Up to 73,000 people died in the earthquake and thousands were left homeless, leaving the Pakistan government with the task of rebuilding the lives of the people who survived.
Many NGOs have stepped in to support the recovery process headed up by the International Federation of the Red Cross (IFRC), and although progress has been made - there are only 10% of the displaced population still living in tents - reconstruction is going slowly.
Many of the refugees are back living in tents after monsoon rains in August washed away their homes. The loss is evident in the voices of those now living in the camps.
Bhool Biba, a 45-year-old grandmother from Sachabela village, told Aljazeera.net that she had nowhere to go after her home was destroyed in the flooding.
"After the earthquake we returned home to rebuild our house, but then the rains hit and our place was totally destroyed by the flooding so I came here, back to the camp," she says.
Bhool Biba says that she had lived in the Shaval camp at Balakot (the epicentre of the quake) after the earthquake, but went home when the government closed the camps in March.
Others echo this story. Bibi Survarjan, 50, from Maramandgrah village close to Muzaffarabad (an area that suffered heavy losses in the earthquake), said that she was living in temporary housing when the rains hit because her property had been destroyed.
"We left the Kestara camp in March and built a temporary shelter, outside the camp, where we lived until the rains completely washed our home away."
Bibi Survarjan lost six members of her family to the earthquake and the trauma of the second displacement is evident by the tears that run down her face as she recalls the memories.
"Everyone has been affected by it here," she says.
Although stories like these abound, many people are rebuilding with government aid. The road to Balakot is littered with new houses and the foundations for many more.
The Earthquake Reconstruction and Rehabilitation Authority (Erra) was set up by the government after the earthquake to help with reconstruction. Although Erra was set up quickly by the government, it has been criticised for its slow implementation.
Junaid Quasim, the mayor of Balakot, told Aljazeera.net: "We support the government, but the implementation of infrastructure has been delayed by unnecessary bureaucracy."
Erra grants are paid in three instalments, each needing approval from Islamabad. Christopher Jackson, head of field office at the IFRC, says this controls the building.
"The aim is to build houses that are earthquake resistant," he says.
However, with many children still studying in tents, local officials say the process is too slow.
Any new homes built in Balakot
must be quake resistant
Quasim says: "Why should we go to Islamabad to seek approval every time we want to do something? They should give the responsibility to the province so that we can manage it ourselves."
In response, Muhammed Ali Durrani, the Pakistan minister of information, who was visiting Balakot on the eve of the first anniversary, told Aljazeera.net that it was normal for the initial stages of recovery to be slow because comprehensive solutions were necessary.
"Only 10% of individuals who were affected by the disaster are living in temporary accommodation today. We have the funds and there is a momentum now to build on this," he said.
At Garlat primary school in Balakot, the story one year on is quite different. At least 300 children are studying in ragged tents donated by Oxfam a year ago. The conditions are unhygienic with students sitting on flimsy canvases on top of the rubble of the old school.
One teacher, Sabir Hussain, told Aljazeera.net: "Living in a tent and studying in a tent is a traumatic experience for children. They are already traumatised after losing their classmates in the quake."
Eighty-seven students were killed and two teachers died while trying to rescue children from the rubble.
"The government schools are suffering. We don't get any help from NGOs unlike the private schools. We have no clean drinking water, toilets or furniture. Children are still buried under the rubble we are sitting on."
Hussain said that there are at least 300 government schools across Balakot.
The story across town at the Balakot Girls Higher Secondary School is somewhat better with temporary shelters made from corrugated sheets and raised foundations acting as classrooms, although there are only five rooms for 400 students.
Two classes are held in one room at the same time, and desks have been set up in the playground.
Children at Garlat primary school
are still studying in tents
Tanveer Begun, acting principal, told Aljazeera.net: "The children are studying outside in the midday heat. But we don't have room for them. We have at least 400 students studying in five rooms."
The shortage of teachers has is also a problem.
"We lost three teachers and no one wants to come here to replace them. Many of the other teachers we had have migrated to other cities close by such as Mansehra and Islamabad because we can not provide accommodation for them," Begun said.
Up to 200 students and three female teachers died in the disaster.
The IFRC is running a number of psychosocial programmes in Balakot to help children deal with the trauma of losing their family and friends.
Harsh winter ahead
With winter approaching and many refugees still in tents, the focus has shifted to providing shelters that can withstand Himalayan weather conditions where temperatures can fall to -1C.
It is estimated that about 400,000 people still live in temporary shelter according to the IFRC. It is also estimated that a further 20,000 people will come down from the hills this winter.
The IFRC has been putting plans into place that will ensure people are not left out in the cold this winter.
Jackson, told Aljazeera.net: "We have a contingency plan to provide shelter support for 13,500 families [94,000 people] during the coming winter across NWFP and Pakistan-administered Kashmir.
"The Pakistan army will also work hard at keeping the roads open as this will act as a deterrent to those living in the mountains against coming down to the towns. They will most likely move if they feel they will be cut off."
There are plans by the government to relocate Balakot as it has been designated a red zone - it sits directly on top of the fault line - and therefore rebuilding has been restricted there.
According to the minister of information, the plans for the new Balakot have been finalised.
Rubinoreen (L) and Rubinashaheen
were both injured in the quake
The new site at Bagrial is 27km south of Balakot, but many families who have lived in Balakot for generations do not want to move.
Rubinashaheen, 28, disabled by the earthquake and now living in a temporary shelter on the site of her old house lost two brother and two sisters, but was saved when a door fell on her as the house collapsed.
She told Aljazeera.net that, although the earthquake had been traumatic, she did not want to move to the new Balakot: What should I do? My forefathers owned this land. I don't want to go."
Others are looking forward to the move because they are tired of the living conditions where there is no proper water supply and sanitation.
Bibi Rukhtaj, who lives in a tent a few kilometres away from the site of the house she lost, says she will happily go to the new Balakot.
"I would move to the new Balakot. Last night there was an aftershock and the children were awake all night. I don't want to live afraid and I don't want my children to either," she said.