CARREFOUR, Haiti — Children gather on street corners playing improvised games. They make toy cars and kites from trash and play hide-and-seek among the rows of shabby makeshift tents.

But even while they play, thoughts of the Jan. 12 earthquake are never far from their minds. Many, like 14-year-old Pierre Feedenly, fear the ground will shake again. Pierre prefers to spend his time in a wide alleyway between two streets, so he won't be trapped under a building in the event of another earthquake. He won't enter any buildings.

"Whenever I go inside a house, I think about what happened that day," Pierre said. "My heart starts beating fast. I get really scared."

The earthquake has taken a clear emotional toll on the children of Haiti. Families have been broken. Children remain afraid. They feel the strain of lacking food and shelter. And while adults labor to rebuild the country — and to cope with the tragedy themselves — they are looking for ways to provide counseling services to the earthquake's youngest survivors.

Many children are coping with death for the first time — a challenge even under the best of circumstances. There's also survivor's guilt.

"Some children are overreacting; others have blocked it completely from their minds," said Norah Salnave of the Haitian Association of Psychologists. "It's not only the trauma, but a lot have lost their parents, brothers and sisters. That's a tremendous thing for a child to process."

Kenson Jean, 16, lost his uncle and his cousin when their house collapsed in the Port-au-Prince tent city known as Mais-Gate.

"I'm thinking about them and knowing that I'm alive," Kenson said from his bed at the University of Miami field hospital, where he was recovering from injuries to his left leg. "It's difficult for me."

Inside the children's tent at the field hospital, the kids talk constantly about the earthquake. Where they were. Where their parents were. What they were doing. They tell their stories over and over again, said Carmen Diaz, a clinical psychologist volunteering at the hospital.

The doctors are also providing specialized counseling services for the children who lost limbs. In Haiti, a county in which manual labor is king, amputees struggle to find work.

"For the most part, those children are just glad to be alive," said Burton Goldstein, a University of Miami psychiatrist at the field hospital. "The consequences of the amputation will come later, when they are dealing with day-to-day life."

Although schools in the outlying areas reopened Monday, more than 5,000 schools in Port-au-Prince were destroyed or significantly damaged. Haiti's minister of education has yet to announce when schools within the capital city will reopen.

Across the city, more than 1 million people are living in tent cities. Some, such as the camp in the city center of Chann-Mar, are home to more than 2,500 children. There, the children play games to pass the time. This week, nurses handed out fliers with colorful cartoons, warning the children to stay away from the piles of garbage and not urinate in the street.

At the tent camp at Saint-Louis de Gonzague, a prestigious parochial school, little boys constructed a soccer goal from pieces of scrap metal and red twine. U.S. military from the 82nd Airborne personnel played basketball with the older children.

Across the camp, 8-year-old Junior Alexis, his skinny arms and legs covered in dust, pulled a toy car fashioned from an old milk bottle. He had collected four orange bottle caps for the wheels, which he kept taking off and putting back on.

"It's not bad," the budding mechanic said of his new life in the tent city. "I play most of the time. I have friends."

But at night, Junior said he thinks about what has happened to his country. He struggles to understand what it means. "People are dying," he said.

This past weekend, first lady Elisabeth Delatour Preval convened a group of psychologists, educators, politicians and artists to determine how to get mental-health services to children before school starts again. The team will soon be establishing children's therapy centers in the tent cities.

The therapy centers will be called Plas Timoun, the Children's Place, and will provide free counseling services, said Fabienne Elie, the executive assistant to the first lady. There will also be art and music therapy, sports and make-believe activities available to any children who show up.

More than 60 psychologists and 80 psychology students are ready to help out.

Amanda Melville, a UNICEF child protection specialist who is coordinating mental health and psychological support services with the Haitian government, said regular access to food, water, shelter and the family unit is key to a child's mental health.

"In these kinds of situations, we have to understand that the biggest stress on children is the lack of basic services and normality," Melville said. "The sooner we can get these children good, water and shelter, the better."

Many of the children say their bellies ache from not having enough food. They wonder when their next meal will come.

"When the people come with food, not everybody gets enough," said Berthony Azor, 13. "We wait and wait, but sometimes we don't get anything."

Joanne Pierre worries about the affect the earthquake has had on her 10-year-old daughter. Jonise Francois was playing outside when the earthquake hit. A wall fell and crushed her right leg.

Since the earthquake, Jonise has become quiet, reserved. She doesn't like to talk about what happened. She cries only when the doctors change her bandages.

"It's horrible," said Pierre, who sleeps beside Jonise in her hospital bed at night to comfort her. "You don't want your child to go through something like this."

The stay at the field hospital has had another effect on the girl.

Jonise, like the little girls lying in either of the hospital beds next to her and the bed directly behind her, wants to become a nurse when she grows up.

Said her mother: "She wants to help people."

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