One year on from the South Asia earthquake, the picture is still bleak with more than a hundred thousand survivors living in temporary shelters and winter fast approaching.
But over the past year, ActionAid has spent nearly US£4m dollars helping to rebuild people's lives.
"The earthquake has been a huge logistical challenge covering an area the size of Belgium in an extremely remote part of the world," said Roger Yates, Head of Emergencies at ActionAid.
"Our priority in both India and Pakistan has been to help people rebuild their lives and homes for the long term."
On 8 October last year, the earthquake measuring 7.6 on the Richter scale devastated 30,000 square kilometers of Pakistan and India, leaving at least 3 million homeless and more than 70,000 dead. Of those, 18,000 children were killed when their schools collapsed during morning classes.
The generosity of the international public and a huge relief effort has saved thousands of lives. Over the last year, ActionAid has led a major international initiative for safer schools and? worked with nearly 160,000 people in Pakistan, providing shelters, health care and cash grants as well as training people to become carpenters, stonemasons and electricians to rebuild their homes.
In India, in the context of tight military control, ActionAid was one of the few organisations already working in the area when the earthquake hit and was able to reach more than 84,000 people with food, tents and other essentials.
"We continue to have a unique presence, implementing a large-scale 'cash-for-work' project which has seen the planting of 38,000 trees to protect the environment and provided a source of income for thousands left destitute by the quake," said Babu Mathew, Country Director for ActionAid India.
ActionAid is urging the government of Jammu and Kashmir to speed up compensation payments and create a disaster management authority as a matter of priority, to coordinate efforts in what is still seen as a high risk area.
Throughout the region, ActionAid is working with some of the most vulnerable in the community. "Widows and disabled people have benefited from our 'back to work' projects, which have so far seen the delivery of 850 goats, 50 buffalo and the restoration of 50 shops in Pakistan," said Rubina Saigol, Country Director for ActionAid Pakistan. "Honey bees have also been provided to 250 bee-keeping families," she added.
As winter approaches, the immediate challenge is to move survivors out of temporary shelters - which in Pakistan have seen the spread of disease - and back into permanent homes.
A combination of government bureaucracy, high construction costs and the remoteness of the region has left many survivors in limbo.
Villagers often have no documents to prove land ownership, hampering progress, while too few government inspectors are available to inspect homes and process compensation claims.
ActionAid is now focusing on long-term, sustainable recovery. "We have committed to a three year project in Pakistan alone which will see 10,000 families with access to clean drinking water and 4000 families with safe houses," said Yates. "Vocational skills training will open up new employment opportunities for women and men otherwise faced with desperately limited ways of earning a living."
"The coming year is going to be equally tough but we're committed to helping people rebuild their lives and get back to something approaching normality."