Almost eight weeks after the devastating October 8 disaster, which killed more than 73,000 people, the fate of the 3.5 million others who were left homeless is far from secure.

Aid officials have warned for weeks that people in remote Himalayan villages are at risk of dying, but the situation in the refugee camps is causing increased concern as victims descend from the mountains.

"We survived the earthquake but we dont know if we will survive the winter," said Haji Abdul Rehman, living with his two sons and eight daughters in a single tent in Muzaffarabad, the ruined capital of Pakistani Kashmir.

Rehman, formerly a driver and fruit seller, said living in the squalid camp in the grounds of the city's destroyed university was "sheer misery".

"I lost an 11-year-old daughter when her school collapsed and now we are stranded in the camp and pray to God to help us," he said.

Daily life in the camps dawns with men and boys trying to find loaves of bread for their families and queuing up at food distribution outlets set up by aid agencies and Islamic relief groups.

Women and girls stay behind in the tents, most of them pitched on wet soil along the banks of the Neelum and Jhelum rivers that converge in Muzaffarabad.

Sanitation has been one of the biggest problems, despite efforts by United Nations and aid agency workers to bring order to the camps. In November hundreds of people at the University Ground were struck with acute diarrhoea.

Most camp dwellers have hardly bathed for the last two months, as the swirling river water passing by is too cold to enter.

"The hygienic situation is fairly deplorable, so I would have to say that water and sanitation is our main priority right now," United Nations Children's Fund health officer Tamur Mueenuddin was quoted as saying in a statement Thursday.

Relief workers have dug pit latrines and brought water tanks to the camps. They are also educating displaced families about how to use latrines and teaching children to wash their hands with soap and water regularly. But the onset of harsh winter weather at the weekend is set to bring even more refugees down from the soaring peaks and into the already-overflowing city, UN officials say.

"This is our major concern. We have to be prepared for the impending situation and it's going to be a very difficult task," said Rashid Khalikov, the chief UN coordinator in Muzaffarabad.

While snow and rain have stopped for a few days, temperatures at night are set to plummet as low as -10 degree Celsius (14 Fahrenheit) in the highest hamlets, meteorological officials said.

At one relief camp run by one of Pakistan's biggest religious parties, Jamaat-e-Islami, people complained of a lack of food. "We used to get meals twice a day, but for the past few days they have only given us rice in the evening," said Mohammad Yaqub, a father of eight.

Camp administrator Sheikh Atiqur Rehman said they had been distributing ten thousand packs of cooked rice a day. "People are traumatized, but we are trying our best to help them," he said.

The only hope on the horizon is that some people had started rebuilding their homes in Muzaffarabad after the Pakistani government started paying out compensation, the UN's Khalikov said.

Yet officials warn that recent international pledges of more than six billion dollars for long-term reconstruction should not take the focus away from the urgent plight of survivors right now.

"The race against time continues," the UN's emergency coordinator in Pakistan, Jan Vandemoortele, said during a visit to Muzaffarabad on Wednesday.

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