With winter starting to set in, some survivors of Pakistan's earthquake are without shelter, sufficient food or warm clothing nearly eight weeks after the disaster struck.
The first heavy snow fell across the region at the weekend but while there has been no spike in the mortality rate, more deaths were inevitable unless aid reaches victims soon, aid officials said.
The focus of the relief effort was shifting towards food, even though shelters were still needed, said Jean-Philipe Bourgeois, a field coordinator for the International Organisation for Migration (IOM).
Jean-Philipe Bourgeois, field coordinator for the International Organisation for Migration
"It's a combined problem. Not only food, not only shelter, but both."
The earthquake on October 8th killed 73,000 people, most of them in Pakistani Kashmir and North West Frontier Province. Aid officials fear sickness sweeping through a cold and poorly nourished population will cause a second wave of deaths.
But a UN spokesman said there are deaths in the region every winter from cold-related ailments and it would be alarmist to talk of a second wave of fatalities from the cold now. "There will be some deaths but there isn't an unusual rate of death at this time," UN spokesman Ben Malor said. "We've done the best we can to reach these people and pre-position supplies."
Pakistan has won pledges worth more than $6 billion from world donors for relief and reconstruction operations in the quake-hit zone. Most of that was earmarked for long-term reconstruction.
UN and other aid officials say funds are short for a six-month emergency operation to keep survivors alive over the winter.
"In other disaster-hit areas there had been great efforts, but here not enough in view of the magnitude of the problem," Mr Bourgeois said. "The relief goods we have here for the survivors are just a drop in the ocean."