DHERKOT, Pakistan — For four days, Dr. Mohammed Iqbal and his staff stitched up earthquake victims with ordinary sewing thread and wrapped the patients' wounds with torn pieces of dirty clothing.
A semblance of relief finally came Wednesday to the clinic in this mountainside village: enough antiseptic, antibiotics, syringes and bandages to get through one more day.
The Pakistani relief workers delivering the supplies also threw in 12 boxes of Valium, but the pills were not expected to do much good for either the patients' agony or the doctor's frayed nerves.
"We use them as painkillers, but they aren't strong enough," Iqbal shouted above the terrified screams of 8-year-old Keala Khan, who suffered a gash at least 6 inches long across his scalp during Saturday's earthquake. A medical assistant was trying to clean out the dirt, disinfect the wound and stitch it up.
"Momma! Momma!" the child shrieked. "The pain is too strong!"
Another boy writhed on a wooden bench on the front lawn as two nurses and a medical technician stitched up a wound as wide as a baseball on his arm, using no anesthetic. Other patients, arriving for treatment four days after the quake, lay in cots and on the stairs outside.
All in all, it was a slow morning for Iqbal and his six staff members, who have treated about 3,000 earthquake victims with almost no medicine or supplies.
Iqbal, however, fears that the worst may be yet to come.
The 7.6-magnitude quake left so many people homeless, and sleeping outside in freezing weather in the mountains of Pakistani-controlled Kashmir, that his patients were beginning to come down with pneumonia, flu and other potentially fatal illnesses. Iqbal said he had treated 15 quake victims with pneumonia.
"If we don't get the proper aid soon, that will be the next storm," he said. "It is really getting worse day by day."
Snow is already falling on the higher peaks of the Hindu Kush range, and villagers living about 5,000 feet up the mountainsides near Dherkot say they expect the flakes to come their way in no more than six weeks.
Last winter, one of the harshest in memory here, villages were covered by almost 8 feet of snow in January.
Iqbal's clinic, which is run by Pakistan's government, was so poorly equipped when the quake struck that it ran out of even the most basic drugs and medical supplies in the first hours after the catastrophe. The doctor fears that the estimated 50,000 mountain villagers who depend on him for healthcare will be forsaken when winter sets in.
In Geneva, the World Health Organization said that cold, weakened people living in close quarters were at risk for measles or cholera outbreaks.
At dawn each day here in Dherkot, as the suns begins to warm the freezing mountain air, villagers walk down dirt paths to the main road and watch relief trucks pass. The trucks are headed for worse-hit areas, but the people hope someone will stop and provide them with some crucial supplies.
"We don't need anything to eat -- just tents," Raja Mumtaz, 30, said as an army truck belching black exhaust rumbled past.
Waiting for tents to arrive has become such an obsession in the mountain villages surrounding Dherkot that groups of women break the taboo against loitering in public and join the vigil each day.
An elderly, bent man with a long gray beard and a walking stick scolded more than a dozen women sitting on rocks at the roadside, watching each truck come and go with the expectation of children watching parade floats.
"Men can wait for tents," the old man harangued. "It's against our culture that young women should be sitting at the side of the road."
The army has distributed only 6,500 tents so far, military spokesman Maj. Gen. Shaukat Sultan said Wednesday. President Pervez Musharraf has appealed to foreign donors to send more to meet the huge need.
Outside the Dherkot clinic, an army truck loaded with tents for villages farther up the road had broken down. As the soldiers waited for repairs, several spread out on the rolled-up tents and took a midday nap.
Since Saturday, Raja Abdul Salam and 21 relatives have spent each night shivering beneath blankets, under plastic sheets pitched in front of his badly damaged home.
They have had to share 12 blankets salvaged from the ruins of their houses in the village of Mora, just outside Dherkot. Several villagers said they had not received any aid, and some whispered that local officials had stolen emergency supplies dropped off by the army.
Only half of Salam's house is still standing. It looks ready to fall at any time, but it's still the best the clan has. His relatives' two homes were flattened by the quake, and his sister's 6-month-old baby and its grandmother were trapped in the rubble for several hours.
Salam, who saw the building collapse, rescued them with the help of other relatives. Neither the woman, in her 70s, nor the infant needed much medical attention.
At least not yet.
Times staff writer Carol J. Williams in Islamabad, Pakistan, contributed to this report.