Scientists at the Philippines’ official volcanology institute think the Taal volcano, located in the Batangas province, is unlikely to burst into life-threatening eruption at this point. But the story is far from over.

Although many have returned to their homes, more than 125,000 people still remained in approximately 500 evacuation centers on January 28, according to a report issued by the Philippines’ Department of Social Welfare and Development. Even more – about 180,000 – are reportedly staying with friends or relatives.

It’s not clear exactly how widespread the damage is, according to Dr. Irvin Miranda, a medical officer in the Health Emergency Management Bureau. A 7-kilometer (approximately 4.3 miles) danger zone is still on lockdown.

Although thousands have likely lost their livelihoods, Dr. Miranda said it would be some weeks before the Philippines’ government knows the extent of the damage.

“It will depend on the activity of the volcano,” he said. “We are still quite in the dark when it comes to the status of our health facilities in those regions.”

And for the more than 300,000 displaced, the situation is “traumatic,” according to volunteer Mark Cervantes, who had been working at several evacuation centers. Many of them “are really heartbroken because they can’t go back to their homes. Their livelihoods are gone.”

Volunteers interviewed in the midst of the crisis described people sleeping on cardboard boxes. People some of them undernourished children – without enough food. Latrines unable to handle the tens of thousands of people relying on them. Widespread respiratory and other health conditions, caused or exacerbated by the heavily falling ash.

“There’s no privacy. People say it’s cold at night,” said Rebecca Galvez Tan, a program director at the Philippines-based organization Health Futures Foundation.

Galvez Tan’s organization moved through shelters at the height of the crisis, offering medical care in tents. Health care providers saw respiratory infections, asthma, and infections of the eyes and skin.

“From a medical perspective, the main need is actually for those with asthma and respiratory disease,” said Cervantes, whose own speech was punctuated by heavy coughing.

N95 masks were scarce, he reported, and many were reduced to using basic surgical masks, which experts believe are inadequate for filtering particles from the air.

The situation has improved somewhat, said Dr. Miranda. The government has been providing medical care to the displaced, and most evacuation centers are currently able to provide three meals a day, although some “have not been lucky enough” to have as much food as required.

Still, he said, “most [people] are sleeping on whatever they have that can cover the ground.” Health care providers working on the ground have seen respiratory disease, influenza, chronic diseases like hypertension, skin ailments, and diarrhea – that last, Dr. Miranda explained, is likely caused by the congestion and lack of sanitation in the evacuation centers.

In addition, Dr. Miranda said, tracking down people staying with relatives or friends to offer them health care and other service has been challenging. “If any home-based person goes to the clinic, they should be given proper care and then reported…so it can go up to us at a national level,” he explained.

And perhaps worst of all, the situation remains uncertain. Although the Philippine Institute of Volcanology and Seismology has downgraded the threat from a level four to a three, indicating a “decreased tendency toward a hazardous eruption,” they have cautioned that a major eruption is still possible.

People whose homes and livelihoods were destroyed could be displaced for months. “Probably in the next few months it will be difficult for the people who have lost their livelihood” despite the availability of government assistance, Dr. Miranda said.

The situation has taken its toll, said Galvez Tan: “You see in their faces, they’re of course distressed and sad. They’re not OK.”

But authorities tended to see the situation differently.

“Many of the persons that I have seen and talked with…are in good spirits because they are overwhelmed by the support and help coming from other people,” said Czar Quinto, municipal health officer for the Balete municipality.

“We have been through so many tragedies and calamities for the past several years. I think it is in us that we respond well to these challenges,” said Dr. Miranda, citing 2013’s Typhoon Haiyan as an example. “If you know our culture, you know our people, even in the face of calamity, can always put on a ready smile.”