MUZAFFARABAD, 21 October 2005 — Helicopters and foot soldiers headed out of the shattered city in the heart of Pakistan’s earthquake zone yesterday in a frantic attempt to get medical aid and supplies to remote villages damaged in the quake that killed more than 79,000 people. The World Health Organization reported that three survivors of the disaster died of tetanus.

The death toll in South Asia’s Oct. 8 quake jumped dramatically after regional authorities reported new figures based on bodies recovered and information from outlying areas, making it one of the deadliest temblors of the past century.

The Pakistani government’s official toll is 49,739 dead and more than 74,000 injured, but central figures have lagged behind regional numbers. The regional figures, from officials in Pakistan’s North West Frontier Province and the Pakistani-controlled portion of Kashmir, add up to about 78,000. India reported 1,360 deaths in its part of Kashmir.

Aid workers fear casualties will rise further because communities without adequate food, shelter or health care will soon face the harsh Himalayan winter. Snow already has begun to fall in high mountains, and some upland villages now face subzero temperatures at night.

“There is a continued need for more helicopter capacity, to move in the inaccessible areas,” Hilary Benn, British secretary of state for international development, said during a visit to the quake zone. “The terrain here is very difficult and winter is approaching.”

A relief official, Lt. Gen. Mohammed Zubair, said Pakistan will complete its damage assessment by Nov. 15, and will launch its first phase of rebuilding homes, schools, hospitals and infrastructure. Many people who have walked out of the mountains to aid stations in Pakistani Kashmir’s capital, Muzaffarabad, have badly infected wounds, said Brig. Gen. Zafar Gondal, said a doctor who runs a Pakistan Army field hospital.

“We are doing whatever is possible,” said Gondal, who warned that children in particular are in need of shelter and food as temperatures drop to near freezing at night in the hills.

“One cold night is enough to put the life of a child in danger,” he said.

The UN Children’s Fund warned that as many as 120,000 children remain without access to aid, and some 10,000 could die from hypothermia, hunger and disease in coming weeks if no relief reaches them.

Brig. Sajjad Ali Khan, an army official in Muzaffarabad, said there were reports that a school teacher and 16 students were trapped in a cave in a valley, and that an army helicopter had gone to the area to check out the information.

In the quake-stricken town of Balakot, survivors have been storing wood and burning the abundance of donated clothing that litters the streets for heating instead.

The World Health Organization said there have been 17 cases of tetanus in the quake-stricken area, three of them resulting in deaths in Balakot.

Senior surveillance officer Sarfaraz Tan Afridi, leader of the WHO team in North West Frontier Province, said his group was trying to immunize as many people as possible.

Tetanus, also known as lockjaw, is a bacterial infection that can cause fever, high blood pressure and severe muscle contractions. It can lead to the “locking” of the jaw, general stiffness, and death, especially among the elderly. People are infected when the bacteria, found in the ground and feces, enter through cuts and scratches.

The number of helicopters flying relief missions is limited, and people like Abdul Aziz decided it was better to walk in for help than to wait any longer. His wife was killed in the 7.6-magnitude temblor on Oct. 8 when his house came crashing down. He walked seven hours to Muzaffarabad with his three sons and daughter, who had a fracture.

All were suffering from exposure and malnutrition. He said 150 people, out of 220 in his village, had died.

“I will not go back to that village where I lost my wife, my relatives and my friends,” Aziz said.