Fourteen months ago, a 7.6 earthquake directed worldwide attention to northern Pakistan. More than 3 million people lost their homes. More than 73,000 people lost their lives. More than a year later, many people still live in tents and temporary shelters that provide little warmth through the winter months in these small towns high in the Himalayas.

Since the earthquake struck, Northwest Medical Teams has partnered with various organizations to aid in relief efforts. Volunteers Ashley Johnson and Christine Hawrylow, both nurses from Calgary, recently returned from serving at Kunhar Christian Hospital in Balakot district-one of the hardest hit regions. Located a mere 10 miles from the quake's epicenter, Kunhar Christian was the only hospital still standing, with staff and electricity intact.

Prior to the earthquake, local support for the Christian hospital in a primarily Muslim region had been non-existent. But the hospital's aid during and after the earthquake helped ease the formerly tense relations. During Ashley and Christine's three-week tenure in the hospital's nursery, the welcome and appreciation of families was clearly evident.

"Quite often I would have family members and patients stroke the side of my face, pat my head, or hold my hand because they were so grateful for us being there to help them," Christine said.

Generous spirits in a land filled with need

Though they had so little, many patients and family members attempted to give the nurses presents in return for their care. One woman, "Grandma Abida," was particularly appreciative. Her grandson was born in a van on his way to the hospital. Ashley provided care for the baby during his first week of life.

"Grandma Abida had a smile for everyone," Ashley said. She often expressed her gratitude in her native language, Urdu, and left apples and other treats for the nurses as they worked.

Another patient, eventually called "Dr. Nawaz" because he learned to dress his own wounds so well, insisted on offering Christine part of his lunch every day as she cared for his injuries from a construction accident.

Ashley and Christine found that same gratefulness elsewhere, as well. Strangers, they said, often offered them a cup of chai tea and kindness. "One vendor in the bazaar gave us free bangles when he found out what we were here for, even though we hadn't bought anything in his store," Ashley remembers.

Casualties in the struggle

Yet the traumatic effects from the quake were clearly evident. People still suffer emotional trauma; others have not regained their lifestyle.

"Some have not spoken a word since that day," Ashley said. "There is limited income and resources, and poor nutrition." Many people make a living foraging for scraps of plastic and cardboard, selling it in the market.

The struggle for survival was most clear in the hospital nursery, where the fight for life at times grew desperate. Ashley remembers twin premature babies they nicknamed Samuel and Holly.

"Both were fighters, and each day you could see their personalities develop," Ashley says. "Holly was very dainty while Samuel was a little trickster."

Unfortunately, services remain limited for little ones like these. Eventually they had to be transferred to a government hospital, where they lost the little girl, and later the little boy.

"More equipment is needed;" Christine urges, "the list is endless, but the greatest need is proper transportation. In North America we would have spent thousands of dollars arranging a neonatal transport...We just sent the twins in the back of a pick-up truck lying skin to skin on mom's tummy."

Northwest Medical Teams continues to be part of the solution, helping the hospital raise more than $10,000 to tile the entire hospital floor, and sending another $20,000 to install central heating. Three medical teams in 2006 gave immediate care in the hospital, and at Kunhar Christian Hospital's request, two more teams are on the calendar.

"Medical missions always make me more aware and grateful for all the resources and opportunities that I have," Ashley says. "This trip I was especially touched by the little ones I worked with and their families. I look forward to offering my services in future trips."