Quake deaths near 40,000 as Britons rush to the rescue

Many of the wounded are still not receiving treatment, officials admit

By yesterday, Pakistan had raised its estimate of the death toll from 25,000 to 38,000, but said it was likely to rise well beyond 40,000 as news trickled in from remote valleys. A further 1,650 have been killed in India, making it the strongest quake to hit south Asia in a century.

As attention moves on from the rescue operation, a massive international relief effort is now under way to help the millions left homeless, out in the open air, and many with wounds that could soon become gangrenous.

In some mountainous communities, the first snows of winter are falling, creating an additional peril. The United Nations is seeking $312m (£176m) in aid. Helicopters, heavy lifting equipment, winter tents, field hospitals and medicine are desperately needed, it says.

In Mansoor Ramzan's home in Leyton, east London, the family was observing the first Saturday of Ramadan when the news broke. Thoughts flew to the fate of relatives, including Mansoor's 110-year-old grandmother, Hajin Sardar Begum, who lives in Jhelum, a town within the outer perimeter of the quake zone.

The family's worst fears were allayed by a phone call from neighbours in Leyton who were visiting Mirpur, not far from Jhelum. Mirpur is nicknamed "Little London" because of the many houses built with money from Britain. The neighbours said the Ramzans' relatives were safe but shaken. Their grandmother had bolted from her front door and crouched in the alley under the open sky, praying while the earth rumbled and swayed.

But if relatives were alive, the television images of the disaster soon convinced Mansoor, 28, an investment banker, and his brother, Asif, who works in the City, to take direct action to help the victims.

"I saw a father like myself, holding his kid with a squashed leg and feeding him from a bottle cap," Mansoor said. "I knew I had to help. We looked at our uneaten leftovers and thought of so many in need."

Fifteen relatives pledged money for emergency aid. Women donated jewellery worth £3,000, nephews handed over pocket money and work colleagues wrote cheques. By the time the brothers had checked into Heathrow airport on Wednesday, their fund had grown to £33,000. They also packed 10 tents, heaps of blankets and warm clothing, plus every scrap of tarpaulin left in Leyton marketplace.

They reached Islamabad airport to find it clogged with cargo planes carrying emergency supplies from scores of countries. It took an extra hour before the brothers could haul their parcels of clothes and medicine off the carousel to meet their waiting cousins.

Mansoor shook his head on learning that some Islamic extremists from Lashkar-e-Taiba, a group linked to al-Qa'ida, had rushed to provide desperate villagers with food or burial only hours after the earthquake.

But it was not, perhaps, surprising. Neither local Pakistanis nor those who have arrived from Britain have seen much sign of help from the army-dominated government of President Pervez Musharraf.

The brothers' first stop took them to Jhelum to see their grandmother, who caressed their heads as a blessing and recounted her escape. "Allah gave us this test and it is for him to protect us," she said. "This is by far the biggest earthquake I remember and I have been through three."

Then it was on to Mirpur, where the brothers were relieved to see that the dam on the outskirts of the town had held fast. But in the town, there was plenty of damage. The 200ft-high minaret of a mosque had collapsed, killing several.

A by-passer recalled his escape. Four students and two teachers had run from the mosque, as the ground began shaking, he said, only to be killed instantly by a hail of bricks and steel. The man himself had been knocked about by the aftershock, trying to pull the bodies free.

Mirpur's main street was blocked by another collapsed tower, which had crushed a passing rickshaw and a roadside stand. The workers tiling the tower had been hurled to the pavement. Three died and others were seriously injured.

The brothers had a final shopping spree in Mirpur, buying matches, fuel and food bought wholesale from a maternal uncle. After tearful hugs from another clutch of relatives, they set off for Bagh, closer to the epicentre of the earthquake.

Mansoor and Asif joined a relief convoy of four lorries going to Rawalkot, a staging post from where supplies can be taken up to outlying rural hamlets.

The closer the Ramzans got to Bagh, the more devastation they saw. Hillsides were scarred and trees lay snapped casually in two. Huge boulders had hurtled down the slopes on to buckled, twisted roads.

With no shelter in the upper valleys, where landslides had levelled most houses, they passed victims left in desperate situations. This was where the tents and sweaters they had picked up in Leyton would be essential, they reasoned.

The trucks drove for hours on the clogged roads, only to find Bagh in ruins. But people "graciously accepted anything we gave them", Mansoor said

"There's so much devastation. Children are just roaming around and the stench is overpowering. We have got to get something more sorted before winter."

The Ramzans distributed their supplies from a tent camp, flung up beside a foul mound. More than a thousand bodies lie buried there.

Jet lag was now setting in, but the brothers' sense of emergency won out. Mansoor and Asif would be going on with the convoy to Rawalkot, still trying to make a difference.