Paintings hang on the walls of the severely damaged church in the village of Santi Lorenzo e Flaviano, central Italy, on Saturday. (Andrew Medichini/AP)

This was once a quiet hilltop town in the rustic countryside of northern Lazio, relatively untouched for over 1,000 years. Now, in the wake of Wednesday’s devastating 6.2-magnitude earthquake, this medieval village is little more than a pile of rubble, already a memory.

At least 291 people died across central Italy during and after the earthquake, and the body count may still rise in the days ahead. Funeral services for the 50 victims killed in the Marches region were held Saturday in the cathedral of Ascoli Piceno. Italian President Sergio Mattarella and Prime Minister Matteo Renzi attended.

In addition to the human cost of Wednesday’s tragedy, Italian authorities are beginning to assess what the loss of Amatrice and similar small, ancient and remote towns means for the country’s extensive cultural heritage.

In a preliminary report issued Friday, the Carabinieri Art Squad — a branch of the Italian national police — listed more than 50 historic sites gravely damaged or destroyed in the earthquake. Most of them were small village churches that have stood in dusty town squares for centuries, marking the events that still define the cycle of life in rural Italy: christenings, weddings, funerals.

In Amatrice, known as the town of “100 churches,” at least 15 were destroyed — including Sant’Agostino, a 15th-century structure decorated with elaborate frescoes and a rose window on its facade. What does remain is the town’s clock tower, with the hands stopped at 3:36, the moment Wednesday morning when the earthquake struck.

For art historians, Amatrice and the other nearby towns affected have always been frozen in time, and their unspoiled longevity — as opposed to any specific building or work of art — was their true legacy.

Philippe Daverio, a well-known Italian author and art critic, said that the major loss in the earthquake is the simple, rural aesthetic that towns such as Amatrice represented, a quintessentially Italian style. “It’s an age-old way of constructing,” he said of the architecture in these towns, “very simple, very rustic, with lines that seem to approach the horizon.”

Survivors of the earthquake, crammed into tents and makeshift camps outside these destroyed towns, share this view: Some of them lost their families, many lost their homes, but all of them lost a way of life that stretches back centuries.

This was ultimately a lifestyle characterized primarily by families that have lived in small towns for generations and whose children and grandchildren have remained there, despite the siren call of urban sophistication and the prospects of glamorous careers abroad.

On Friday, Marina Gentile, 53, and Roberto Serafini, 52, a longtime married couple who lived in Amatrice, found themselves in an emergency camp outside their town, struggling to make sense of what had happened to their universe.

Marina said she had lived in Amatrice her whole life, and that the two of them ran a shop on the town’s main street that had been in her family for decades: first as a printery, then as a cosmetics boutique. After the earthquake, the shop is badly damaged, with nearly everything around it destroyed.

“Same goes for our house,” Gentile said. “All of the houses of Amatrice have been left from the grandparents to the parents to the sons.”

Kristian Talamonti, 40, is a psychologist from Rome who had been called to Amatrice to assist survivors such as Gentile and Serafini in the aftermath of the earthquake. In the camp on Friday, he highlighted the particular traumas that confront a population so deeply rooted in a now-vanished, age-old environment.

“This is an aging population, so many of them will be brought away from here — away from their homes, animals, the main square that no longer exists, the main street and all of the places of social aggregation,” he said.

“And one day, when the camp will close, when no one will care for them and feed them, they will be brought back to reality,” he said of the survivors. “And the anxiety will return: Where do I go? What’ll become of me? Will we be left alone?”

Although their family’s future remains uncertain, Gentile and Serafini said they found solace in what little does remain of Amatrice’s architecture — particularly its clock tower, always something of a landmark but now an eerie emblem of lost time.

“This is our symbol,” Gentile said, gesturing at the tower in the distance. “Only that tower remains, which means that if she was left standing, we can make it, too. If she falls, I don’t know.” She began to sob.

Serafini comforted his wife. “No, she won’t fall.”

“Traditions cannot die,” he said.

McAuley reported from Paris.

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