The US missile-attacks destroy militant training compounds and cars but they also hit mosques, homes, religious schools and civilian vehicles.
I witnessed the fear, stress and depression this causes for the tribal communities on a visit to the region in May.
The drones do not suddenly appear over the horizon, carry out the attack and leave. At any given time of the day, at least four are hovering in the sky, emitting a distinctive and menacing buzzing sound.
They call them "mosquitoes".
"Anybody who has been listening to the buzzing
all through the day usually can't sleep at night," says Abdul Waheed, a
tribesman in North Waziristan.
"It's like a blind man's stick - it can hit anybody at any time."
People here tell me that it is not just Taliban and al-Qaeda members who are targeted, many ordinary citizens have been killed as well. In some cases, tribesmen, motivated by a clan or blood feud, have pointed out a rival as a Taliban member or al-Qaeda sympathiser, they say, in the hope he will be blown to bits.
Everybody believes they could be next.
"There is only one way to sleep now," says Mateen Khan, a car mechanic in the town of Miranshah. "I take sleeping pills like many other people here. It is either that or stay awake all night."
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