China, a Year After the Deadly Sichuan Quake

Editor's note: To protect the identities of some interviewees who feared government retribution for their statements, we have changed some names and omitted geographical information for some communities.

In the mountains of Pengzhou, less than 40 miles from the epicenter of the earthquake that shook the Sichuan province May 12, 2008, Mr. and Mrs. Lu stand proudly in the middle of their modest room in a block of temporary housing.

What little they recovered from their house fills the room. Plastic ivy garlands -- and a pair of wet socks -- hang from the ceiling. Their outfits have been assembled from donations from relief organizations.

After their home collapsed in the earthquake, they set up a ramshackle tent on their crumbled foundation, where they lived for six months. Then, as the harsh winter approached, they were allocated a room in this temporary housing block.

"We constantly worry about our children and friends who have not found jobs after the earthquake. We wonder how we will pay for the future," reveals Mrs. Lu. Due to these financial constraints, they recently celebrated the wedding of their only daughter in this cold tin-roofed room.

The couple is still eagerly awaiting the day when they can move from these cramped quarters to a house of their own. However, in this mountainous region at risk of landslides and future earthquakes, land for rebuilding has not yet been allocated.

Stories such as these abound in the region affected by the earthquake, which shook the Sichuan province of China one year ago. The scope of the destruction was massive. The quake toppled villages and turned buildings to rubble. When the dust settled, millions of lives had been disrupted. Almost 80,000 were confirmed dead, and more than 370,000 were injured.

This spring, locals are still struggling to find a semblance of normalcy. According to the United Nation's Office of the Coordination of Humanitarian Affairs, more than 5.5 million homes were destroyed and between 5 million and 11 million people were left homeless. Losing most of what little they had, these people essentially became refugees in their own country.

They lost not only their homes but also their communities, livelihoods and access to health care.

Sichuan's Struggle for Survival, One Year After the Quake

Although the disaster quickly garnered worldwide attention and aid during the acute phase, the global consciousness has since shifted. It is easy to forget that, a year after the quake, the important task of long-erm rebuilding and recovery has only just begun.

The transition from acute emergency relief to sustainable long-term recovery and development activities is a challenging path fraught with innumerable obstacles. While the majority of disaster response focuses on the acute needs, long-term recovery often proves to be less straightforward.

One quickly moves beyond the numbers and statistics while spending time with the affected families. A firsthand view of the recovery process a few months after the quake as well as six months later reveals the issues pressing on the minds of residents of the region: the long wait for permanent housing and the lack of viable long-term jobs, not to mention the psychological aftermath.

Housing is foremost on most residents' minds. Initially, blue tents provided by aid organizations dotted the countryside. Since then, residents of the larger villages and cities have been moved into enclaves of temporary housing with shared kitchens, bathrooms and a small square room for each family of four.

"Living in the temporary housing is better than outside without a roof, but the air feels trapped and hot in the summer and it is freezing cold inside in the winter," said Mr. Jun, a resident of a village in which every resident -- hundreds in all -- lost their homes.

After surviving one harsh Sichuan winter, residents are eagerly looking forward to the prospect of more permanent housing. Some locals are taking matters into their own hands and have cobbled together makeshift homes from construction debris, tarps and salvaged wood.

In the smaller villages, if any walls still stand, families only have the option of temporarily patching up their old houses and living within these precarious structures.

The Yu family has lived for many generations in a village in the northern earthquake area. The grandmother points out large cracks that run through the walls of their house. As some of the rooms are more stable than others, at night, all three generations squeeze into two rooms to sleep.

The rafters in the dining room were put up by her great grandfather, who inscribed them, by hand, with short verses from famous poems. "Although we are looking forward to moving into a new house when it is built, it will be a shame to knock down this old house with all our memories," said the mother, who was born in the house.

Red Cross: Rebuilding Sichuan is Like "Rebuilding Los Angeles"

The magnitude of the task of rebuilding is immense: In an interview with Reuters, the China spokesman for the International Federation of the Red Cross has likened the challenge to "rebuilding Los Angeles." Given this need, the Chinese government has stepped up its construction of new homes and recently pledged 1 trillion yuan ($147 billion) toward rebuilding efforts.

However, the significant pressure to push forward with the rebuilding may invoke unintended long-term consequences. The government-directed rebuilding program is already showing the telltale characteristics of a short-term mentality focused on putting up concrete structures that may not serve the needs of the population.

Posters promoting the new developments give locals a glimpse of the proposed rebuilding. In this area populated by subsistence farmers, many live the same way residents of this province have for generations -- in traditional family homes situated on large plots of land used for agriculture. One issue will be the long-term impact of rebuilding communities not in the traditional configuration but in planned clusters modeled after the surburban neighborhoods in the West.

Although this shift may seem inconsequential, it will have far-reaching effects as residents search for new ways to sustain their livelihoods. Some housing developments have been built over fertile land. This has left residents, whose only skills are related to farming and agriculture, at a loss when they consider how to support their families in the future. The result is bittersweet -- they will have roofs over their heads, but at the expense of their means of living.

A little before lunchtime in a former mountainside resort famous for its homemade tofu and river fish, a 75-year-old woman with her back bent from years of manual labor, counts the short scraps of wire she was able to salvage from old city construction. Most of the original buildings were destroyed by the earthquake, and the village has since been replaced by a large expanse of temporary housing. Her family is no longer able to farm the cropland that was razed in preparation for housing developments; she has spent all morning sifting through rubble for wire, which will be traded in for the equivalent of 70 cents.

In an ideal situation, disaster recovery also addresses prevention -- the building of new structures to withstand future quakes, for example. This is particularly important in Sichuan, which has experienced no fewer than five major earthquakes since the turn of the last century. The thousands of aftershocks rumbling through the area in the past year have served as constant reminders that the question is not whether there will be another earthquake, only when.

Back in the temporary room occupied by the Lu household, the ivy garlands looped through the rafters are a reminder of the recent festivities. The couple recall the gathering of family and friends who, for a moment, were able to forget their heartache to commemorate this happy occasion. "Life still moves on, but we will never forget."

The continued weddings, births, reunions are a poignant demonstration of how life has moved on in the province. The Sichuan people refuse to be defined by loss, sorrow, or tragedy. Despite the adversity they have survived, and the uncertainty they face, they are mind-bendingly resilient, and hopeful for the future.

Drs. Kendall Krause and Charlotte Wu traveled to the Sichuan region of China to provide medical care and survey the progress of rebuilding after a massive earthquake hit that region May 12 last year. Both graduated from the Yale School of Medicine. Wu is currently a resident physician in primary care at Beth Israel Deaconess Medical Center in Boston. Krause completed her emergency medicine internship at the Harvard affiliated program, and is currently a medical writer.

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