While much of the surface rubble has now been cleared, survivors are still living in tents or shelters rattled almost daily by aftershocks. Musarad Nazir, 30, lost her 12-year-old son, whose body has never been recovered. A further six of her relatives perished. She and her remaining three children and husband live in a rigid plastic shelter, not much bigger than a garden shed, where the air is stale and despair is palpable.
"We thought it was doomsday," she remembers, sitting on a thin, grubby mattress with her sister, who also lost a son. "There were too many dead bodies. We're not happy to have survived - we lost our children. It would have been better if the whole family had died. We are worried that there will be another shock that will open up the ground or cause the mountains to collapse. We feel that every day might be our last."
Standing in the doorway is Muhammad Parvez, 40, who lost his wife, four brothers, two nephews, his four-bedroom house, his possessions and his fruit and vegetable shop. He now shares a tent with 10 relatives. "To lose one family member is unbearable," he says. "When you lose so many, only God can give you the strength to survive it. It's still chaos here. It's no different from the first day, and it's been six months." What these survivors do not know is that with two parallel fault lines passing under Balakot, the government is planning to move the population and reconstruct the town at a location yet to be decided.
According to official figures, around 73,000 people died in the quake, Pakistan's worst natural disaster, which struck NWFP and Pakistan-controlled Kashmir on 8 October last year. At least a further 1,300 died on the Indian side of the dividing line in Kashmir. Aid agencies believe the number of victims could be as high as 100,000.
When I came last November to the remote villages of Biyari and neighbouring Pokhal, 5,400ft up in NWFP's Allai valley, a second wave of deaths was feared as survivors struggled with a harsh winter. If nothing else, people feared that their relief tents would collapse under several feet of snow. But a fresh disaster was averted, thanks both to a late snowfall which melted quickly and a massive national and international aid operation.
Independent on Sunday readers donated more than £132,000 for the charity ActionAid in our Christmas appeal. Much of the money has gone towards 2,412 tents and 3,329 shelters for survivors. The tents in Biyari and Pokhal have since been replaced with corrugated iron shelters. Standing in the spring sunshine, villagers are naturally grateful. But like millions of other survivors, they face enormous hurdles as reconstruction begins.
"Our worry now is the rain," says Agha Farooq, chief of staff for the Federal Relief Commission, the Pakistan body that has been handling the disaster. "It started in March and will continue until July. It will destabilise the mountain slopes, and there will be massive landslides. The relief work was a sprint. The rehabilitation phase is a marathon." Foreign pledges total $6.523bn (£3.75bn), but less than half has been received.
Many can no longer earn their living. Farmers lost their harvests and have not been able to afford seed for this year's crops. Most families whose homes were destroyed have now received the first of four government compensation payments, largely deemed insufficient by survivors, particularly as labourers and masons have increased their charges. Others are still waiting, and have been for months. "There is rampant corruption," said Bushra Gohar, emergency response project director for ActionAid. "They have to bribe so many people to get their cheque. Because they are so poor, they will accept whatever they can get."
Tenant farmers, like those in Pokhal and Biyari clambering over the remains of the homes, face a particular problem. Payments are being awarded to landowners, although it is the farmers who have lost their homes and possessions. To add to their misery, bird flu has just broken out in the region.
Compensation is being paid in stages to encourage the 263,000 survivors still in relief camps to return home and rebuild their lives. Camps are due to be closed shortly, but many do not want to return. "The government is asking the people to go back, but we are afraid of the aftershocks," says Mohd Shabbir, in H11 relief camp in Pakistan's capital, Islamabad. The 29-year-old labourer from Rawalakot in Pakistan-controlled Kashmir shares his tent with seven other relatives. "What will we do when we go back? How will we rebuild our houses? Our pockets are empty. I won't go back to Kashmir."
Many are trying to get back to some sort of normality. A short drive up a mountain road from Muzaffarabad, our path is blocked by a landslide. After a 15-minute walk up to the summit, past snoozing goats and fruit trees in blossom, we reach Tanda, where children are having lessons in a dome-shaped corrugated iron shelter. The school is one of 20 provided by ActionAid. Almost 70 per cent of schools and colleges were damaged or destroyed, killing 18,000 students.
The shelter stands next to the collapsed remains of the former schoolhouse, which entombed a seven-year-old girl and an eight-year-old boy. It is a sight that still frightens the 52 children who survived. The charity is training people to become trauma counsellors, as well as setting up 20 community and health care centres.
In Islamabad, others are struggling with the physical effects of the disaster. A spinal injury unit was set up at the National Institute for the Handicapped to care for around 100 of the 700-odd people left paraplegic or quadriplegic by the earthquake. The majority are women, as many were indoors when it struck. Only a handful have started to walk again, but Khalida Noorkhan, 20, from Bagh in Pakistan-controlled Kashmir, is convinced she will be one of them when implants to support her spinal column are removed. But according to Dr Humaira Khalil, it is unlikely that those still unable to walk six months later will ever regain the use of their legs. She fears that many of her patients will be rejected by their husbands when they eventually return home, unable to work in the fields or in the home.
There are others, though, for whom the future looks even bleaker. Ishred, a mother from Bagh, has been in a coma at the Pakistan Institute of Medical Sciences, Islamabad, since the tragedy. She lost her four-year-old daughter and one-year-old son, and later the unborn baby she was carrying.
With no long-term facilities for coma patients in Pakistan, Ishred's family is about to take her back to a relief tent in Bagh. There is only a 20 per cent chance that she will come out of her vegetative state, and she is likely to spend the rest of her life bed-bound - not that there is a bed waiting for her when she returns.
KEY FIGURES
400,000 houses damaged or destroyed
374,000 shelters built since quake
263,000 people still living in tents
$6.5bn pledged in foreign aid - less than half of it received
7,000+ the number of aftershocks
2 quakes since in Pakistan
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