Irfan Ahmed, a doctor with the British-based charity Plan, estimated from witness accounts that 10,000 people died in the Siran valley in Northwest Frontier Province.

Riffat Pasha, the region's police chief, put the toll in the province at 3,500 dead since Saturday's earthquake, which killed at least 23,000 people across the country.

"People are getting gangrene as they are not getting any help," said Ahmed, adding that the charity's medical team was the first to reach the badly hit village of Tevli near the main town of Balakot.

Gangrene is caused by a lack of blood supply to parts of the body, which can happen when a person is trapped for a long period of time. The disease can be fatal without proper dressing and stitching.

Ahmed said his team of five volunteer doctors and two assistants, who flew in by helicopter with the Pakistani military, provided filters for clean water but more help was needed.

"One problem is diarrhea because the water supply has gone out and the people are drinking whatever they can. What I saw was muddy water," he told AFP by telephone.

Ahmed said he saw more bodies in the rubble in the village but he doubted there were still survivors.

"There were a few hands coming out under the debris but they were obviously dead and lifeless," Ahmed said.

"Most of the buildings are either not fit to live in or they have just collapsed. Big or small, there is hardly a pillar you can see," he said.

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