NOWSHERA, Pakistan — The floodwaters that ravaged this northwestern town a year ago have long receded. Gone, too, are the makeshift tent camps on roadsides. But as a new monsoon season starts, last year’s trauma and economic pain still linger, and the flood’s consequences are likely to be felt for some time to come.

The devastation caused by the worst floods in Pakistan’s history was easy enough to quantify: almost 2,000 deaths, nearly 20 million displaced or similarly affected and one-fifth of the country under water. A year later, the picture is murkier.

Estimates are hazy over how many flood refugees returned home and in what conditions. Many roads, levees and houses have been rebuilt, but authorities acknowledge that much remains to be done. Residents here say underground water has been contaminated and is not safe to drink. Lost possessions have been replaced at higher costs or not at all, and aid money from the government has been unevenly distributed.

Mamreez Khan said floodwaters filled his house completely before the roof eventually collapsed. He lost most of what was inside and now lives in a small room while his children were sent away to stay with relatives. A laborer by day, he uses his free time to rebuild his house brick by brick. But the work is progressing slowly, and for the most part the house remains a roofless ruin.

“Relatives and friends help us, but it is very difficult to rebuild our life,” he said. “I don’t see in the coming two years that I will have my house completely rebuilt.”

Shortly after the floods started in late July last year, nongovernmental organizations warned of dire consequences for millions of flood refugees, from homelessness to hunger and vulnerability to infectious diseases. The United Nations called for donations amounting to $2 billion but was able to collect only two-thirds of that sum.

Thanks in large part to rescue efforts by charity groups, the Pakistani army and the U.S. military, larger losses of life were averted. Feared epidemics also failed to materialize. But it is also Pakistanis’ resilience and support networks that mitigated the hardships.

Nowshera resident Janas Khan said his auto-parts business was destroyed in the floods, but help from family members and loans from business partners allowed him to replenish his stocks.

Not everyone has been so lucky. In a recent report, aid group Oxfam estimated that about 37,000 flood refugees are still living in camps in the southern province of Sindh and that more than 800,000 families remain without proper homes. Beyond the tragedy, Oxfam Country Director Neva Khan said last year’s floods represent an opportunity to better protect this disaster-prone country against future catastrophes.

“It’s important that we learn our lessons,” she said. “One year on, Pakistan is still not prepared for this year’s monsoon.”

Pakistani authorities and the United Nations estimate that between 2 million and 5 million people may be affected during this year’s rainy season. Rains have only just started, but already people have died in flash floods in the northwest and the capital region.

In Nowshera, false rumors of massive floods have been spreading since mid-June, leaving residents on edge.

“It is a mental torture when we are hearing that there might be another monsoon flood,” said 36-year-old Hayat Khan, who is still struggling to rebuild his damaged home.

Brulliard is a special correspondent.