Latest from the Quake Zone

Photo: Cassandra Nelson/Mercy Corps

Cassandra Nelson is Mercy Corps' senior global media and communications officer, based in Islamabad, Pakistan. For the past week, she's been accompanying emergency-aid workers as they deliver medical care and assess ongoing needs in villages affected by the earthquake.

Here are excerpts from the report she filed on Tuesday from the field:

On conditions in the affected area:

The temperature now falls to 3 degrees centigrade (37 degrees Fahrenheit) at night in some parts of the disaster area. Where we're working, it's expected to start snowing within the next 3 weeks. Already there is snow on the mountains above us that is clearly visible -- a reminder of the limited time we have to work.

It has rained for several days, but today the skies are clear. The rain has washed out many of the roads that had been opened, making it very difficult to get large trucks through with aid shipments. We've had to transfer many loads from one large truck onto numerous smaller vehicles that can drive along the deep mud-rutted roads.

The high use of many small vehicles is causing terrible traffic jams everywhere, especially in population centers such as Mansehra, which slows aid delivery.

Rain and cloudy conditions have also grounded helicopters, further delaying aid deliveries.

On the well-being of survivors:

Many of the survivors do not have any form of shelter yet. On the streets, people squeeze under overhangs and any other cover they can find to protect them from the rain. Crowds of children and men huddle around wood fires for warmth.

Frustration levels are rising as people wait for tents and receive other items they do not need. There have been reports of violence and looting, almost all a result of desperation.

Injured people are still making their way down from isolated (and unserved) villages seeking medical care. Our doctors are seeing more cases of severe secondary infections and gangrene. They're also seeing the first cases of severe diarrhea, a telltale sign of a looming outbreak of water-borne illnesses such as cholera and dysentery.

These illnesses are life-threatening for everyone, especially children, the elderly and women who are nursing or pregnant.

The people on the streets of the communities where we are working appear to be in a state of shock. They are often confused, staring into space and look lost and hopeless. Many of the children I have talked to cannot answer simple questions (such as, What is your name? How old are you?).

Many have lost parents and siblings, and have been put in the position of having to care for their other siblings, either because their parents are dead or distracted by trying to get aid distributions for the family. I've seen many children in the streets carrying younger siblings, many with injuries that have been treated and bandaged. These children are shocked and confused and very vulnerable.

On aid delivery:

Survivors that we're working with are telling us they do not need food or clothing - they've received a lot from the Pakistani military and from Pakistan citizens. They do need tents and blankets. (It's difficult to tell whether these needs reflect the wider affected population.) There are still many reports of villages that have not received any aid, and are in desperate need of anything and everything. The communities where we are working are generally accessible by road, and thus have received distributions from many sources, mostly clothing and food.

On the response from Pakistanis:

The outpouring of assistance from Pakistanis who were not affected by the quake has been tremendous. In the cities, there are major collection drives (blankets, food, etc.) to deliver to the affected areas. These efforts are a mixed blessing: on the one hand, it's great they are able to assist, but the many of the distributions have consisted of just throwing stuff off trucks, which has created security concerns and unruly crowds. Then there's the crush of traffic on the roads this creates as everyone rushes into help.

Since I've lived here a long time I have received many calls from Pakistani friends who want to help, and are seeking advice on how they can deliver goods they have collected for people in need. We have also received several offers from Pakistani volunteers. Tomorrow, two Pakistani women will be coming up to Mansehra to assist us with assessments or distributions. They'll be especially helpful in communicating with the women survivors, who have been cloistered and not usually seen in public. We have received many other offers of volunteers that we are assessing and trying to determine how we can utilize them.

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Nelson plans to be in the field the rest of the week, returning to Islamabad on Monday. Mercy Corps continues to solicit help to enable the agency to continue to deliver critical medical aid and other essential supplies in these critical weeks before winter arrives.