Between 20,000 and 30,000 people are estimated killed in Pakistan, India and Afghanistan as a result of Saturday's 7.6 quake.
The death toll is expected to rise once remote areas of Pakistani-controlled Kashmir and the country's North-West Province are reached. Communication to many of those areas was cut off because of the temblor, and landslides had rendered roads inaccessible.
The death toll may have been compounded by the calendar. This week marked the beginning of Ramadan, the Muslim holy month of prayer and fasting. As a result, many Pakistanis were asleep when the earthquake struck, having risen before dawn to pray and have a light meal in preparation for the daylong fast, then gone back to bed.
Pakistani President Gen. Pervez Musharraf issued a plea on Sunday for foreign aid -- specifically, cargo helicopters and relief goods such as tents and blankets. He also appealed to the international community for medicine and financial assistance.
"We do seek international assistance. We have enough manpower but we need financial support ... to cope with the tragedy,"
Helicopters are necessary, he said, because roads leading into some remote areas have been buried by landslides and the areas cannot be reached. Musharraf said he had asked the U.S. government to send helicopters from Afghanistan, and had been promised those helicopters.
"We are handling the worst disaster in Pakistan's history," said Pakistan's military spokesman, Maj. Gen. Shaukat Sultan, and the country has launched its largest relief operation.
"In certain areas, the entire villages -- they have collapsed. In certain areas, almost entire towns, they have vanished from the scene," he said.
India's prime minister, Manmohan Singh, offered his country's help. "While parts of India have also suffered from this unexpected natural disaster," he said in a message to Musharraf, "we are prepared to extend any assistance with rescue and relief which you deem appropriate." India and Pakistan have fought two wars over Kashmir but since early 2004 have been engaged in negotiations aimed at ending their historic enmity.
In Washington, Secretary of State Condoleezza Rice offered U.S. assistance to both countries. "At this difficult time, the United States stands with its friends in Pakistan and India, just as they stood with us and offered assistance after hurricane Katrina," she said in a statement.
Aid organizations warned that relief efforts could be hampered by winter conditions that will soon prevail at the higher elevations of Kashmir. "Winterized tents and blankets will be urgently needed," Raphael Sindaye, Oxfam's humanitarian response coordinator, told Reuters reporters after a meeting of aid agencies in Islamabad.
The quake hit Saturday at 8:50 a.m. Its epicenter was about 60 miles north-northeast of Pakistan's capital, Islamabad. At least 22 aftershocks followed within 24 hours, including a 6.2-magnitude temblor.