In the four years since the devastating earthquake in the northeast part of the country, reconstruction of the region has been an important component of the development portfolio at the U.S. Agency for International Development (USAID) in Pakistan.

In the immediate aftermath of the Oct. 8, 2005 tragedy, the U.S. government mobilized all of its available resources. Military helicopters transported survivors out of destroyed cities and brought in thousands of tons of relief materials such as food, medical services, clothing, and tents in collaboration with the USAID Disaster Assistance Response Team. Heavy machinery moved debris to search for victims and set the stage for rebuilding.

The close teamwork of Pakistani and U.S. governments, along with other international donor organizations and NGOs, prepared the remote, devastated region for the inevitable onset of winter and averted another tragedy for the survivors.

As the dust settled, USAID joined ERRA, the new Pakistani Earthquake Reconstruction and Rehabilitation Authority, in planning and managing the massive task of rebuilding the region.

"We saw the situation as an opportunity - a chance to help rebuild more than schools and health centers, but whole communities," USAID Mission Director Bob Wilson said. "Not only did we replace bricks and mortar, but also provided isolated areas with technical assistance to improve local administration and delivery of health and education services."

USAID created a five year, $200 million program consisting of four projects, which include construction, education, health, and livelihoods restoration and development in the Mansehra district of Northwest Frontier Province (NWFP) and the in Bagh district of Azad Jammu & Kashmir (AJK).

More than half the program - $120 million - was allocated for physical reconstruction of destroyed buildings such as schools and basic health units. Programs cut across the development portfolio, with $23 million to strengthen education systems, $28 million for healthcare, and another $28 million for livelihoods restoration.

School reconstruction plans include 59 buildings - 25 in Bagh district and 34 in Mansehra. More importantly, USAID has trained 10,000 teachers in these two districts, and helped establish 2,300 school management committees, Wilson said. These committees give parents and community members an opportunity to get involved in school activities, and help identify and address their priorities and problems.

The USAID livelihoods project has created more than 6,500 permanent jobs in the earthquake-stricken area. A matching grants program with local firms has generated more than eight million dollars toward the rebuilding of the local economy and creation of new business in small industries linked to agriculture, such as dairy, or linked to local tourism in some parts of the earthquake area.

In health, USAID has also addressed a near total absence of female health care providers trained to work with expecting mothers and newborns, and to assist with deliveries in the earthquake zones. In the last three years, seven of 10 health units in the region have been staffed with female health workers, starting from none. Now half the units are equipped to provide reproductive health services, and overall individual health unit performance indicators have improved exponentially.

"Despite the difficulties presented by the mountainous terrain and harsh climate, projects are on schedule to be completed by October of 2010," said Robert MacLeod, leader of the USAID reconstruction team.

"Over the next year, we will complete construction of the schools and health units now under way, and shore up capacity in the communities that we hope will demand improved services from local administration long after the completion of our projects," he said. "After that point, we hope to integrate the social welfare elements of our program into our health, education, and economic growth offices."

MacLeod said that the tragedy has opened the door to development activities previously unavailable to the politically sensitive area of AJK, which has been disputed between Pakistan and India since independence.

"We've had a rare opportunity to work there," he said. "We hope the region will remain less isolated than before."