Wanted: donkeys and nurses

For some aid workers, three words were descriptive enough: "Whole mountains moved," they said, when a 7.6-magnitude earthquake struck northern Pakistan. Gathering the dead and tending the survivors of such a massive trembler is arduous work in the best circumstances. But torrid weather and rocky terrain made recovery and rescue almost impossible for days.

The Oct. 8 quake hit Pakistan's Northwest Frontier Province, killing at least 35,000 and injuring tens of thousands more. Most of the victims were in Pakistani-controlled Kashmir, which is a territory disputed by India and Pakistan. UN estimates put the homeless at 2 million and those altogether affected at 4 million.

For days, rains caused mudslides that blocked roads and made them impassable for relief vehicles. Five days after the quake a 5.6 magnitude aftershock struck the region even as remote villages were still waiting for help to arrive.

Given the challenges, the aid groups best equipped to bring relief were the ones already working in northern Pakistan, a region best known to outsiders for harboring Taliban and al-Qaeda terrorists. Aid workers understandably asked not to be identified, long accustomed to the dangerous territory in which they work. They risk running into trouble with the Pakistani government, which forbids evangelization. Equally dangerous: "A couple miles down the road is an al-Qaeda group," one said.

An aid worker with Wheaton-based mission group TEAM described conditions this way four days after the quake: "Save the Children had a large planeload of supplies arrive today. Trucks can go only so far; maybe we need to pray for donkeys!" The hardest-hit town was Balakot, which one worker described as "incomprehensible": "People on the road had lost the light in their eyes. Not to mention all the dead relatives, still many under the rubble."

Another aid group helping early in the region, Mercy Corps of Portland, Ore., reported half the homes in Balakot (a city of 40,000) were destroyed, another 40 percent were missing a wall or roof, and the final 10 percent had cracks. Fearful survivors, said Susan Laarman, a Mercy Corps spokeswoman, "are spending the night in open fields, and the first night there was rain and hailstorms."

Like many of the victims, aid workers also sleep in the cold open air. "Since the earthquake on Saturday morning we have felt continuous aftershocks," one said. "Even as I write this, there are little tremors and I have to [be] running outside! But I know God is watching over us."

Tents arrived one night at 2:30 a.m., allowing missionaries and aid workers to start distributing makeshift shelter to the homeless. Ms. Laarman said the number of people displaced rivals Southeast Asia's tsunami: "For Indonesia, it was half a million. The challenges to provide aid and economic recovery are going to be greater because there are so many more people."

At Bach Christian Hospital, doctors and nurses are working 24 hours a day to treat quake victims and have added 50 beds, doubling the number of beds in use at the facility, which has operated in the region for over 50 years. The longstanding mission work has a steady reputation for serving the community, despite sometimes fragile relations with the local mosque. Last week, however, its imam arranged for Muslim families to supply meals to patients at Bach.

The hospital is located just 75 miles southwest of the epicenter. Built to be earthquake-proof, it sustained little damage and workers set out on foot following the quake to bring in the injured. The hospital is staffed primarily by Pakistani, but also some American, physicians. TEAM assists the hospital, and spokesman Brynn Slezak said the hospital currently needs more nurses.

Isolated private relief efforts are proving hard to jumpstart in these conditions. The United States has pledged $50 million for the relief effort, and supplied helicopters to deliver tents, blankets, and military equipment to the hard-hit areas and take back injured survivors. Britain also promised $21 million, while some 30 countries have been funneling in food and medical supplies.

One of them is India, which has fought three wars over Kashmir with Pakistan. The quake also rattled Indian Kashmir, where authorities reported at least 1,400 dead. Aditya Nath, Delhi regional manager of ActionAid International, said for his group disaster response hinges on the mundane: Tents are not widely available on the local market. There has been no earthquake in the region for more than 100 years, he said, and the Indian government, caught unprepared, had to order most of the supplies directly from manufacturers.

Still, his group has supplied thousands of blankets and kits with food, educational materials, and medicines. The organization's effort has also drawn two dozen unusual volunteers in the Islamic region: women, rarely seen in public. In this case they are female students from Kashmir University, who are surveying needs and counseling women and children.

The immediate needs are so great in Pakistan and Kashmir that the transition from relief work to recovery will be a long time coming, Ms. Laarman said. Saving lives will be a priority for weeks to come.

-- With reporting by Mindy Belz

Select organizations accepting donations to assist with earthquake relief

ActionAid USA www.actionaidusa.org 1112 16th St. NW, Suite 540 Washington, D.C. 20036 (202) 835-1240, ext. 2

Christian Aid Ministries www.christianaid.org P.O. Box 9037 Charlottesville, VA 22906 (800) 977-5650

International Aid www.internationalaid.org 17011 W. Hickory Spring Lake, MI 49456 (800) 251-2502

InterServe www.interserve.org Checks payable to InterServe Attn: Finance Clerk P.O. Box 418 Upper Darby, PA 19082-0418 (800) 809-4440

Mercy Corps www.mercycorps.org Dept W, P.O. Box 2669 Portland, OR 97208 (888) 256-1900

Samaritan's Purse www.samaritanspurse.org P.O. Box 3000 Boone, NC 28607 (828) 262-1980

TEAM The Evangelical Alliance Mission www.TEAMworld.org Send funds payable to TEAM, marked Pakistan Assistance P.O. Box 969 Wheaton, IL 60189 (800) 343-3144

World Emergency Relief www.wer-us.org P.O. Box 131570 Carlsbad, CA 92013 (888) HUG-4-KID