The dead remain uncounted in quake that struck four countries

Villages have vanished, cities have been reduced to rubble - but the full horror of the devastation in the disputed border territory of Kashmir remains to be revealed

On the ground, it is far worse. Here, in dust and blood, in broken homes and broken bones, is the appalling detail of the disaster: a hill of rubble that was once a block of flats in Islamabad, over which and under which rescuers scrabble for survivors. In Mirpur, there are bodies of children killed by falling minarets, and, in the words of one eye-witness, "bodies in the rubble, only their heads visible". And in Muzaffarabad, six miles beneath whose land this quake struck at 4.50am London time, survivors huddled on open ground. The law courts have been razed, and two schools ­ with pupils inside ­ have collapsed. The place looks as if it has been trampled by the wilful stamp of an angry giant's boot.

To emergency workers inured over the years to such scenes, the awesome thing about this quake is the geographical breadth of its impact. Buildings in the capitals of no fewer than four countries were shaken by the 7.6 tremor and its sizable aftershocks. More than 500 miles to the south of its epicentre, apartments in Delhi shivered; and in Kabul, 250 miles to the west, office blocks swayed. Glenn Tasky, a US advisor to the central bank of Afghanistan, said: "I lived in San Francisco for nine years and I had never before experienced such a long-lasting quake as this one." It was an earthquake on a continental scale.

In north Pakistan and India, there are dead and injured in numbers that can still only be guessed at. And the reports to date are not encouraging, especially for the many Britons who have family in these areas. Munir Awan, from Karachi, said: "I have just talked to my friend on the cell phone, who is on an official trip to Balakot [Mansehra] ... his entire native village has vanished and his mother is still missing."

Muhammad, from London, emailed the BBC: "Four of my housemates are from Muzaffarabad and every single one of them has lost a loved one in this tragic earthquake. Reports say the whole city has been flattened, hospital destroyed with patients and doctors buried, two schools destroyed with girls in it."

About 50 miles to the south of the epicentre is Islamabad. In such cities it is the well-heeled who live in apartment blocks and several have collapsed with uncounted numbers inside. One of the worst-hit blocks was the 10-storey Margallah Towers complex, whereWestern residents lived, and where scores were trapped.

Qaiser Rasul, who lives opposite, said the building went down "like one of those staged demolitions you see on TV". Another resident, Sabahat Ahmed, said: "The quake jolted me awake and I saw people running down the staircase. By the time the second tremor hit, the building had already started to collapse. As the building was collapsing, people were still coming out from it. I heard and saw various people in a state of panic and many stuck under the collapsed building."

One of the first on the scene was Rehmatullah. "I rushed down, and for some time you could not see anything because of the dust. Then we began to look for people in the rubble," he said. "We pulled out one man by cutting off his legs."

A BBC correspondent said there was "a small hill of broken concrete over which and under which rescue workers are desperately trying to dig out survivors". Aided by two cranes, hundreds of police and soldiers helped to remove chunks of concrete. A concrete slab was splattered with blood.

Rescue workers laboured all day to drag out the living and the dead. They pried off solid blocks of concrete with their bare hands, sometimes pulling out a survivor who was carried off on an improvised stretcher. Miraculously, some 82 survivors were borne away in this fashion; but 10 residents, including an Egyptian and two Japanese, died.

"What can you say about such a natural disaster?" asked Mohiuddin of the Pakistani civil defence force, who helped co-ordinate relief. " Only that they should make the buildings properly."

Elsewhere in the city, witnesses could hear people screaming in their houses during the initial quake, which lasted for about a minute. Car and house alarms were set off. Minutes later, sirens could be heard as emergency vehicles raced through the city of close to a million people.

In Abbotabad, north of Islamabad, reports emerged that "two mighty plazas were reduced to rubble and a school building also collapsed". At the city's hospital, dozens of injured quake victims and other patients lay on the lawn after officials said aftershocks made it unsafe to stay inside. Hospital staff with loudspeakers appealed to the public for food and other relief supplies. And in Gujrat, part of the Fatima Jinnah College collapsed with one dead and many injured. Landslides closed many roads, including two of Kashmir's highways.

In Lahore, nearly 200 miles from the epicentre, walls and floors shook for 30 seconds. Jamshaid Hafeez, who teaches in the city, told the BBC: "I and students felt every thing moving. I led the classes outside the building. Here I saw the buildings were swinging, glasses were cracking, and we were trembling with fear."

The worst of this disaster is still awaiting discovery in Kashmir, the disputed Himalayan territory divided between India and Pakistan. Officials in the Indian-controlled portion reported at least 220 killed, including 20 soldiers. But from Azad Kashmir, the Pakistani side, little information trickled out. The capital, Muzaffarabad, was cut off by road. Telephone lines were down, bridges had developed cracks, but, in a sign of the desperation to reach the stricken, traffic bearing supplies was passing over them.

In Kashmir alone, officials said 2,700 homes were destroyed or damaged, and, as night fell, army soldiers and volunteers were frantically trying to rescue people from under the debris of what were once villages like Kunzru, near Srinagar on the Indian side. Here, almost the entire village of 200 homes had been flattened, yet some villagers escaped with their lives. In a hospital bed, where he lay with a fractured leg next to his wife with a lacerated head, was Ghulam Mohiuddin Khan. When asked what had happened, he said slowly: "The floor started shaking, and everything turned upside down." It is a measure of this disaster that he is one of the lucky ones.