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A Nepalese villager surveys the damage from an earthquake in Sankhu, a village in the Kathmandu Valley of Nepal, May 14, 2015.DANIEL BEREHULAK/The New York Times

I was snapping pictures of two adorable little girls, just a little older than my own five-year-old daughter, and chatting with them through a colleague when the earth began to tremble.

More than two weeks after the magnitude-7.8 earthquake hit Nepal, killing nearly 8,000 and injuring thousands more, the aftershocks had continued daily, but had seemed to be growing less. Those of us who arrived after the first Great Quake barely noticed most of them, though for those whose homes and lives had collapsed each one was a cruel reminder of what they had endured, and stirred up the fear all over again.

Aid was beginning to get out, and people – keenly aware the monsoon is less than a month away – were beginning to rebuild temporary shelters.

But this was no minor aftershock. My girls' auntie scooped them up and was out the door of the community health clinic where we'd been chatting before I even knew what was happening.

The tremor seemed to last an eternity, though later I was told it was no more than a minute. Buildings already weakened by the first quake teetered dangerously; bricks came down here and there. My colleague snapped a photo of the dust from a collapsing building; I can't remember seeing or hearing it happen.

When it was over, more buildings had fallen, more people were dead and injured, and a country that had only just started the most fragile of recoveries had to pick itself up all over again.

I was on my last day in Nepal after 10 days of helping our WaterAid country team document damage to projects which in some cases have been running for more than two decades, and speaking to the few journalists still in town. With hundreds of thousands of people now in tents or what the aid world calls transitional housing – here, generally wooden frames with corrugated metal as walls and roofs – and monsoon rains due to begin next month, the risk of an outbreak of cholera or another waterborne disease is high, and worrying. We are working with local NGOs and other organizations to distribute water purification tablets and drops, but the need is greater than what we can get in country, and shipments to this mountainous, landlocked country with few entry points are slow.

In 10 days of travelling through some of the hardest hit districts – Gorkha, Kavre, Lalitpur, Bhaktapur – we met family after family who had very little before and even less now. Their resilience is incredible; nearly everyone we met was already trying to cobble together some sort of shelter and getting back into their terraced fields of corn, wheat and potatoes.

But the challenges are so vast. We were encouraged to see in some places that the water supply was intact and so were the toilets – even where houses had collapsed – giving people at least some basic comforts and hope of keeping cholera and other diseases at bay. However in others, water was running sporadically or not at all, or had been contaminated, leaving medical officials watching carefully reports of diarrhea for fear of a wide-scale outbreak.

We visited a corner of Bhaktapur, a district known for its trekking, near Nagarkot village, and learned that all but one house had been severely damaged by the first quake and its aftershocks. In the cities, entire blocks of homes have been marked in red by municipal inspectors, signalling they are unsafe to live in; how these will be demolished and the rubble carried away in a tiny, land-locked, mountainous country with narrow streets and little heavy machinery is impossible to imagine.

The damage from the second quake will be in some ways less devastating than the first. People were already out of unsafe buildings, for the most part, and sleeping outside; the second quake, like the first, occurred at midday when families were more likely to be in the fields or in their ground-floor kitchens for lunch. The death toll is mercifully much smaller this time.

What is more difficult to measure will be the level of human misery. Temporary shelters may have collapsed. Buildings from which there was still hope of retrieving possessions may now have tumbled. Health posts have been damaged and schools destroyed. Water connections that had become fragile and sporadic may now be cut off entirely. And entirely new communities have now been affected, adding to the number of remote places that must be reached with aid.

We met a teacher this week who'd almost single-handedly created a secondary school in his village – starting it in a temporary building, working with foreign donors and the district education council to get funding for a new building, installing a beautiful library with the help of an American NGO, and working with WaterAid to ensure students had a regular supply of safe water through filtered rainwater collection tanks, and separate, clean toilets to encourage girls to continue their studies after reaching puberty. On Monday that school was barely standing; its walls deeply cracked. The teacher said the building seemed to have sunk into the ground. Then, he still hoped retrieving books and computers for their new temporary location – already identified – would be possible. Now I have trouble imagining how they will.

After Tuesday's tremor subsided, I huddled with my colleagues in the open square in front of the health post for a few minutes, then we carefully made our way to the car and down the hill towards Kathmandu, through streets even more littered with debris than before. We'd gone to the health post to help hand out bars of soap, diapers and sanitary pads, and to talk to families about the importance of good hygiene practices in emergency situations to prevent disease. It seems simple, but it keeps people healthier and out of clinics, and provides a bit of dignity at a time when cleanliness and privacy are almost impossible to maintain.

It's hard to know where to start now. People need shelter, food, water, sanitation. Schools and clinics need to be reconstructed. Building codes need to be strengthened and enforced to try to make Kathmandu more resilient to the inevitable next earthquake. Routine health care gets neglected in times of crisis, so there will be catch-up required on vaccinations, prenatal care and other more routine matters.

The UN mounted an emergency appeal for Nepal after the first quake but has managed to raise very little of it so far. They estimate $65-million will be required to rebuild water and sanitation systems alone, critical to curbing the risk of outbreaks. Even before this quake Nepal had grim statistics: one in seven of its people without access to a source of clean water, and two out of every three people without a basic, hygienic toilet. The average national income here is just $1,500 a year; 34 children out of every 1,000 don't make it through their first year.

That evening, as my colleagues prepared for yet another night in tents and I reluctantly made my way to a battered but still functioning airport, I wondered how this beautiful country will recover from this. And I wonder if anyone will even remember to pay attention, once the aftershocks subside.

Carolynne Wheeler is a former special correspondent for The Globe and Mail who reported from Russia and the former Soviet Union, the Middle East and China before moving to London in 2013. She is now news manager for the development organisation WaterAid and has just returned from Nepal.