For some quick-thinking villagers in the remote upper valleys of Indian Kashmir there was a simple method amid the chaos that accompanied the earthquake relief effort - although it was too rarely used to be effective on a wider scale.

Before Riaz Mohammad was roughly bundled on to a rescue helicopter from the fringes of his destroyed village on the Pakistani border 10 days ago his uncle scrawled the boy's name and address on a piece of paper, frantically stuffing it into the pocket of the injured child's tattered shirt.

He feared that, without any means of identification, his orphaned nephew would disappear in the panic and become another link in Kashmir's seemingly endless chain of human suffering.

In the dank and unwelcoming paediatric ward of Srinigar's Bone and Joint hospital there is no uncle or even distant relative to take five-year-old Sayed home when doctors finally declare him fit to leave. He has no piece of paper to clutch to his chest and the nurses who tend to him have very few clues about the fate of his family. He is beginning to show signs of severe depression and trauma. 'He cannot express his feelings, but we are trying everything we can to get through to him,' says Razila, the nurse who spends her days tending his leg and head wounds.

The volunteer therapists who are attending to Sayed are not asking him any more questions - they fear he will go into shock. Occasionally local Samaritans drop into the hospital ward and present him, and the other children, with colourful toys - by his bedside is a crudely made wooden puppet and a pile of untouched crayons. 'The hospital is planning to send him to a youth hostel if nobody comes to claim him after he recovers,' says Razila. 'There is little else we can do.'

But Sayed faces other, more immediate challenges. Six days after he was airlifted to the hospital doctors amputated his right hand after it began rotting. Around him many other children bear the same gruesome signatures of the earthquake: crush injuries to the head, abdomen, chest and head, broken limbs, and worse.

'We had to amputate the limbs of five children, aged from six to 12. They had either hand or leg injuries and they were very serious. What they have to deal with now is the fact that their lives will never be the same,' said one doctor.

A fortnight after the huge earthquake struck, doctors are also increasingly dealing with mental wounds in Indian-ruled Kashmir where psychiatrists, overwhelmed by their own workload, have begun to urge local Muslim clerics to help with spiritual healing. Twelve hospitals in three Kashmiri districts have started offering counselling to survivors of the catastrophe which killed 79,000 people and left up to 250,000 homeless. Mental health experts have also been sent to the worst-hit frontier districts of Uri and Tangdhar where 90 percent of homes were destroyed or damaged by the biggest natural disaster to hit the region in a century.

Medical charity Medecins Sans Frontieres says it has now recruited more help to bolster counselling centres. 'We now have 20 qualified people working in Srinagar as the most critically injured are being brought here by the army and we are offering counselling to orphans and people who have lost entire families,' says the charity's chief representative in the region, Stephan Hiltsher, who is expecting a deluge of mental health patients.

'In general, their resilience is high but you wonder what they're repressing. Trauma is undoubtedly widespread but most of it is not visible now as people are busy gathering their lives together.

Local mental health groups are looking to religion to ease tortured minds. 'Religion can definitely play a very important role and help people overcome trauma,' according to Srinigar-based psychologist, Mushtaq Margoob. 'The imams and the clergy must urge people to accept destiny. We are calling on the imams to deliver the healing balm through the words of religion. Also the priests will help them believe that whatever has happened was in their destiny and so accept it.'

Imtiaz Ahmed, a prominent Srinagar cleric, says the clergy are eager to help. 'We are more than willing to offer any assistance that will mitigate suffering and fight mental agony. We have to teach them that it was Allah's wish.'

Charities such as Medecins Sans Frontieres also claim that lessons can be learned from the aftermath of the Boxing Day tsunami. Children were encouraged to engage in cathartic role play and communicate their feelings through art - using crayons and pencils to draw what they had experienced. According to Mushtaq Margoob some children are clearly blaming themselves for the earthquake, he said: 'We are encouraging the children to draw pictures to communicate their experiences. Many youngsters believe that they caused what happened to their parents or siblings. This guilty feeling is common amongst survivors of a young age.'

But there are also wider concerns for the younger victims of the earthquake. Relief agencies fear children separated from their families are at risk from human traffickers and couples left childless by the disaster seeking to take in other youngsters. In Pakistan thousands of injured and unaccompanied children have been flown across the country to major hospitals hundreds of kilometres from their homes in the remote North-west Provinces and Kashmir. Many are in the Pakistan Institute of Medical Sciences (Pims) hospital in Islamabad. Its director confirmed yesterday that armed guards had been posted outside children's wards after reported attempts to abduct children.

Even before the earthquake, the US State Department had labelled Pakistan 'a source, transit, and destination country for trafficked children' while the International Labour Organisation estimates that close to 100,000 people, mainly minors, are trafficked in the country each year. Children have been a particular target for use as labourers and in the sex industry.

Not surprisingly, Pakistan's embassies and consulates around the world have been inundated with requests and offers from westerners looking to take in orphans quite literally left out in the cold by the earthquake. But in the UK the charity Save the Children strongly cautioned against rushing to adopt. 'Legality is the cornerstone of adoption and that cannot be done in a chaotic situation. Adoptions are inappropriate during the emergency phase as children are better placed being cared for by the communities they know,' it said in a statement.

In a televised address to the nation, Pakistan's President, General Pervez Musharraf, said his government would take 'full responsibility' for the orphans. He also pledged state aid for widows.

Adoption is extremely uncommon in Pakistan's tight-knit, clan-based culture, in which tradition requires relatives to take in orphans. But that safety net could easily fray in such arduous circumstances. The truth here is that those families hardest hit by the disaster cannot afford to feed extra mouths.