The earthquake dead are estimated at near 30,000 with huge swathes of the Himalayas in northern Pakistan still unreachable. Some 176,000 were killed in the tsunami, but another 50,000 are still missing.

The earthquake has destroyed more than 80 percent of structures and buildings in parts of northern Pakistan, officials in the nation's capital, Islamabad, said. Many cities and villages in Pakistan-administered Kashmir and North West Frontier Province, the most affected areas, have been wiped out.

More than 4 million people are affected, of whom 1 million are in acute need of help. More than 2 million people need to be re-housed, relief agencies said.

"Search and rescue is coming to an end to focus more on the relief effort," Hansjoerg Strohmeyer, Office for the Coordination of Humanitarian Affairs chief of staff, told reporters Friday at U.N. World Headquarters in New York. "Search and rescue is usually something that realistically takes place in first five or six days and usually after that most people will have died if not from immediate impact but from injuries and lack of water."

There was an improvement in funding and access to victims and for relief workers to Pakistan, the hardest hit of the nations. Islamabad was granting visas of up to three months for aid workers.

A $272 million U.N. Flash Appeal was made Tuesday and is expected to be updated next week in Geneva, Switzerland, by U.N. Undersecretary-General Jan Egeland, head of OCHA, who is touring the quake area.

"We have now in addition to the $5 million committed that we discussed yesterday (Thursday) up to $50 million pledges against the U.N. appeal," Strohmeyer said. "The situation with helicopters is improving."

He said while there were more than 50 helicopters in the region, 48 of them were flying and expected 65 to be ready for missions beginning next week. He said the number included government, military, U.N. and non-governmental organization choppers.

More are being sought, double the present number was being eyed, relief officials have said.

The helicopters are needed to reach what is left of heavily damaged or destroyed mountain villages and the wiped out roads or foot tracks leading to them.

Some international agencies believe the devastation caused by the earthquake last Saturday is still being underestimated.

The World Health Organization has said the calamity was bigger in scale than the December tsunami and the long-term problems created as a consequence will prove more difficult to deal with.

"The number made homeless, the destruction of roads and infrastructure and the terrain over which the catastrophe has struck make this a bigger disaster than the tsunami," Hussain Gezairy, the U.N. health agency's regional director, told reporters at the emergency health center in the Pakistan Institute of Medical Sciences in Islamabad.

Gezairy said as no roads were destroyed by the tsunami, destruction took place mainly within a few hundred meters along coastlines and it was far easier to assess the damage and plan relief.

"The fact only helicopters can reach so many mountain areas and that the affected areas are so remote, makes it extremely difficult to even gauge the full-scale of the damage and determine what needs to be done first," Gezairy explained.

According to WHO, the number of health workers needed to be doubled or even tripled in some places.

"There is a particularly urgent need for general practitioners with experience in emergencies and basic surgical skills," said Geneva-based WHO in a statement earlier in the week. "Paramedics, primary health care specialists and public health specialists, including epidemiologists, are also desperately needed."

Working with the Pakistan Ministry of Health in the largest operation ever launched in the country, WHO has put hundreds of experts in the field.

The teams are set to work on building early-warning systems for disease surveillance and epidemic control, he said. For this purpose, acting on WHO advice, the Pakistan military has already set up vaccination centers for relief workers along the roads to affected areas.

The poor sanitation conditions, hundreds of dead bodies still lying unburied, and severe shortages of clean drinking water have made dangers presented by disease among the top concerns of relief agencies, WHO said.

The health agency said the situation seemed most alarming in major centers of destruction, particularly Muzaffarabad, Bagh and Balakot. WHO planned to deploy hundreds more medical staff in all affected areas to work alongside Pakistani medical teams.

Children were particularly hard hit, having just reported for school when the 7.6 magnitude quake struck Saturday morning.

Now, the U.N. Children's Agency says keeping children who survived the earthquake alive in the days and weeks ahead must be a priority.

"With wintry conditions arriving in the higher elevations, children are facing a potentially deadly combination of cold, malnutrition, and disease," said UNICEF Executive Director Ann Veneman in New York. "Most housing has been destroyed in the hardest-hit areas, so the survival of thousands of young children is now at stake. Shelter, nutrition, and health care for children must be a priority."

Routine immunization coverage in the heart of the quake zone stands at about 60 per cent of young children, meaning that hundreds of thousands are unprotected against deadly diseases such as measles, the agency said. UNICEF and the government are planning a quick-impact measles campaign in the region to protect children who have not been reached previously. Measles is one of the greatest threats to child survival in emergency situations, especially when their immune systems have been weakened by exposure and malnutrition.

UNICEF is also moving to deliver Vitamin A to the relief effort, which helps boost children's immune systems.

"Our focus right now is on providing basic aid - shelter, clothing, water supplies, food, and emergency medical supplies," said Veneman. "We've emptied our emergency stockpiles inside Pakistan, and we're distributing those supplies in places like Mansehra, where we've established a forward operations center."

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