Seven-year-old Tesneem Bibi grimaces with pain. Her tears are mixed with sweat as a nurse wraps her foot.
Her father, Ismail, had already dug a grave for her when he pulled her out of the remains of their home, unconscious, two days after the quake. He carried her for two more days, through the mountains, to reach help.
By then gangrene had set in and Tesneem was rushed to an operating room, where doctors had no choice but to amputate part of her foot.
"When I think of the pain and suffering," says Ismail, "it would have been better if we'd all died. The pain is more than she can bear."
Tesneem isn't alone. Eight thousand schools were destroyed in the quake, and survivors now fill beds in a hallway that’s been turned into a hospital ward.
The children have head wounds, fractures and gangrene. Doctors are now vaccinating them against tetanus and measles.
UNICEF estimates as many as 120,000 children are in need of shelter or medical care. And since the aid isn't getting to them, parents and children who can are hiking across broken roads and steep mountain passes for help.
In the foothills of the Himalayas, Dr. Kaiser Jalal was trying to bring aid to them Thursday, but when the road stopped, so did he. He knows, as a doctor, this is a critical time.
"Yes, of course, it's a very critical time," says Jalal. "And if nobody reaches them in one or two days, nobody knows how many lives we are going to lose there."
UNICEF says as many as 10,000 children could die. And for those who survive — amputees like Tesneem — life may be difficult.
"In our culture there is a stigma, especially for girls that can't be married," says Dr. Muhammed Amjad Chaudery of Islamabad Children's Hospital.
But with rehabilitation, time and a father's love, perhaps Tesneem will have a brighter future.