Then, as with Haiti now, a huge international aid effort swung into action.

More than four years on, a visit to the city closest to the epicentre reveals that many problems remain.

Day after day, young pupils at Muzaffarabad Government Girls' High School in the centre of the city are still having to study outdoors.

Some wearing coats and woolly hats, they sit in the playground for their lessons, or in tents or structures that were only meant to provide a temporary solution.

Abdullah Khan is still waiting for his family to be rehoused

The rebuilding of their classrooms is only just getting under way. A lone workman is carrying out noisy soil tests as the pupils strain to listen to what their teacher is saying.

But these children are some of the lucky ones. The wait for new schools for tens of thousands of other children across the region will be even longer.

Some of the most traumatic scenes in 2005 were of parents searching for sons and daughters in the rubble of their classrooms.

In total, well over 70,000 people died, and an estimated three million were made homeless.

'Broken promises'

While the initial international aid effort was huge, the long-term development did not carry on as it was meant to.

More than four years later, some of the displaced are still living in tents.

In a dusty camp, in squalid conditions, we find Abdullah Khan. After the earthquake, in which he lost more than 20 relatives and his home, he lived in a tent close to Muzaffarabad's university.

After a year, he was moved to this camp, and is still waiting for his family to be rehoused.

After more than four years, the reconstruction of basic urban infrastructure, like water and sewage systems, has still not happened Zahid Amin Former head, local development authority

"The politicians keep making promises, that they'll solve our problems, and that we'll have places to stay soon, that they'll do this or that, but it never happens," he says.

So why, after so much time, and so much money pledged, are people still living like this?

Zahid Amin, the former head of the local development authority, is one of many who blame political mismanagement and corruption.

"After more than four years, the reconstruction of basic urban infrastructure, like water and sewage systems, has still not happened," he says. "Educational institutions have not been rebuilt either.

"The reason is that there is no political stability," he says. "There is frequently change in the government: new people, with new development plans and new agendas.

"Also, the federal government has taken away our money that they were supposed to spend in earthquake-affected areas. It has shifted that money to other parts of the country and to other political projects."

It is an accusation that is denied by Pakistani Information Minister Qamar Zaman Kaira.

He refuses to accept the local assessment that the majority of schools in the urban centres of the earthquake zone have yet to be rebuilt or repaired.

"And there has been no diversion of funds," Mr Kaira told the BBC.

"In fact, more foreign loans have been taken and sent to the region for development."

But Mr Amin and others say the loans taken on behalf of earthquake survivors have also been channelled elsewhere.

Out of necessity, of course, a lot of the buildings are being used again, and many shops and businesses have reopened. Even if they have had to rebuild their houses themselves, most people do have somewhere to live.

No burials

But the scars in Muzaffarabad are not just physical.

Amina Irshad has not been able to lay the body of her husband to rest

It feels like everyone in the city has a story of where they were at the time of the earthquake, and of the loved ones they lost.

And while most have adapted and are getting on with life the best they can, the circumstances for some have made it much harder to move on.

Amina Irshad, 34, has not been able to lay the body of her husband to rest. He was on his way to work at the time of the earthquake, but neither he, nor his remains, have ever been found.

"I think about him all the time," she says. "I wish I could bury him and have somewhere to pray for him."

She bites her lip and pauses for a moment. "I wish he could just walk back in here now. Life's so hard without him."

Remarkably, bodies are still being found. Road-builders recently came across a bus that had been buried in a landslide in the earthquake.

It was a traumatic discovery for the families of the 17 victims whose remains were found inside. But they were finally able to hold funerals.

In Muzaffarabad, the reminders of that tragic day in 2005 are still never too far away.