Gilgit, Pakistan - Escalating protests in villages perched on the "Roof of the World" - a mountainous territory disputed between Pakistan and India - have exposed deep animosity towards Islamabad.
After 67 years of control by the Pakistani government, many local people want the country to either accept them as a new province - or grant them independence.
Pakistan's authorities have responded to the unrest - sparked by poor public services and anger at corruption - with a brutal crackdown.
"The problem is in the system - it's a colonial system. The laws come from Islamabad and we have to live under them," Nazir Ahmed, a local lawyer who helped organise the protests, told Al Jazeera.
The two hundred thousand residents of Ghizer district now have an ambulance, a crucial service in a region where the nearest hospital is a precarious five hour drive along narrow roads hugging cliff faces thousands of feet above fast-moving rivers.
Two weeks ago, hundreds of residents converged to besiege government offices, demanding that officials provide an ambulance and basic medical facilities.
|Nearly 500 Pakistani soldiers have died fighting India since 1999, manning border posts in the highest battlefield on earth. [Umar Farooq / Al Jazeera]
Ghizer has no surgeon or gynaecologist, and just one female health worker.
Similar unrest has erupted in villages across Gilgit-Baltistan in protests that began with calls for an end to government corruption.
"There is massive corruption, and no one here is answerable," said Ahmed, who adds that the struggle for better medical facilities is just the beginning.
The protests have been met with a brutal crackdown by authorities, who are using special courts to prosecute 'terrorists' and who have jailed hundreds on charges of sedition and 'terrorism'.
In April, hundreds of thousands of protesters held an 11-day sit-in in Gilgit's legislative assembly after Islamabad threatened to end a wheat subsidy established in 1972 to match a similar package in India-administered Kashmir.
The protesters won back the subsidy but their other demands, including self-rule for Gilgit-Baltistan, have yet to be met.
"Pakistan is seeking that the United Nations solve the Kashmir dispute, and is unwilling to officially integrate Gilgit-Baltistan into its political system," said Ahsan Ali, the head of the Gilgit-Baltistan High Court Bar Association, and an expert on constitutional law in the region.
The Roof of the World is part of a pre-1947 Kashmir, claimed by Pakistan and India and home to the only land route to the Indian Ocean for Pakistan's closest ally in the region, China.
The territory is home to 12 of the 30 highest peaks on Earth, and its massive glaciers are the source of water for most of the Indian subcontinent.
Since independence from Britain in 1947, Pakistan and India have fought several wars over the status of Gilgit-Baltistan - part of the Pakistan-administered Kashmir - and the rest of disputed Kashmir to its east.
According to binding resolutions from the UN, a plebiscite is to be held to determine whether the region is to join India or Pakistan, or become an independent state, but this has yet to happen, leaving millions in legal limbo.
Pakistan has not constitutionally integrated Gilgit-Baltistan into its political system because it believes the area could one day prejudice the plebiscite vote to settle the Kashmir dispute with India.
This legislative assembly...we feel is powerless. All the power is in Islamabad. Until this [Advisory] Council in Islamabad, which has all the power... until their power is transferred to the [Legislative] Assembly here, we feel the problems here cannot be solved.
No taxation without representation
Ghizer district is an unlikely place to find such animosity towards Islamabad as it is the home to 12,000 soldiers in an elite division that specialises in high-altitude warfare.
Nearly 500 have died fighting India since 1999, manning border posts in the highest battlefield on earth.
Islamabad has also spent billions of dollars building infrastructure in the area like the Karakoram highway, which links remote mountain communities and provides a reliable land route to China.
Yet locals receive no revenue from customs duties with China, or the sales tax collected by Pakistan, which generates up to $550m in annual revenue and is destined entirely for Islamabad.
The Awami Action Committee (AAC), a coalition of 23 religious and political groups behind the current protests, is demanding that there be "no taxation without representation".
Stretching 28,000 square miles, and home to 2 million people, the region is not even mentioned in Pakistan's constitution, a fact that irks young activists like Sajjid Rana, 19, who says textbooks only refer to it as "the land of glaciers".
