by John Tulloch and Mubashir Fida of the International Federation in Pakistan.
Thousands of kilos of relief items are being airlifted by the Red Cross and Red Crescent high into the snow-laden mountains of northern Pakistan to assist earthquake-affected communities in extremely remote locations.
Using United Nations Humanitarian Air Service (UNHAS) helicopters, the International Federation and the Pakistan Red Crescent are in the midst of a three-week operation shifting 166,000 kilos of materials to locations in the North West Frontier Province's Allai Valley.
The "heliops" are part of a wider operation to assist 13,500 families across the North West Frontier Province and Pakistan-administered Kashmir as cold temperatures and snowy conditions persist.
The UNHAS helicopters are essential to get relief items, such as corrugated galvanized iron sheets, shelter repair kits, tarpaulins and quilts, into locations that cannot be reached by road. The three areas in the Allai Valley, where the choppers are making deliveries, would take two-to-three hours of lung-busting hiking to reach by foot.
Some of the chopper loads are being delivered by sling. Up to 3,500 kilos encased in a net dangle underneath the helicopter and are transported from a base in Muzaffarabad to the various locations.
This method enables the UNHAS Kamov choppers to drop their load without landing and return to base, speeding up the number of rotations possible. However, flying at high altitude and delivering loads to small drop zones surrounded by huge mountains demands extremely precise skills and steady nerves from the pilots.
Pakistan Red Crescent Field Officer, Irfan Hameed, is supervising the heliops on the ground. He and his team hike to the drop zones, and organise unloading and distribution. He admits working in knee-deep snow, in the midst of a Himalayan winter, is challenging.
"It's tough! To get to this location at Gantar, we had to drive as a far as we could for an hour and a half and then walk another two hours to get here,"
he said.
Bearing the brunt of these conditions are the communities who live in the mountains.
Harzat Bilal, a 25-year-old farmer supporting a family of six, spent the first winter after the October 2005 quake in a relief camp at a lower altitude. This year, he is toughing it out in his village of Gantar, which is perched on the side off a mountain range at an altitude of 2,240 metres (7,350 feet).
"We went to Maira camp last year as there was nothing left here... It is difficult this year, but we are rebuilding. We were born here and we will be buried here, so we have to cope with whatever the situation is," he said.
With no other means of transport, Harzat makes two, two-hour return trips to his home, hauling on his back the 10 sheets of corrugated iron and a shelter repair kit distributed by the Red Cross and Red Crescent.
In the more remote locations, like Gantar, there is a shortage of fuel, such as wood to burn to keep warm, and people rely on staying indoors and huddling under quilts to ward of the bitter cold.
Each family targeted by the Red Cross and Red Crescent receives four quilts, resulting in a total distribution of 40,000 over the coming weeks.
With many affected people still to complete reconstruction of their homes, the corrugated galvanized iron sheets are being used to improve temporary shelters. Communities have told International Federation that the sheets are more useful to them than tents due to their durability and the fact they can use them in so many ways.
The winter conditions are taking a toll on the health of communities with an upsurge in acute respiratory infections.
One of the Red Cross and Red Crescent mobile health units in the Allai Valley has reported a 30 per cent increase in patients this winter. Recently, numbers have gone up to 1,000 patients per week - numbers not seen since immediately following the quake. There were so many respiratory cases that the unit ran out of medicine and had to restock.
The International Federation and the Pakistan Red Crescent hope to complete the winter assistance distributions in early February.
Meanwhile, the Red Cross and Red Crescent continues to provide a range of assistance to quake-affected communities in areas such as health, water and sanitation, livelihoods and reconstruction as part of an operation which will continue until the end of 2008.