GHALANAI, Pakistan: The United States plans to pour $750 million in 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 Qaeda 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 issues between local officials and American 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 American and Pakistani governments seek to drive out. A closely scripted visit to the hospital in Ghalanai, Pakistan, which is being used for a pilot project by the United States 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 3 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. Boucher explained the plan before a Congressional hearing on Wednesday. "Pakistan government is going to put $100 million a year for 10 years into the development of these areas," he said, "and we've told them we will come up with $150 million a year for the next five years to support the economic development of the tribal areas." The aid money is in addition to billions of dollars in American military assistance that Pakistan has already received.
