Hidden behind the cracked walls of their mud-brick compounds, or shrouded by the thin blue or white canvas of donated tents, grandmothers, mothers, sisters and aunts have remained largely silent about their own and their children's fears following the quake that shook them out of their sleep that chilly October morning.
In Akhari village - a collection of pale, mud-brick and thatch houses on the far side of the mountain that was at the epicentre of the quake - dozens of women and as many children crowded into a newly erected tent to ask for medicines. It was the first time that the Pakistan Red Crescent Society's (PRCS) mobile medical team had visited the village, and, according to the women, the first time that any doctor had ever been there. This was confirmed later by the women's husbands who said that if someone got sick it was a 14-kilometre journey on the village tractor or by pick-up to the nearest health facility.
"All the women are telling me that they have insomnia," remarked Dr Rashida Semir, one of two doctors who made up the five-member PRCS medical team that day. She was sitting cross-legged on a carpet inside the tent, busily writing out prescriptions on slips of paper. These she handed to the women who in turn gave them to the children who scampered off to a makeshift dispensary set up in the back of the PRCS vehicle, and returned clutching syrups and pills.
"The women have hypertension as well," Dr Rashida added. "They feel fear."
Sleeping out in the open
Throughout the earthquake-stricken region, families are still sleeping out in the open, too concerned about aftershocks to return to their cracked and damaged homes in case another jolt should bring the thick mud walls and wooden roof beams crashing down. Instead, men and women alike are sleeping in tents donated by relief agencies, keeping them heated with traditional wood stoves, or small, highly dangerous electric fires, in villages connected to power lines.
As temperatures plummet below freezing at night, many of the children in Akhari have already caught colds.
"We are seeing a lot of respiratory tract infections," commented Dr Rashida, giving the patient she was examining a reassuring smile.
A blessing of sorts
Life for women in the mountain villages of Ziarat district, where Akhari is situated, is hard at the best of times. The arrival of the mobile clinic has been a blessing of sorts to the women, secluded as they are in their homes and dependent upon their menfolk for their well-being. Crucially the clinic has provided timely reassurance to mothers worried about their own and their children's health in the wake of this latest disaster, that help is at hand.
Since the day the earthquake struck, the PRCS mobile teams have conducted over 2,500 consultations in dozens of stricken villages. They have also tried to promote better hygiene. At first, two mobile teams were deployed but this was reduced to one after ten days as more and more aid agencies and health specialists arrived.
Doctors from the local hospital in Quetta run the PRCS mobile clinic on a rotation basis, changing teams every ten days. The medicines are bought locally by the PRCS. The ICRC supports the mobile clinic financially. There are now plans to run it with a permanent team of doctors, nurses, hygiene promoters and pharmacists for the coming six months.
A place where mothers-in-law double as midwives
During the visit to Akhari, one woman, Najina, who looked about 30 and shrugged her shoulders when asked her age, said that she was six months pregnant with her sixth child. She had already had three miscarriages. According to custom, when her labour starts her mother-in-law will help her. Asked if she was the village midwife, Najina shook her head. "No, it is just our tradition," she replied. "Each woman assists her daughter-in-law when she gives birth."
Her words gave a glimpse into the kind of difficulties women face in the isolated mountain villages where the earthquake happened, and about the time-honoured ways that they overcome them. Now they are facing insomnia, fear and hypertension on top of all the other grim challenges.
Asked how the children were faring, a young mother said simply, "When they hear the wind breathing they think another earthquake is coming. Like us, they are afraid."
There was no need for any further explanation. She had said it all.