Some 73,000 people were killed and about 3 million people rendered homeless by the disaster. Those who have struggled to survive since the earthquake said the thick snow that fell on the region yesterday had made life even more miserable.
Inside of their makeshift shelters, families huddled around fires built from twigs and logs that they had collected from the debris of shattered buildings. Many complained that their tents did not provide adequate shelter against the freezing temperatures.
Tanvir Naqvi, a survivor from the village of Pieer Chanasi, spoke outside of his snow-covered tent yesterday as he surveyed the first major winter storm.
"People here are very upset because of the snow. It is so severely cold that the children have fallen ill," he said.
Pakistan's Meteorological Department said that up to 20 centimeters of snow fell in some high-altitude areas of the quake region. Lower areas received up to 32 millimeters of rains, triggering landslides and disrupting traffic on roads up to the mountain villages.
In Muzaffarabad -- the capital of Pakistani Kashmir -- officials of the International Committee of the Red Cross and the UN's World Food Program temporarily canceled aid deliveries by air and road until the weather cleared.
Authorities said they hoped people at high-altitude settlements would journey down to tent camps in the valleys for the winter, where it would be easier to deliver food and other aid to them. But thousands of people appeared to have chosen to remain with the ruins of their homes instead.
That left aid workers with a renewed sense of urgency to reach them with food and building materials before winter makes further deliveries impossible.
UN Secretary-General Kofi Annan said during a recent visit to Islamabad that quake victims would have to survive until the spring before promised building materials and other reconstruction aid became available. In the meantime, he said, the focus remained on the delivery of emergency food and medical aid.
"The difficult terrain makes this one of the most challenging relief operations ever undertaken," Annan said. "The pitiless Himalayan winter is almost upon us and growing more and more severe every week. We must sustain our efforts to keep people healthy and as strong as possible until we can rebuild."
Angelina Jolie -- the Hollywood starlet who has become a goodwill ambassador for the UN Office of the High Commissioner for Refugees -- was in Pakistan in late November, trying to encourage international donors to send whatever funds they can before the winter begins.
"It is important to stress that the support obviously needs to continue to come," Jolie said. "And the pledges that were made need to materialize soon. Because, from what I am understanding, there are so many wonderful pledges of money that could come in the next few years. But this winter is in the next few weeks. And so many people are in danger of possibly freezing to death."
UN officials were still making plans in case severe weather sent a flood of people down into the unsanitary and overcrowded tent camps at Muzaffarabad and other towns.
"The thing I hope is that we will all be able to work as well as we can to make sure that those who have survived those awful moments [of the earthquake] will be able to go through this winter and to have the chance to rebuild their lives," UN High Commissioner for Refugees Antonio Guterres said.
The International Committee for the Red Cross said good weather during the past seven weeks -- combined with the urgent efforts of aid workers -- had allowed emergency supplies to reach many affected areas ahead of schedule. But those supplies were not enough to last through the harsh, prolonged winter that was being forecast.
(compiled from Reuters reports)