Three-quarters of the once postcard-perfect towns of Amatrice and Accumoli remain in ruins. Pescara del Tronto, another medieval hilltop settlement, is a pile of rubble.
The recent opening in Amatrice, which gave its name to the pasta sauce, all'amatriciana, of a food village, an innovative facility built of low-cost timber, has been touted by its private-sector sponsors as marking a post-earthquake turning point.
But for the shattered communities, the fear is that a government promise made quickly after the August 24, 2016, earthquake to rebuild will be as slow in coming as the reconstruction of L'Aquila, which was struck in 2009 by a powerful tremblor. Eight years on, more than 8,000 L'Aquila residents still live in temporary accommodations.
The mayors have been urging the government not to repeat the snail-pace post-quake reconstructions of recent years.
Six-months ago, 400 residents from Illica, Accumoli, Arquata del Tronto and Capodacqua staged a protest demanding quicker recovery efforts. "Bureaucracy kills more than the earthquake," read one of the banners being waved by protesters.
Hundreds of residents from the affected towns have been placed in hotels in nearby San Benedetto del Tronto, a seaside resort on Italy's Adriatic coast, among them the mayor of Accumoli, Stefano Petrucci. He travels each day to his flattened town to oversee the slow clearance work, and says rebuilding plans are ensnared in burdensome administrative procedures.
"It is not moving fast enough," he sighed. "We must begin to return to live as a community.'
The remains of the Pescara del Tronto, a tiny hilltop town are seen in Italy';s Marche region. More than 10 people died here in last year's tremblor out of a permanent population Of 100. (J. Dettmer/VOA)
The survivors, many of them elderly, say they feel exiled. "We worry that by the time our homes have been rebuilt, we may not be alive," said Lidia Lombardi, a gray-haired pensioner sitting outside a three-star hotel in San Benedetto.
Other quake survivors remain closer to their devastated homes, living in temporary accommodations, including in trailers.
At least 300 farms in the quake zone were affected by the tremblor, with many farming families living and working in unsafe buildings. In Italy, most homeowners can't get private insurance cover for quake damage, and the government is responsible for financing rebuilding - although not of holiday or second homes.
Government officials say rebuilding the devastated towns will take at least 10 years, and they estimate the damage cost of last year's tremblor at 23 billion euros. Local mayors are worried that the young, especially, will give up, move away and never return.
In a bid to keep young families in the area, a prefabricated school has been built on the outskirts of Amatrice, and army engineers have been setting up pre-fabricated homes.
Amatrice's mayor, Sergio Pirozzi, says the town was rebuilt after another major earthquake in 1639, and must do so again - if for no other reason than as a tribute to those who lost their lives last year. He has been urging youngsters not to give up on the town, arguing that if they they leave, it really will mark the end of a town famous for supplying chefs to the Vatican.
But many of the young in Italy's mountainous heartland already were struggling with diminishing job opportunities, a driver for them to leave the area. The slow pace of reconstruction is hardly encouraging - and continued jolts that have followed last year's earthquake leaves them even more worried.
Arquata del Tronto - residents in the medieval towns of the quake zone hope one day to attract back tourists; now though they get upset with disaster tourists taking selfies of themselves amid the ruins, which they see as being disrespectful. (J. Dettmer/VOA)
8203;Seeing little future
"The earthquake has left in my heart a sensation of fear and insecurity, and this fact has confirmed my thinking about a future that I can't see in Italy," said Laura Sterpino, a 22-year-old student.
Tens of thousands of jolts have been recorded in central Italy in the past 12 months, and there have been 86 quakes. Locals fear that the jolts may not be after-shakes, but could presage another big tremblor.
A sense of foreboding hangs over Italy's mountainous heartland. In the central regions of Lazio, Umbria and Marche, inhabitants increasingly are fatalistic about their prospects and mistrustful of government. Tourists see the pastures of sunflowers and poppies, abundant vines, rows of ancient olive trees and medieval hilltop stone towns but not the hard-scrabble day-by-day existence to get by.
The inhabitants have battled for years to offset the decline in commercial agriculture, desperately exploring ways to refashion the area as arts venues, tourist destinations and centers of artisanal trades and crafts. The 2008 financial crash sent the regional tourism industry into a tailspin from which it has yet to recover fully, although this year the Marche region recorded a strong year in its seaside resorts.
Away from the coast, the highways and byways running through last year's quake-affected area are devoid of traffic. The picturesque, winding road that links the Marche town of Ascoli Piceno to the Umbrian city of Spoleto, perched on a foothill of the Apennines, is closed for large sections. Soldiers guard the entrance to Accumoli and turn back the curious.
In Amatrice, some 'disaster tourists' have been able to enter parts of the town and have been taking selfies of themselves - to the disgust of locals.