Rescue workers searched frantically for survivors of Pakistan's massive earthquake on Monday as the death toll marched past 20,000, while thousands of people spent a second chilly night in the open.
The U.S. military in neighbouring Afghanistan said it was diverting eight helicopters being used in the war against Islamic militants to assist with emergency operations as offers of aid poured in from around the world.
Relief workers had yet to reach many remote villages in the mountainous areas worst hit by Saturday's quake, and officials said the number of dead was likely to climb far above the 19,400 already known to have died in Pakistan.
Officials in North West Frontier Province and Pakistani Kashmir say the final death toll could be close to 40,000.
There was still no medical attention for many of the more than 40,000 injured by the quake which, at a magnitude of 7.6, was the strongest in South Asia for a century.
Across the border in Indian-held Kashmir, almost 700 people are known to have been killed, reports Reuters.
According to News24, Officials said the hospitals in Muzaffarabad had been hard hit, and the Pakistani military flew in special teams of surgeons and set up field hospitals in the town.
"It's not only rescue work that is being affected, we have to start relief efforts as well. There's a huge need for field hospitals, water, sanitation and for food," said Gerhard Putman-Cramer, head of the UN's disaster assessment and co-ordination (Undac) team.
The earthquake also hit the Indian-held zone of Kashmir hard with officials there saying over 600 people were confirmed dead. They also warned many remote villages had yet to be reached and the death toll would likely rise.
The epicentre was close to the dividing line between the Indian- and Pakistani-controlled zones of Kashmir, and scores of soldiers on both sides died when their heavily-fortified positions collapsed around them.
Nuclear-armed India and Pakistan have fought two wars over Kashmir, but a peace process is under way and Indian Prime Minister Manmohan Singh has reached out to Pakistan President Pervez Musharraf to offer help.
Photo: EPA Photos P.T.