Gullam Jainani at the refugee camp in the Panjshir Valley that has been his home for two years.

ANAWA, Afghanistan - Gullam Jainani has weathered two bitter winters as a refugee living under a plastic tarp in the Panjshir Valley, where four feet of snow is not uncommon. He is not looking forward to the onset of another winter.

"This place is safe from battles, so we don't worry about the war," said Jainani, whose family was displaced from areas north of Kabul in 1999 by fighting between Taliban and opposition forces. "But we do worry about the winter. We're worried that if the international organizations don't help us, we'll die."

Fortunately for Jainani, several humanitarian organizations distributed food to the 10,500 refugees in and around Anawa last week, providing some cushion against the coming winter. But hundreds of thousands of other Afghans aren't so lucky.

Humanitarian organizations warn that the U.S. bombing campaign launched Oct. 7 has disrupted distribution of aid to Afghans caught in war zones. Some agencies have asked for a suspension of air strikes to allow aid flows to resume.

In the Panjshir Valley, aid agencies managed to position supplies before early winter snows blocked the only overland route through the towering Hindu Kush mountains. But if the war intensifies or the winter becomes worse than forecast, humanitarian needs could outstrip those supplies.

"It's difficult to predict," said Pierre-Andre Junod, a representative of the International Committee for the Red Cross, one of the only agencies operating in this area under control of anti-Taliban forces. "If there is fighting and people are displaced or more displaced people from Kabul come here, then you could have real problems."

Aid deliveries were initially disrupted when the Taliban kicked out international relief workers after the Sept. 11 terrorist attacks in the United States. Since the bombs began falling, the Taliban has raided the warehouses of humanitarian organizations and confiscated equipment and vehicles.

The World Health Organization on Friday said it fears the winter could lead to epidemics of pneumonia, measles, and water-borne illness such as typhoid. "There is a major risk of epidemics," Afghanistan coordinator Mohamed Jama told journalists in Geneva.

The Red Cross had delivered only half the food and medicine it planned to send to 900,000 people in battle-weary Ghor province when the Sept. 11 attacks occurred.

"We were able to help out about half the people, but the rest of them, it will be very difficult to help," Junod said. "We fear the worst."

By Saturday, the Red Cross planned to position food and medicine for half a million people in countries around Afghanistan that could be distributed in short order. UNICEF, likewise, last week sent 40 tons of biscuits, dried milk, medication and hygiene packs to a warehouse in Termez, Uzbekistan, on the border with Afghanistan.

The problem is not a shortage of food and medicine for a nation of 20 million people that has suffered from two decades of civil war and three years of drought, but the inability of aid agencies to move the supplies to their destination.

The World Food Program, which resumed food deliveries to Northern Alliance territory after a hiatus following the terrorist attacks, projects that 400,000 people are already suffering acute food shortages in four north-central provinces and 1.3 million will have little to no food by the end of December.

Oxfam, the British aid agency that has called for the U.S. government to suspend bombing, said the failure of the international community to deliver enough has left hundreds of thousands suffering.

"In some areas of acute need, the bombing and the increased fighting from the Taliban and Northern Alliance has added to a climate of fear that has made many truck drivers and aid workers too frightened to work," Oxfam said.

Paul Wolfowitz, the U.S. deputy secretary of defense, told radio reporters in Washington on Friday that the U.S. military would use Ramadan to increase its supply of humanitarian aid to Afghanistan through a land bridge to Mazar-e Sharif, the northern city that guerrillas reportedly captured Friday night.

The reported rapid collapse of the Taliban's control over much of northern Afghanistan will probably open up that area to relief workers. The anti-Taliban Northern Alliance has said that it will open up access to the north from Uzbekistan, allowing aid to reach some of the most remote regions in central Afghanistan.

Aid convoys are already poised in Termez, Uzbekistan, to cross the Amu Darya River into Afghanistan.

The Red Cross said it was uncomfortable with predictions from some humanitarian organizations that thousands of Afghans would starve to death. "Afghans are very resourceful, though 450,000 people in Ghor province are very much at risk," Junod said.

In the Panjshir Valley, where snow high in the Hindu Kush mountains has already blocked the only road access to the Northern Alliance stronghold, the Red Cross is still attempting to send some medical supplies across the 15,000-foot Anjuman Pass, even by horseback.

The French relief group ACTED - Agency for Technical Cooperation - is trying to keep the pass open until the end of December to continue shipping U.N. food into the Panjshir, but its attempts to plow the road will eventually be overwhelmed by nature. The pass often lies under 15 feet of snow by December and is always impassable, even by horseback, by the end of the year.

The Red Cross is concerned about distributing too much relief too soon, attracting refugees from Kabul as well as leaving itself unprepared should the war escalate and needs increase.

"Do we distribute the blankets now or do we hold on and wait?" Junod said. "If we distribute them now we might not have enough later if there is a big need. If we hold on to them, we might end up with a warehouse full of blankets."

In places such as the Anawa camp - one of many refugee camps that formed after a Taliban offensive in 1999 - the residents are eager for all the aid they can get.

"We have no food, no jobs, no land," Jainani said. "We sold most of the things we brought with us so we could survive."

Last week each family received 200 pounds of rice from the Red Cross and 10 pounds of sugar and 15 pounds of cooking oil from ACTED.

Many residents traded some of the commodities in the bazaar for items they needed - soap, fuel, clothing, shoes, blankets.

"We are suffering," Jainani said, "but the best thing you can send us is the U.S. military" to oust the Taliban from their villages 50 miles from here, so they can go home.