THE headache of how to shelter hundreds of thousands of quake survivors who now face a fresh threat with the onset of the bitter Himalayan winter continues to haunt aid workers in the mountains of Pakistan a month after the disaster.
"The first snowline at around 1,500 metres (4,900 feet) marks the line of risk. People who stay above it will be in serious danger," regional United Nations coordinator Rashid Khalikov said during his visit last Sunday to Bagh in Pakistani Kashmir and Batagram further west.
Nestled above this point at an altitude of 1,600 metres in the mountains circling the town of Bagh, the small village of Ratnoi accommodates hundreds of patients who seek treatment in the tents of foreign aid organisations.
But close by, the inhabitants of houses which lie now in ruins in the clutch of the mountains did not receive any help. Thousands of other houses, scattered beyond the summits and invisible, are also cut off from the rest of the world.
"This is an emergency worse than the earthquake. Thousands are going to die of hypothermia if they don't get shelter," said Louise Paterson from the American Refugee Committee which has set up a small medical centre in the village.
"We have a small window of opportunity, two weeks. People are in the mountains without shelter, they don't want to leave their ancestral land, their family," she said.
Doctors have noticed an increase in acute respiratory problems, bronchitis, pneumonia.
"You have to treat them otherwise they will die," stressed Dagmar Chocholackova, a young woman doctor with the Czech organisation People in Need.
Around the devastated cities of Muzaffarabad and Balakot, tent cities shelter hundreds of thousands of survivors of the massive quake on October 08.
The reopening of some sections of road has made it possible for some relief supplies to get through to the needy.
Many high altitude areas remain inaccessible, because landslides block the way or because the houses are so widely dispersed throughout the immense mountain ranges, as in the valleys of Kaghan, north of Balakot, Jeelhum and Neelum, in Kashmir, and Allai, the north of Batagram.
"Hundreds of thousands of people are still in serious danger," Khalikov warned.
"The priority is still to provide them with shelter, to try to reach those who are in danger."
To this end, international organisations and the Pakistani army have been preparing camps to accommodate the villagers in the valleys, while at the same time sending building materials into the mountains to repair damaged homes.
"With heavy snow falls, the tents will not stand in high altitude," said UN representative Jemilah Mahmood.
But many villagers cannot bring themselves to abandon the little comforts which make up their lives: their houses, even destroyed, land and cattle.
The situation is particularly urgent in the narrow Allai valley, a hundred kilometres from the quake epicentre, where the UN say up to 80,000 people are at risk.
The army tried to persuade the villagers to leave, without much success. The few tracks that lead to the remote area will soon be blocked by snow.
On top of the logistical nightmare, there is a lack of money from donor nations.
"The risk remains," Khalikov reiterated, "that we will have to cease our operations. The international community always stops to ask itself if it needs to give us money. It is a very dangerous game."
Meanwhile, Monday's opening of their frontier by Pakistan and India in divided Kashmir for earthquake relief, has raised hopes for progress towards resolving their corrosive dispute over the territory.
After the meeting at 0620 GMT (11.50am Indian time, 12.20pm Pakistan time) between the army commanders and government officials from the two sides at the Line of Control (LoC) -- the de facto border dividing Kashmir -- and shaking of hands before posing for photographs, Indian civilian porters began unloading the trucks and handed the supplies to civilians on the Pakistani side. This was for the first time ever a shipment of relief had crossed the frontier.
Neither group of civilians, nor the trucks actually crossed the border.
White tape had earlier been laid along the LoC at the crossing -- Titrinote on the Pakistani side and Chakandabagh in the Indian zone -- and both sides had laid out red carpets.
A sign on the Indian side read, "We have not opened the LoC, we have opened hearts."
An Indian army officer said while earthquake relief would start flowing across the LoC, no civilians would yet be allowed to cross over.
"The ceremony is to hand over 25 truckloads of relief to the Pakistani side. This includes tents, rations and medicines," said Shantanu Ghosh, commanding officer of Poonch district.
"There will be no cross-border movement of people. We have asked for the names of people who want to visit their relations in India across the border and Pakistan also has asked for the list from the Indian side.
"It will take time. It will take at least seven to 10 days for the lists to be prepared but no dates have been fixed so far."
The two countries have fought three wars, two of them over Kashmir, but began a ceasefire on the LoC in late 2003, followed by a complex, slow- moving series of mutual confidence-building measures in January 2004.
AFP and AP