The largest cities in the Hindu Kush Himalaya region number in the millions of inhabitants. The most populous cities include Khabul (Afghanistan), Kathmandu (Nepal), Srinagar (India), Peshawar (Pakistan), Quetta (Pakistan), Xinning (China), and Dehra Dun (India). Large cities such as Kathmandu, Lhasa or Dehra Dun are growing at rates that double the population of these cities every 10 to 15 years or so. At the other extreme are vast rural areas suffering from the paucity of basic services, and where out-migration has evolved as a survival strategy.