Homeless hibernation

For workers at Kunhar Christian Hospital in the rugged hills of Manshera, Pakistan, limited medical supplies and treacherous road conditions aren't the only obstacles they've long faced. The openly Christian ministry situated in a heavily radical Muslim region has also faced persecution and aggressive opposition, particularly from leaders of a local mosque who have pressured the government to shut down the 16-bed facility.

But when a 7.6 magnitude earthquake wracked northern Pakistan last October, killing more than 80,000 and leaving some 3 million homeless, mosque-goers just 10 miles from the epicenter were surprised to receive critical help from the Christian neighbors they had worked to expel. In the quake's devastating aftermath, Kunhar Christian Hospital's staff provided them with funds to dig a well, an urgent necessity in a region that lost access to clean drinking water.

Tensions between the two groups eased, and "the whole thing has really turned around," says Sarla Mahara of Christian Aid, a Virginia-based ministry that supports the hospital. Ms. Mahara told WORLD that Muslims in the region are "more welcoming and more curious" toward the Christian community: "Every time a Christian comes to their door to offer help, they wonder why they're doing it. . . . Impressions of Christianity are really changing."

The work at Kunhar Christian Hospital is a modest piece of a massive relief effort still underway in the hardest hit areas of Pakistan. The work of dozens of relief groups, both religious and secular, has taken on a frantic pace in recent weeks as hundreds of thousands of displaced survivors prepare to endure a severe Himalayan winter that could bring as much as 5 to 10 feet of snow in elevations above 5,000 feet.

This month severe weather has stifled UN efforts to reach tens of thousands of people stranded at high elevations in isolated villages cut off from roads by landslides and avalanches. The UN deployed helicopters to deliver aid to those living in below-freezing conditions in dilapidated tents with dwindling food supplies. But snow, wind, and rain grounded the flights for days.

The harsh weather also forced former president George H.W. Bush to cancel a planned visit to hard-hit Kashmir on Jan. 17. Mr. Bush traveled to Pakistan as UN Secretary-General Kofi Annan's special envoy for the quake. Mr. Bush, 81, instead visited a massive camp on the outskirts of Islamabad that is home to 30,000 survivors of the quake. The former president said he has "a great affection in my heart for the Pakistani people," and said his role will be "mainly to encourage people that have pledged money to get it in." Pakistani Prime Minister Shaukat Aziz told Mr. Bush: "We have total pledges of $6.4 billion now, about $4 billion in debt, and $2.4 billion in grants. All this now we have to convert . . . to reality."

Before the snow began to fall, thousands of survivors had hiked miles down perilous mountain slopes to valleys below, joining thousands more settling in impromptu tent cities. On Jan. 14, 100 days after the quake hit, the UN said tens of thousands of people were living in some 100 camps in the North West Frontier Province and the Pakistani-controlled region of Kashmir.

Weather conditions in camps at lower elevations promise to be less severe, but tent-dwellers won't escape freezing temperatures and heavy snow. Mercy Corps, a Portland-based, nonprofit relief organization, offers an alternative to the standard tents that are unable to bear snow loads. The organization discovered the idea by observing survivors scrounging for scrap materials, according to John Stephens, a program officer for Mercy Corps' South Asian desk. Mercy Corps quickly began a cash-for-work program, paying people a daily wage to return to their homes, salvage scrap material such as wood and metal, and stockpile it for the construction of semi-permanent structures. The modest wages infuse cash into the local economy and help meet temporal needs, while the scrap materials eliminate the need to order costly, heavy-duty tents. "Within a week or so they usually have enough materials to build a structure that will last through the winter," said Mr. Stephens. Mercy Corps workers join the locals to build small structures that will withstand rain and snow.

Aid groups often go into towns "where not a building is left standing," according to Mr. Stephens, who was in Pakistan at the time of the quake. When he reached the northern city of Balakot, population 80,000, Mr. Stephens said, "There was nothing left standing. Nothing. Not a light post, not a bench." As many as half of the city's residents were killed, the government estimates. In Balakot and surrounding regions, about 5,000 people have participated in the cash-for-work program. "Everyone who wants to work can work," said Mr. Stephens, including widows and other vulnerable groups.

Further north, some 70 miles from the quake's epicenter, volunteers at Bach Christian Hospital are treating a steady stream of patients and are passing out relief kits with blankets, food, pots and pans, tents, and tarps. According to one aid worker, the hospital's "greatest contribution" to survivors is "listening to their stories, crying with them, and speaking comfort into their minds and hearts." Volunteers from The Evangelical Alliance Mission (TEAM), a Wheaton, Ill.-based group, are assisting hospital staff and building Quonset-hut-style shelters that provide 12 feet by 10 feet of living space per family.

TEAM workers are planning on longer-term community development projects after residents get through the winter, but staying in the country may become difficult for short-term workers. Volunteers say the Pakistani government is requiring all foreigners helping with ongoing work to secure a visa, a process that may prove complicated and costly. According to one TEAM volunteer, the government is also warning groups against proselytizing: "The government has warned the NGOs [nongovernmental organizations] that if they do evangelism while helping people, the ones doing it will be forced to leave."

The complications associated with short-term travel to Pakistan are one reason that Christian Aid, the Virginia-based group assisting Kunhar Christian Hospital, relies entirely on indigenous workers to carry out relief and other mission efforts. Ms. Mahara cites several advantages: "They speak the language, they look the same, and they can move about relatively safely." She also says employing locals is faster and much more cost-effective. Staff at the Kunhar Christian Hospital are still treating earthquake victims and passing out sheets of corrugated metal to fortify temporary structures. Ms. Mahara says Christian Aid also hopes to help establish a school in the region where "every school structure is gone."

But long-term plans will have to wait until the long weeks of winter are gone. Mercy Corps' Mr. Stephens says efforts to prepare for winter will soon end as heavy snow arrives. He says it may be March before people begin digging out, and until then "people will just have to go into their tents and wait it out."