Four days of winter storm all but halted the relief effort in Pakistan's earthquake zone earlier this week. The storm has now ended, but VOA's Benjamin Sand visited some of the hardest-hit villages, and he reports from Muzaffarabad that weary survivors - who know the region well - expect more bad weather before the winter ends.
American helicopters deliver a fresh payload of emergency supplies to Muzaffarabad, the largest city in Pakistan-controlled Kashmir, which bore the brunt of last October's devastating earthquake.
After four days of freezing rain and snow, officials here say relief operations are running again at full capacity.
But they say more bad weather is on the way, and temperatures are expected to drop significantly in the next few days.
In Hassan Gilyan, a small village sitting more than 1,500 meters above sea level, 65-year-old Mohammed Ayub says that without more help, he doubts his family will survive the long winter.
"I already have pneumonia," he said.
The canvas tent he and his family share leaks whenever it rains or snows.
During the storm, his family had to sleep in the gutted remains of their old home. He says the area normally gets more than a meter of snow every winter, which will last for at least another four months.
The October 8 earthquake killed an estimated 80,000 people and left more than three million homeless.
It did some of its worst damage in the higher and more remote Himalayan villages, like Hassan Gilyan, which were damaged by the quake itself and blocked by landslides. An estimated 400,000 people are still living in these remote villages, where weather conditions are considered the most dangerous.
Officials say that more and more families are packing up and seeking shelter further down the mountain. For many, their first stop is right here, at the American military hospital in Muzaffarabad.
Local officials have reported several cases of measles and meningitis. Captain John Fernaud, a U.S. army doctor, says the hospital is seeing a sharp rise in new patients.
"We're seeing a lot of respiratory illnesses, mostly pneumonia or asthma," said John Fernaud. "The main issue here is, they don't have access to health care, so that by the time we see them they're already very, very sick."
From here, many families make there way to one of the sprawling tent villages that sprang up in Muzaffarabad after the earthquake.
If they are lucky, they find room in one of the better organized camps, where experienced relief workers help coordinate everything from food distribution to proper sanitation.
But aid agencies say most official sites are already overcrowded. The United Nations says there are more than 250,000 people living in registered camps In Muzaffarabad.
New arrivals are increasingly forced to find space in the city's so-called spontaneous camps.
Some of these camps are managed by local charities and religious groups, but others lack any outside support whatsoever. Almost all are making do without even the most basic of facilities.
Not far from the hospital, Mohammed Javed lives with his wife and daughter in a small camp with about 20 other families. There is no running water here, and most people are using a nearby stream as a latrine.
"I'm not here by choice, " said Mohammed Javed. "The other camps in the area are already full, and this is all he could find."
Aid workers say health conditions in camps like this one are particularly bad, and will likely get worse during the coming winter.
Officials say their priority now is arranging proper shelter for as many people as possible, before the next storm hits.