For weeks, health officials have warned of the possibility of widespread death from cold and exposure if residents of isolated mountain villages did not move into tent camps in the lower valleys for shelter, food and healthcare.
Experts including Salahud Din, a Humanity First physician from the Netherlands who has helped set up a medical clinic at Old Government Camp, wonder whether such a move is wise.
"People might be better off back up in the mountains, taking their chances against the elements in their own villages, than to endure conditions like this," Din said.
At this teeming camp, even some of the smaller tents house 18 people. Infants crawl on dirt floors and through puddles, ignoring the carpets their mothers have spread on the ground.
Dozens of goats scavenge from garbage mounds as chickens and feral cats wander among open campfires where women cook their daily meals, shooing away ever-present flies.
Many of the tents are made of a single layer of burlap, and rain drips inside as steadily as a hospital IV machine. Some residents have dug trenches to divert the rainwater, but others have no tools to do so.
Worst off are families with slapdash shacks made from sheets of corrugated metal that lean against a center pole, with no way to stop the wind and rain.
There was only one tank for drinking water, which soon became contaminated. Without latrines, residents relieved themselves just outside their tents, Din and other doctors said.
Volunteers from the aid group Oxfam have constructed a second water tower and installed sets of latrines around the camp's perimeter. They are emphasizing better sanitation.
But doctors still worry that the worst is yet to come.
On his first visit last week, Watson diagnosed 170 cases of acute diarrhea -- "sick men, women and children -- lots of them," he said.
Officials say treatment has helped reduce cases of diarrhea, which could lead to worse illnesses such as cholera.
Doctors also found cases of gastrointestinal infections, vomiting, meningitis, pneumonia, measles, scabies, chickenpox and hepatitis -- illnesses that can spread easily in the absence of proper sanitation and clean water.
Among adults in the quake-stricken area, respiratory illnesses are the second most-pressing medical problem after quake-related injuries, according to the World Health Organization.
