The 6.4-magnitude pre-dawn quake on Wednesday flattened mud-brick houses and triggered landslides in the impoverished province of Baluchistan bordering Afghanistan, killing or injuring their occupants as they slept.

"We are doomed," said Mohammed Hashim, a resident of Wam, the worst affected of eight villages that were hit hard by the quake.

"We have nothing left to save our families from the cold in the night."

Destitute survivors sat beside campfires as the night brought sub-zero temperatures to the mountainous quake zone bordering Afghanistan.

International and Pakistani agencies were struggling to get help to survivors of the quake.

The World Health Organisation said it was sending enough medical aid and supplies for 50,000 people. It is also flying trauma supplies stored at the UN Humanitarian Response Depot in Dubai to treat 400 people into the region.

In Geneva, the International Committee of the Red Cross said thousands may have lost their homes and hundreds may have died in the temblor.

The United States also offered to send humanitarian relief.

"We are currently working with the Pakistani government, the UN (United Nations) and other potential donors to assess the damage," State Department spokesman Sean McCormack told reporters on Wednesday.

"Once we are able to make that assessment and also talk to the Pakistani government about what their needs might be, we will stand ready to provide an assistance package."

Neighbour and rival India has also offered to help.

Some 46,000 people living in the wider region, especially near the historic hill resort of Ziarat, could now be in need of shelter and other assistance, officials said.

An AFP correspondent in Wam said emergency tents had not arrived by Wednesday night, forcing exhausted villagers to hunker down in the ruined shells of their homes.

They spent the day in a desperate search for loved ones or burying the dead in mass graves, as aftershocks nearly as big as the initial quake pounded the landscape, sending rocks spewing from nearby peaks and sparking fresh panic.

Virtually all houses were reduced to rubble either in the initial quake or by aftershocks. Schools and hospitals were also damaged, he added.

Soldiers, helicopters, tents, blankets, food and medical help have been sent from Quetta, the provincial capital, to Ziarat and an aerial assessment of the damage has begun, the Pakistani military said.

A 7.6-magnitude earthquake in northwest Pakistan and Kashmir killed 74,000 people and displaced 3.5 million in October 2005.

In 1935 a massive quake killed around 30,000 people in Quetta, which at the time was part of British-ruled India.

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