RAZMAK, Pakistan — On an operating table at a makeshift trauma center at this military base in North Waziristan, a Pakistani soldier lay anesthetized, blood-soaked bandages applied in the field just an hour earlier a testament to a near-fatal wound.
The bullet through his neck from a Taliban militant had narrowly missed an artery, and after some minor surgery, the army medics declared the patient, Sepoy Aziz, out of danger.
In an offensive nearly two years old, the Pakistani Army has been fighting Taliban militants in the nation’s tribal areas and beyond, and like the United States across the border in Afghanistan, it is finding counterinsurgency warfare tougher, and more costly, than anticipated.
Months after declaring victory on several important fronts, including in South Waziristan and the Swat Valley, the army has been forced to reopen campaigns after militants seeped back in. True victory remains elusive. Soldiers like Sepoy Aziz — a sepoy is the rough equivalent of a private — are killed and wounded almost daily.
Much like the challenge facing American and NATO forces in Afghanistan, an absence of Pakistani civilian authority has made it nearly impossible to consolidate military gains. While eliminating some Pakistani Taliban insurgents, the long campaign has dispersed many other fighters, forcing the Pakistani Army in effect to chase them from one part of the tribal areas to another.
As the campaign drags on, the Pakistani military relies more and more on American-supplied F-16 fighter jets and Cobra helicopter gunships to bomb militants in areas of treacherous terrain, increasing civilian casualties, according to reporters and Pakistani officials in the tribal areas.
Many of the Pakistani Taliban fighters organize and rest here in North Waziristan under the protection of Sirajuddin Haqqani, the Afghan Taliban leader who runs a network of several thousand fighters of his own.
Allied with the Taliban and backed by Al Qaeda, the Haqqani group makes up a significant part of the insurgency in Afghanistan, too, and American officials have pressed the Pakistani Army for an offensive against them. But for now the brunt of the effort against Al Qaeda and the Haqqani fighters is borne by American drone strikes launched with Pakistan’s acquiescence.
The Pakistani Army says it is too overwhelmed tamping down the Taliban on other fronts in the tribal areas to take on a full-blown campaign in North Waziristan. There is truth to the Pakistani concern about being overstretched, American officials said.
But there are also deep suspicions that Pakistan’s military and intelligence service use Mr. Haqqani’s force to exert influence in Afghanistan, and keep India at bay.
The Pakistani Army chief, Gen. Ashfaq Parvez Kayani, has even offered to help broker a deal between the Haqqani group and the Afghan government as part of an Afghanistan peace settlement, according to Pakistani and American officials.
Meanwhile, more than 2,000 troops have been killed in the last two years fighting the Pakistani Taliban, the military says. In South Waziristan, Taliban fighters operating in groups of 4 to 15 regularly hit Pakistani soldiers, army officers said. The Taliban use classic guerrilla tactics — sniper fire, roadside bombs, ambushes — and their innate knowledge of the terrain to great advantage, they said.
“The terrorists have been raised here; they can find their way around blind,” said Maj. Shahzad Saleem, as small gunfire sounded around the hills near Nawazkot where Sepoy Aziz was shot.
More than 120,000 farmers, shopkeepers, women and children who were ordered to leave South Waziristan at the start of the offensive were expected to be back home by now. But the lands here remain devoid of any residents, and the fruit trees laden with summer apricots are untouched.
The civilians will be allowed back in stages, starting in about two weeks, and their return will be carried out under the guidance of the army, said Lt. Gen. Asif Yasin Malik, the commander of the army’s 11th Corps.
In other parts of the tribal areas to the north, and in the adjacent Swat Valley, which was reclaimed by the army from the Taliban last summer, the Pakistani Army faces similar problems.
Two parts of the tribal region that Pakistani Army commanders had said were secure, Bajaur and Mohmand, have come under renewed attacks from the militants in the past month.
The Taliban resurfaced in Bajaur, warning the few residents who had returned not to challenge them. In Mohmand, a border post was taken over by the Taliban after 60 Pakistani soldiers of the Frontier Corps ran out of ammunition — and nerve, according to a senior army commander — when several hundred militants operating from Afghanistan attacked.
The army has made the most gains in Swat, where bazaars are bustling and some tourist hotels have reopened. But few schools have been rebuilt, and residents complain of slow compensation for reconstruction of ruined homes. Taliban fighters have singled out for assassination key tribal leaders involved in negotiations in Swat for a more permanent political settlement.
Civilian casualties have become harder to ignore. In April, the head of the army, General Kayani, in a rare statement of apology, acknowledged that more than 70 tribesmen had been killed after what he said were inadvertent aerial strikes against a house in Khyber belonging to a tribal elder loyal to the government.
A senior Pakistani military official said, “There have been no reports of large numbers of civilians who have become casualties.”
The Pakistani Army opened what it thought would be its final front against the Taliban in March when it deployed five army battalions backed by F-16 jets in an offensive in Orakzai, a part of the tribal areas that became a refuge for Taliban displaced by the campaign in South Waziristan. It has also become a critical staging ground for the Taliban and other militants groups to penetrate the adjacent Punjab Province.
In June, General Kayani visited Orakzai and congratulated the troops at what was reported as a victory ceremony. But since then Pakistani fighter jets, attack helicopters and artillery have continued to bomb Orakzai, causing civilian casualties in villages close to the Khyber-Pakhtunkhwa Province, formerly the North-West Frontier Province, according to local residents.
“You can hear bombardments day and night from our house,” a prominent landowner in Hangu said.
According to the account of the landowner, who declined to be identified because of fear of repercussions from the military, seven women and children were killed in May during an air attack on the village of Shahu Khel.
“There had been firing between the militants and the army and the next day three helicopters were shelling the village,” the landowner said. “There was constant bombardment at about 4 p.m.” The bodies of three women and seven children were taken to the Civil Hospital in Hangu, he said.
According to reports that appeared in Pakistan’s leading English-language newspaper, Dawn, 226 civilians have been killed in the fighting and aerial bombardment in Orakzai since the campaign started in late March.
The United States is satisfied that Pakistan is using the American warplanes and helicopters in an appropriate manner, an American military spokesman said. Washington was pleased that General Kayani apologized for the deaths in Khyber, the spokesman said.
“In our view the Pakistani Air Force continues to make a concerted effort to minimize collateral damage and fully understand the impact these kinds of incidents can ultimately have on their counterinsurgency efforts,” he said.