Overstretched aid agencies said the disaster underscored the need for the international community to rethink its financial cutoff of Afghanistan since Taliban insurgents seized the country 10 months ago. That policy, halting billions in development aid and freezing vital reserves, has helped push the economy into collapse and plunge Afghanistan deeper into humanitarian crises and near-famine.

The quake struck a remote, deeply impoverished region of small towns and villages tucked among rough mountains near the Pakistani border, collapsing stone and mud-brick homes and in some cases killing entire families. Nearly 3,000 homes were destroyed or badly damaged in Paktika and Khost provinces, state media reported.

The effort to help the victims has been slowed both by geography and by Afghanistan’s decimated infrastructure.

Rutted roads through the mountains, already slow to drive on, were made worse by quake damage and rain. The International Red Cross has five hospitals in the region, but damage to the roads made it difficult for those in the worse-hit areas to reach them, said Lucien Christen, a Red Cross spokesman in Afghanistan.

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Some of the injured had to be taken to a hospital in Ghazni, more than80 miles away that the Red Cross has kept running by paying salaries to staff over the past months, he said. Many health facilities around the country have shut down, unable to pay personnel or obtain supplies.

“It shows if you don’t have [a] functional health system, people cannot access basic services they need, especially in these sorts of times,” Christen said.

On Friday, Pakistan’s Meteorological Department reported a new, 4.2 magnitude quake. Afghanistan’s state-run Bakhtar News Agency said five people were killed and 11 injured in Gayan, a district of Paktika province that is one of the areas worst hit in Wednesday’s quake.

Bakhtar’s Taliban director Abdul Wahid Rayan said Friday the death toll from Wednesday had risen to 1,150 people, with at least 1,600 people injured. The United Nations Office for the Coordination of Humanitarian Affairs has put the death toll at 770 people. It’s not clear how death toll counts are being reached, given the access difficulties. Either toll would make the quake Afghanistan’s deadliest in two decades.

At Urgun, the main city in Paktika province, U.N. World Health Organization medical supplies were unloaded at the main hospital. In quake-hit villages, UNICEF delivered blankets, basic supplies and tarps for the homeless to use as tents. Aid groups said they feared cholera could break out after damage to water and hygiene systems.

In main villages of Gayan District, residents crowded around trucks delivering aid, an Associated Press team saw Friday. People who had spent the past two nights sleeping outdoors in the rain erected tents in the yards of their wrecked houses. For more than 24 hours after the quake, many had been on their own, digging through the rubble by hand in search of survivors.

Still, help was slow to filter across the area. In one tiny hamlet seen by the AP, all 20 houses were flattened, and residents were still taking refuge in nearby forests.

Trucks of food and other necessities arrived from Pakistan, and planes full of humanitarian aid landed from Iran, Qatar and the United Arab Emirates. But it was not clear how long it would take to reach devastated villages. Other countries sending aid have taken pains to make clear it would not go through the Taliban — reflecting the widespread reluctance to deal with Afghanistan’s new rulers.

Aid groups said that while they are rushing to help the quake victims, keeping Afghanistan just above catastrophe through humanitarian programs is not sustainable. Some urged the world to end or find ways around the financial cutoff that has wrecked the economy.

“We are basically letting 25 million Afghan people to starve, to die, not to be able to earn their own living if we keep on with this financial blockade,” said Rossella Miccio, president of the aid organization Emergency, which operates a network of health-care facilities and surgical centers across Afghanistan.

Afghanistan’s economy had been reliant on international donor support even before the Taliban takeover last August as the U.S. and its NATO allies were withdrawing their forces, ending a 20-year war.

World governments halted billions in development aid and froze billions more in Afghanistan’s currency reserves, refusing to recognize the Taliban government and demanding they allow a more inclusive rule and respect human rights. The former insurgents have resisted the pressure, imposing restrictions on the freedoms of women and girls, recalling their first time in power in the late 1990s.

The cutoff yanked the supports out from under the economy. Now nearly half the population of 38 million cannot meet their basic food needs because of poverty. Most civil servants, including doctors, nurses and teachers, have not been paid for months, and salaries remain sporadic.

Many aid groups have left the country. U.N. agencies and other remaining organizations have kept Afghanistan away from the brink of starvation with a humanitarian program that has fed millions and kept the medical system alive.

But with international donors lagging, U.N. agencies face a $3 billion funding shortfall this year.

International sanctions on Afghan banks make it difficult to send funds into the country. Some aid groups have to carry in large bags of cash to pay local staff in an expensive process that incurs fees along the way for transport and security.

The International Rescue Agency’s vice president for Asia, Adnan Junaid, said the international community must set a roadmap to resume development and release Afghanistan’s frozen reserves.

“Only a bold strategy that addresses the causes of this crisis will put an end to the spiral of misery being faced by its population,” Junaid said.

LA TIMES