Desperate survivors bracing for a fourth freezing night in the rubble of their earthquake-flattened homes have appealed for aid as the Pakistan government said thousands more houses had been damaged than previously thought.
Rugged terrain, severed communication lines and an unstable security situation have impeded relief efforts since Monday's (local time) 7.5 magnitude quake killed more than 390 people in Pakistan and Afghanistan and levelled thousands of homes.
With winter fast approaching in Pakistan's worst-hit province of Khyber Pakhtunkhwa, survivors said they and their children were running out of time.
"After November 15 there will be three to four feet of snow here and we have nothing to protect us," said Mir Wali, whose village Charun Ovir is 3000 metres up in mountainous terrain in the northwestern district of Chitral.
Dust is still rising from the mountain after the earthquake caused cracks in it, leaving villagers fearing a landslide or collapse.
"Are we not Pakistanis?" he said. "Today we need Pakistan."
The government must act before the snow falls, he said.
"After that the roads will be blocked and we won't be able to save our children."
Pakistan's National Disaster Management Authority (NDMA) on Thursday announced on its website a spike in the number of houses damaged in the quake, from nearly 14,000 to more than 25,000.
More than 15,000 of those were in Khyber Pakhtunkhwa alone.
For days authorities had been struggling to reach the most isolated communities in the mountainous region, but the NDMA said on Thursday it believes it has reached "most of the affected area".
Pakistan's confirmed death toll so far stands at 272, with more than 2000 people injured, but a spokesman said the NDMA was still in the process of estimating a final toll.
In Afghanistan, authorities have put the death toll at 121 with some 8000 houses damaged – but there are fears the number of dead could still spike, with charities warning that the Taliban presence was hindering access to many of the affected areas.
UNAMA official Mark Bowden said it appeared NGOs had the capacity to help after the quake, but that access to the areas "varies from one [insurgent] commander after another".
Desperate survivors were left marooned on mountaintops in Badakhshan, the remote province where the epicentre of the earthquake was located and where much of the territory is controlled by the insurgents.
In Sawkay district in the badly-hit Afghan province of Kunar, residents said on Wednesday that no officials had yet appeared.
"The government has not asked what happened to us," said resident Mohammad Akram.
"No government official visited us."
The quake was centred near Jurm in northeast Afghanistan, 250 kilometres from the capital Kabul and at a depth of 213.5km.