Doctors said Friday they were running out of drugs and artificial limbs for victims of the earthquake in southwestern Pakistan amid fears that the death toll would climb beyond 300.
The 6.4-magnitude quake hit a poor mountainous region near the Afghan border before dawn Wednesday. It destroyed 3,000 houses and made about 15,000 people homeless.
Troops and relief agencies have scrambled to help communities in remote valleys, from where provincial minister Zamrak Khan said reports of fatalities were still arriving.
Khan said the bodies of 215 people killed had been buried so far. However, he said reports from four badly hit districts indicated that others had been interred without informing authorities and that the real toll was "somewhere above 300."
Authorities are distributing thousands of tents, blankets, coats and food packages to keep people alive as nighttime temperatures fall to the freezing point. Many in more distant valleys have already spent two nights without shelter and doctors said children were falling ill.
At a small clinic in the devastated village of Kawas, Dr. Nek Mohammed said he had treated 300 minors since Thursday and that he hoped medicine would arrive soon.
"Most of them are developing the symptoms of pneumonia and that is inevitable given the serious cold they are exposed to," Mohammed said, as scores of people squatted outside waiting for a consultation.
Those seriously injured when their houses fell down around them have been taken to the regional capital, Quetta, some 50 miles (80 kilometers) away. Even there, doctors said they were stretched.
Zainullah Kakar of the city's Bolan Medical College said it had 90 trauma patients.
"We are running short of antibiotics and other drugs. We need artificial limbs. We need metal plates and rods to treat broken arms and legs," Kakar said.
The relief effort for the survivors began in earnest on Thursday. There is concern that the tents delivered so far will prove too light to keep people going through the impending winter, when much of the affected area will be covered in snow.
In Wam Kotal, a village in the shadow of a towering mountain, one family decided that they would be fools to wait.
Haji Abdul Latif, a turbaned 60-year-old, watched as a son and a nephew began clearing the rubble of their house with the intention of rebuilding as soon as possible.
A can of pesticide used to keep insects off the area's ubiquitous apple orchards was recovered and set aside.
"We have no option except to help ourselves. Snow will start falling soon and we have no place to live," he said, dismissing the tent where 10 of his family members crammed in to sleep.
The need for shelter has been swelled by villagers too scared by frequent aftershocks to sleep in the houses spared by the earthquake.
Amjad Aziz, a 42-year-old teacher, said he was sleeping in his car while his wife and six children bedded down at night in a rented tent pitched near their house in Ziarat, the main town in the affected area.
"I know these are aftershocks and not new earthquakes, and I also know these tremors may continue for a while, but it is hard to convince children that they will be safe," Aziz said.
A poorly managed aid effort in Baluchistan could add to anti-government sentiment as the country's new leaders battle violence by Islamist extremists and try to fix mounting economic problems.
The affected area of Baluchistan province is inhabited mainly by Pashtuns, the same ethnic group from which the Taliban draws most of its strength. However, the region has been spared the level of militant violence seen in other tribal areas along the Afghan border.
Members of hard-line Islamist political parties and groups, including one listed by the United States as a terrorist organization, were among the first to aid quake victims.
The same groups helped out in the aftermath of a quake that killed 80,000 people in Kashmir and northern Pakistan in 2005, something analysts say gave them added legitimacy.