Some will be in plain sight, a rough line running down a stomach or across a forehead. Others will be what’s missing - arms, legs. But most may be harder to spot: nightmares, depression and the loss of parents and siblings.

Some here have dubbed the children killed by the South Asian earthquake the lost generation. But relief workers, doctors and parents now worry about the survivors and see a scarred generation.

In this chaotic city of injured and evacuees, 4-year-old Jamil Khan wrapped his arms around his grandfather’s neck as they walked, his brown eyes as big as planets peering out from under a wool cap.

Abdullah Khan, 65, saved the youngster from the rubble and both the boy’s parents survived, though they were injured. But the old man couldn’t save his two granddaughters, 6 and 7.

The boy has one question he asks over and over again, putting the depth of his loss in words that mean everything: “Who will play with me now that my sisters are dead? Now, who will play with me?” His grandfather’s eyes welled up as he told the story.

“We’ve called this the children’s catastrophe,” said Katey Grusovin of UNICEF, the UN agency devoted to children’s issues.

In a region as big as New Jersey - some 22,000 square kilometers (8,500 square miles) - there are between 1.6 million and 2.2 million children homeless and at risk, the agency estimates. Doctors say roughly half their patients have been children. About 10,000 schools have been destroyed - and many of them took the lives of students, since the quake struck as the school day began Oct. 8.

UN humanitarian chief Jan Egeland said the earthquake exposed glaring failures in school construction, not just in Pakistan but in much of the world.

“They were deathtraps,” Egeland said. “We have to build schools all over the world that are not deathtraps, that are earthquake proof.”

Dr. Namirah Qureshi is tending a field hospital for a week in Muzaffarabad, where she grew up. She flew in from Pennsylvania, where she is a family physician.

The challenges ahead are steep, she said - depression, trauma, physical needs for the many amputees who had limbs crushed by falling homes, schools or boulders, and then couldn’t get to medical care before gangrene set in.

“I had some children who were severely depressed and crying. One was an amputee, one his mom had died,” she said. “I had to give one of them medication to get him to sleep.”

She said she heard a local official call the survivors “cursed,” a comment that left her saddened and furious. But it reflects the mind set in a place where intense physical work is part of daily life, from tending to livestock to just negotiating narrow paths along the mountainous terrain. She worried that the community may have a hard time accepting amputees or those left profoundly depressed.

“There is no concept of counseling,” she said. Her own cousin lost a child, while two survived. Her relatives evacuated to cities farther south. “They were talking to kids with my cousin in Rawalpindi and kept saying, ‘It’s OK, it’s OK.”’

It’s too early to fully gauge how the earthquake will shape the survivors’ lives. It already seems to be driving changes in demographics and population as many flee before the winter, and is spurring an outpouring of international attention relief officials hope will result in better schools and health care.

But for the children, it’s also likely to become life before the earthquake and life after - with mom and after mom, with my legs and without my legs.

In a tale that’s much too common across this region, 22 boys died when their school collapsed in the village of Munnasa, a remote area a few hours drive from Muzaffarabad.

Now the children wake up during the night and cry out, said Zulfiqar Abbasi, whose 6-year-old was injured. The many aftershocks renew their fears.

“When the aftershocks came, they shouted and yelled and were crying,” he said.

The fears and sadness will last a long time, he said, but strong family bonds will help. “In the combined family system, they will cry with each other.”

Officials say the needs demand a comprehensive approach to social services, education and health care. UNICEF is bringing in “schools in a box” to restart the education system and give children stability; government and non-governmental groups are trying to reunite families and keep track of children who have been evacuated, and there is a push to provide counseling for trauma, depression and adjusting to lost limbs.

“To be honest, at the end of the day, what you need is ... skills and you need money - buckets of money,” said Grusovin. “I don’t think anyone can singularly grasp the size of it.”

As a child, Qureshi shuttled between this capital of the Pakistani-held portion of Kashmir, the home of her grandmother, and the village where the rest of her family lived. She went to medical school in Karachi and then came to the United States.

While she mourns the losses, she’s also encouraged by the spirit and the resolve she witnessed.

“The people are very tough ... It’ll surprise you,” she said. “It’s difficult to communicate with them because they’re depressed and they’re scared. Only time will tell how they come out of this.”