It was startling how similar the complaints were from victims of the Kashmir earthquake and Hurricane Katrina. “No one has come to help us,” echoed through the snow-covered mountains in Pakistan just as that phrase was repeated outside the New Orleans Superdome and in small towns along the Mississippi coast. What both natural disasters highlight is how hard it is for governments, local and national, to function when towns are isolated and destroyed.

For now, the focus in Pakistan is on rescue and relief efforts. Estimates of those killed by the temblor that rocked South Asia on Saturday range as high as 40,000. Most of the deaths were in Pakistani-controlled Kashmir, a disputed region in the Himalayas. Rock slides and torrential rains slowed rescue crews trying to reach mountain villages. When relief convoys did arrive they were overrun by villagers desperate for food and water. More than 2 million people were left homeless.

As in other recent disasters, including last year’s Asian tsunami and America’s hurricanes, there has been an outpouring of cash contributions from around the globe. These re-sources, and more, will be needed first to care for the displaced and, later, to help them rebuild.

Just as in New Orleans and along the Gulf Coast, difficult decisions must be made before homes and offices are rebuilt. Rather than simply rebuilding in unstable areas and using material that can’t withstand the inevitable shifts in the Earth’s crust, geologists and government officials must set standards for where and how new structures can be erected.

There were signs that the earthquake could lead to political shifts. India and Pakistan have fought two wars over the Muslim majority region. Each country now controls a portion of the province. India quickly offered food, medicine and tents, which were accepted. An offer of military helicopters, however, was rejected in favor of aircraft from the United Nations.

The death toll in Indian-controlled Kashmir was said to be 1,300, far less than the number who died on the Pakistani side. Some Kashmiris expressed frustration with the slow Pakistani response and noted that a Kashmir liberation group was quick to help while the Islamabad government had yet to arrive on the scene.

While the immediate task is to provide shelter, medical care and food for those displaced by the earthquake, international help will be needed for months to come to ensure the region’s infrastructure, both physical and political, is intact.