If Gilgit-Baltistan gained self-rule, Rana would like to see it become a crossroads for trade between India and Central Asia, as it was for thousands of years before its western and eastern borders were closed under Islamabad's foreign policy priorities.
"A lot of people care about the region, but no one cares about the people," Shabbir Hakimi, a Shia-cleric who helped mobilise thousands for the April sit-ins, told Al Jazeera.
"As Muslims, we care about Kashmir, but give us our rights, make us like Kashmir, or let us go altogether."
Unlike the rest of Pakistan-administered Kashmir, which has its own constitution, democratically-elected legislature, and independent judiciary, Gilgit-Baltistan was long governed by a federally-appointed civil servant who could impose collective punishment on local tribes.
In 2009, Islamabad granted the territory largely symbolic autonomy under a Legislative Assembly whose members are elected, and an Advisory Council, most of whose members are selected by the federal government.
|Follow our special coverage
"Islamabad is basically running the show," said Nawaz Khan Naji, an elected member of the 33-seat Legislative Assembly. "We have stacks of resolutions we have passed that have not been acted upon."
In 2012, the Legislative Assembly passed a resolution asking for Gilgit-Baltistan to be turned into a province, but the Advisory Council, headed by the Pakistani prime minister, ignored it.
Likewise key powers over trade, tourism and natural resources remain effectively under Islamabad's control and judges in Gilgit-Baltistan are appointed and dismissed at the discretion of a federal minister.
"We call it a 21st-century colony," said Israr-ud-Din Israr of the Human Rights Commission of Pakistan.
"All powers are with Pakistan, and we cannot make laws ourselves, for our own interests."
"This legislative assembly...we feel is powerless," Senator Afrasiab Khan Khattak, who heads a Senatorial committee on Human Rights, told reporters after a fact-finding trip to Gilgit-Baltistan in April.
"All the power is in Islamabad. Until this [Advisory] Council in Islamabad, which has all the power... until their power is transferred to the [Legislative] Assembly here, we feel the problems here cannot be solved."
|Pakistani Taliban claim attack on foreigners in Gilgit-Baltistan
The narrow roads throughout Gilgit-Baltistan are littered with checkpoints, manned by paramilitary soldiers and police who question all travellers.
In April, police climbed the cliffs overlooking the narrow highway near the village of Sikandarabad to drop giant boulders on to the roadway in an unsuccessful attempt to keep protesters from reaching the Gilgit sit in.
But blocked roads are not the only obstacle protesters face, with special courts set up to prosecute 'terrorism' suspects now being used against political activists.
|Picturesque Ghizer river, from which the valley and district take their names. [Umar Farooq / Al Jazeera]
More than 250 people have been tried in the anti-terrorism courts, alongside the 300 or so political cases that have been held in conventional criminal courts.
Iftikhar Hussain, 34, has been in a Gilgit city prison awaiting trial in an anti-terrorism court for nearly three years, even though the special courts are required to sentence convicts within 90 days of an arrest.
He is one of 36 men charged with 'terrorism' and 'sedition' stemming from a 2011 protest by locals demanding compensation promised to them by Pakistan after a massive landslide had destroyed their villages.
When police trying to clear the protest killed two men, riots erupted across the entire region and locals destroyed more than 17 government buildings including police stations.
Hussain, who says he was not involved in the riots, was one of more than 100 people arrested. Most of the other suspects arrested with Hussain have been released.
He says that for nearly a month he was tortured by investigators who included officers from Pakistan's intelligence agencies.
"We always raised our voices over local problems in our areas, simple things," says Hussain, who is a member of the Karakoram National Movement, a party advocating for self-rule.
"They don't like this, so they call it sedition."
As always authorities deny having tortured Hussain.
"[Hussain] is accused of serious violent crimes, " a senior Gilgit District police officer, who declined to be named, told Al Jazeera when asked about the allegations. "He was not tortured," he stated.