood relief, and the civilian government weaker than ever, the militants appear to have regrouped.
The waters of this summer's massive floods have receded here in the northwest. But their impact weighs heavily on the security situation. "A lot of people from these far-flung villages have lost everything [because of the floods] and have come to the cities looking for work. They are vulnerable," says Falaknaz Asfandyar Amirzeb, a social activist and the widow of a prominent local anti-Taliban official who was assassinated the day after Prime Minister Benazir Bhutto was murdered in 2007. "This is the perfect situation which the Taliban is waiting for. There is a void, the fear is there, and the void may be filled very easily by the Taliban promising money."
Few here believe that the Taliban will once again control huge swathes of Swat, and enforce their severe, Islamist writ on a cowed populace, but something is afoot in these frontier territories near Afghanistan. The Pakistani army maintains a large and clearly visible security presence. Towns, including Koza Bandai, were placed in temporary lockdown recently by the military as it conducted house-to-house searches for weapons caches and suspected militants. Paramilitary Frontier Corpsmen in black uniforms man checkpoints dotted along the winding roads of this once-popular Hindu Kush tourist destination. Nighttime curfews are in effect throughout several villages, including Dherai, and sporadic armed clashes continue to be reported in the local media. Major Mushtaq Khan, army spokesman in Swat, says the aim of the Taliban violence is "mostly to create a little panic among the people, so that the people have the feeling that they are not safe." Still, he adds, "whenever [the Taliban] come near population areas, the population is with the army, and they give the information to the army and the Taliban are killed."
"We are so used to danger, that we're not easily afraid," Hamida says. Still, both she and Falak requested that the identity of the international NGO they are affiliated with be withheld. Aid workers, particularly those working for international groups, have come under attack by militants in the past, especially those organizations aiming to improve the lives of women. In the bad old days, Hamida's clinic often received threats from the Taliban conveyed by phone, she says, but she and Falak continued to come to work when they could.
Several lady health visitors in rural clinics, as well as doctors and nursing supervisors in the two main hospitals in both upper and lower Swat interviewed for this article said that while they haven't been directly threatened since the military ousted the militants, they are still taking precautions. One doctor who works in the rural clinics of Upper Swat told his employer he is still reluctant to tell people he works for an international NGO. "At checkpoints I tell them I am from the department of health. You never know, they might transfer information. I never give complete information, I try to dodge their questions," he said. "The militants are not neutral when it comes to health; they are exploiting a situation and we must take precautions."
Swat's female health facilities cannot afford to lose personnel. Further north at Matta district headquarters hospital, which serviced 15,500 patients in September and is one of the largest health facilities in Upper Swat, the maternity ward doesn't have a permanent doctor, and there is no gynecologist. The ward, which saw 364 patients last month, needs three female doctors, six lady health visitors (LHVs) and three midwives, according to Akbar Ali, a hospital administrator. Instead, it has three LHVs and two midwives. "and they're from the NGO side, not the government side," says Dr. Amjed, who works in another ward. The health department hasn't filled the positions, and the hospital can't afford to lose its LHVs. "Their role is crucial," says Ali. At the moment, he says, security is holding, but several militants have been killed in clashes with security forces in Matta over the past few weeks.
In Dherai, at the single-story health clinic with mottled white walls and Grecian blue arched windows, Hamida and Falak say they'll continue coming to work for as long as they can. Says Hamida, "But if there is any danger to us, then we won't come."