How best to serve Pakistan's 750,000 IDPs?
Residents escaping the latest round of fighting in Khyber Agency in Pakistan's Federally Administered Tribal Areas (FATA) say they did not even have time to bury their dead before leaving their homes in the Tirah valley.
They are the latest of hundreds of thousands of people who have fled their homes in the tribal belt close to Pakistan's border with Afghanistan over the past five years of Pakistani military operations.
Conflict is not the only cause of displacement - natural disasters have also played a role, creating what humanitarians call a "complex emergency".
But despite the existence of camps set up for internally displaced persons (IDPs) where the government and humanitarian organizations provide assistance, most choose to flee elsewhere - creating a challenge for those wanting to help these vulnerable communities.
Over 75,000 people live in three established IDP camps (such as Jalozai, a half-hour drive from Peshawar) which house families in tents or makeshift structures, and provide food aid, medical facilities and drinking water. They also serve as a central registration point for families arriving from areas hit by conflict or natural disaster.
Large though these camps are, they only account for 10 percent of the three-quarters of a million IDPs, according to the UN's Office for the Coordination of Humanitarian Affairs (OCHA).
Humanitarian agencies are increasingly being pushed to take care of those who prefer to live elsewhere; often in Peshawar, the capital of Pakistan's Khyber Pakhtunkhwa Province (KP), and elsewhere in KP.
NGOs and the UN working in Pakistan carry out so-called IDP vulnerability assessment and profiling (IVAP) surveys to gather information on where off-camp IDPs are, and the type of support they need - from shelter and food to health care and Water, Sanitation and Hygiene (WASH) assistance.
They also gather information about what IDPs say they will need on returning to their homes, generally in FATA - with housing, security and agriculture of particular concern to families.
IVAP findings are then passed to humanitarian partners in an effort to ensure that assistance is targeted where there is the greatest need.
The European Commission-funded IVAP project recommends that aid agencies prioritize assistance for off-camp families, 82 percent of whom have to pay rent and live in difficult, cramped conditions.
IDPs outside the camps
Providing humanitarian services outside of the camp environment can be challenging.
IDPs have direct access to facilities at camps, but tribal customs, perceptions of camp life and a preference to stay with relatives and friends, mean a large number of IDPs choose to live outside the camps, making it more difficult for the authorities and humanitarian organizations to keep track of them and offer assistance.
Those providing aid, and the IDPs receiving it, would be better served if distribution was decentralized, said Sobat Khan Afridi, chairman of the Tehreek-e-Mutasireen Khyber Agency, an NGO set up by different political parties to assist IDPs.
"It is easier for larger organizations, especially international NGOs, to operate from the camp as it is easier to manage for them. The problem is that it is still difficult for all the families not living at the camp to reach Jalozai and get aid," said Afridi.
"It would be better if they set up distribution points across Peshawar in the areas where a lot of IDPs live. That would mean less stress for the authorities at Jalozai, and less problems for off-camp IDPs too."
Yar Mohammed, 29, arrived in Peshawar from Tirah in January after walking with his family for five days, much of the journey through heavy snow. He says going to Jalozai was not an option.
"The ones in the camps are the most vulnerable. They have no other means or resources to set up something else for themselves."
"I spoke to some people who told me the facilities at Jalozai are not enough. They were going to give just one tent to us, and that will not do for 10 people."
Instead, Mohammed stayed with his cousin until he found a three-room mud house in the Scheme Chowk area of Peshawar. He pays 4,000 Pakistan rupees (US$41) a month, and hopes to move his family to a better house soon.
"The movement of off-camp families, especially those from Khyber, is very volatile. Sometimes they are living with relatives. If they can afford it, they rent a house of their own. We try our best to register all of them, but it is a challenge," said Faiz Muhammad, the KP government's chief coordinator for IDPs.
Efforts are made to keep in touch with families who choose to live among relatives or rent property. The government uses mobile phone numbers to register families living off-camp, and officials try to reach families that are not registered in this way during monthly food distributions at designated points, he added.
"Even if they are not staying at camp, most of them visit the food distribution points and that allows us to get information from them, give them information and assess the situation."
Humanitarian organizations and the government have identified areas in and around Peshawar with a high concentration of IDPs, and some assistance, such as medical care, is also provided in those areas.
"Identifying off-camp families was a challenge because of the reluctance of many IDP families to register, as well as humanitarian organizations' own security concerns. That was overcome to some extent by mapping families initially based on information from IDPs living in camps, and then expanding the effort to surveys of off-camp families in host communities," said an aid worker with Save the Children in Pakistan who preferred anonymity.
Khalid Shah from Khyber Agency lives in Sufaid Dheri, a Peshawar neighbourhood that is home to an estimated 250 displaced families. Two years ago, worried about the safety of his children as fighting escalated in the town of Bara, he boarded up his small shop and left home. His first stop was Jalozai.
"Everyone told me that going to the camp was the best idea. It was safe and there was food and shelter. But after a couple of months, I couldn't take it any more," Shah, 42, said.
He started commuting from Jalozai to Sufaid Dheri, where he would earn a daily wage loading and unloading goods in a market. Today, he lives in a two-room apartment in the same neighbourhood with his family. He remains registered with the Jalozai authorities, and often travels to the camp if he requires assistance.
"I have managed to move here, but my brother and his family are still in Jalozai. He works here with me but stays registered there. You never know," said Shah. The brothers also take turns visiting their land and their shop in Bara every month.
For many families, pessimistic about the prospects of peace in their villages and towns, the next step is to plan for a new life away from Khyber. Many have sold their land to buy property in and around Peshawar. Those with the money have set up businesses too.
"The day I am convinced Bara is peaceful, I am going back," said Shah.
However, those without even modest financial resources are the real challenge for policymakers in terms of a return strategy. The poorest of the IDPs have no option but to register and live in camps like Jalozai, where the services provided are far superior to what they could hope for back home.
"The ones in the camps are the most vulnerable. They have no other means or resources to set up something else for themselves. They get health, education and food at the camp," said Faiz Muhammad of the KP government.
"It's an obvious question: why would they go back?"
Pakistani officials say return plans cannot be successful until peace is established in the affected areas.
"We can only begin working on a return programme for IDPs after the government and the military determine that the affected area is safe," said Faiz Muhammad.
In a refugee camp on the outskirts of Pakistan's capital Islamabad, home to many families displaced by the conflict on the border with Afghanistan, Sher Mohammed, from the Mohmand Agency in FATA, says the military has cleared his village, but his family members that visited still fear militant attacks.
"My cousins went back last summer and they had to come back because it was still dangerous there. I can't afford to go back unless it is absolutely safe. It costs 50,000 rupees to take my family back. If it's not safe, I'll have to spend another 50,000 rupees to come back here," said the 40-year-old. "I don't have that kind of money.