The epicenter of the quake was near Muzaffarabad, about 60 miles northeast of the Pakistani capital of Islamabad. Pakistan bore the brunt of casualties, with a death toll of more than 86,000 and over 100,000 people injured. A total of 4 million people have been affected in Pakistan's North West Frontier, Azad Jammu and Kashmir provinces. In India, where the earthquake's devastation was less acute, more than 1,400 people lost their lives and an additional 75,000 were injured. Nearly 200,000 survivors were left homeless.

In Pakistan's Allai Valley alone, where CARE is concentrating relief and reconstruction efforts, homes and health facilities in a 200-mile radius were destroyed, water and sanitation systems were rendered inoperable and irrigation systems, the lifeblood of this dense agricultural region, were ruined. Fewer than 5 percent of schools survived the quake, leaving children especially vulnerable. Even before the earthquake, the people of the Allai Valley were very poor, with few employment opportunities and little education. The area is physically isolated from the rest of the country, making disaster response difficult.

During the harsh winter, more than 300,000 earthquake survivors left their homes for the relative warmth and safety of displacement camps at lower elevations. With the arrival of spring, those people returned to their villages en masse to begin repairing their homes and preparing fields for planting.