GHALANAI, Pakistan -- The United States plans to pour $750 million of aid into Pakistan's tribal areas over the next five years as part of a "hearts and minds" campaign to win over the lawless region from al-Qaida and Taliban militants.
But even before the plan has been fully carried out, documents and officials involved in the planning are warning of the dangers of distributing so much money in an area so hostile that oversight is impossible, even by Pakistan's own government, which faces rising threats from Islamic militants.
The question of who will be given the aid has quickly become one of the most contentious ones between local officials and U.S. planners concerned that millions might fall into the wrong hands. The local political agents and tribal chiefs in this hinterland on the Afghan border have for years accommodated the very groups the U.S. and Pakistani governments seek to drive out.
A closely scripted visit to the hospital here, which is being used for a pilot project by the U.S. Agency for International Development, showed the challenges on full display. The one-story hospital was virtually empty on a recent day.
Local people had no way to get there. Only three of the 110 beds were occupied. Two operating tables had not been used in months. Many doctors had left because the pay was too meager and security too precarious, said Dr. Yusuf Shah, the chief surgeon.
Sher Alam Mahsud, the local political boss who escorted a journalist on a rare visit, said he wanted all the U.S. aid money "delivered to us." But the precarious security does not allow U.S. officials to assess the aid priorities firsthand or to provide oversight for the first installment of $150 million that has been allocated by the Bush administration.
"Delivering $150 million in aid to the tribal areas could very quickly make a few people rich and do almost nothing to provide opportunity and justice to the region," said Craig Cohen, the author of a recent study of U.S.-Pakistan relations at the Center for Strategic and International Studies in Washington.
Fighting terrorism
Yet it is here in Pakistan's Federally Administered Tribal Areas, or FATA, as the region is formally called, that Washington is intent on using the development aid as a counterinsurgency tool, according to a draft of the Agency for International Development plan given to The New York Times by an official who worked on it.
