Pakistan: Arriving by donkey, helicopter, or on the shoulders of desperate relatives, grievously injured villagers are still streaming into makeshift hospitals in northern Pakistan 16 days after the earthquake that destroyed their world.
By mid-afternoon yesterday patients had passed through a well-equipped field hospital run by army medics from the United Arab Emirates (UAE). A total of 70 per cent had infected wounds; many were being treated for the first time.
Nakash Ahmed (8) came with a large gash across his head seeping with puss. Half-crushed by a falling roof, he suffered for two weeks until his father managed to carry him from their mountain village to safety. The wound was wrapped in a dirty cloth.
"It's unbelievable. We've seen wounds here that we've never seen before," said Dr Abdullah Alkaabi. "There is no textbook for this."
The lucky ones make it to the UAE hospital near Balakot, which is equipped with an air-conditioned operating theatre, digital X-ray machines and a helicopter on standby to take the most serious cases to the Middle East for treatment.
But thousands more quake victims are hidden behind the mountainous wall that overlooks Balakot, cut off behind a chain of landslides. Relief workers say time is running out to save them.
The winter starts to bite three weeks from now; it will have gripped the region by the first week of December. "It is very high risk that this population is in," UN co-ordinator Rashid Khalikov said in Muzaffarabad. "Whether we are able to do it or not we will know only six weeks from today. But we will do our best." The frantic emergency effort is hampered by a shortage of helicopters and tents.
Neighbourly goodwill is also in limited supply. Both India and Pakistan say they want to open up the disputed Kashmir ceasefire line that divides them to facilitate an easy flow of aid.
Yesterday Pakistan suggested opening five border posts; India said it would set up refugee camps. Yet there was no action by day's end, although an Indian foreign ministry statement suggested that both proposals could be "reconciled".
The international aid momentum is building, spearheaded by the military. Three heavy-lifting Chinook helicopters are due in Islamabad by this morning. In Muzaffarabad Gen John Abizaid, chief of the US central command, promised to "do whatever is possible to help Pakistan". He said 15 extra American helicopters would be arriving soon.
Attention is turning to freeing the roads. Nato is sending an engineering battalion to start clearing landslides and establish more field hospitals. The Pakistani army is already working around the clock to open up the worst-affected valleys, but warns that it could take six weeks in some areas.
The frontline of aid operations is moving further into the craggy mountains. Immediately after the quake, Balakot was a focus of relief efforts. Now aid workers have flooded in, the crisis has eased, and the town is being used as a launchpad for soldiers and relief workers to push into more inaccessible areas.
Yesterday Maj Muhammad Younas, a Pakistani army medic, stood outside a half-deserted first-aid station. By mid-afternoon his team had treated just 15 patients. Most of his medics had been deployed to the "forward areas", he said, gesturing down the valley.
"That's where most of the casualties are now," he said. "Behind the landslides."
An unlikely coalition of helpers has been forged out of the chaos. On Balakot's main street jihadi sympathisers from Jamaat ud-Dawa set up camp near a banner announcing the "Korean Buddhists medical camp". By the river lay a pile of discarded food tins bearing the stars and stripes and the logo "A gift from the American people".
But not all generosity was welcome. Mounds of discarded secondhand clothes were littered across the town. Abdul Sabur (24) waded ankle-deep through a pile of shirts, pants and blouses.
"Here people have too much of everything now," he said. "But up the valley, beyond the landslides, the people are starving. Even the dead have not been buried over there." Yet the distributions continued. Volunteers from al-Khidmat, the charity wing of a hardline Islamic party, tossed fresh bundles of clothes from the back of a giant, garishly decorated truck.
"These clothes have come from Peshwar for the people here. So we must give them out," shrugged Naeem Shah, an 18-year-old worker.
A few hours later another aftershock hit Mansehra, the nearest main town. Buildings that had not been knocked down already swayed slightly. Unbroken windows vibrated.
And the nerves of the quake survivors, who had started to bed down in newly created refugee camps, became just a little bit more frayed.
- (Guardian service)