Relief workers and military officials on both sides of the border in the Himalayan region of Kashmir struggled to reach hundreds of villages cut off by the worst earthquake to hit this region in a century. Estimates of the death toll ranged Monday between 20,000 and 30,000. Relief agencies have put out a massive appeal for food, tents, and medicines for an estimated 2.5 million people who are thought to be homeless - a number similar in scope to the Indian Ocean tsunami.

Just as Americans voiced anger at the slow response of emergency relief agencies in the wake of hurricane Katrina, many Kashmiris in both the Indian and Pakistani portions of the divided territory decried what they called a slow emergency response.

Pakistani officials urged patience. "We are handling the worst disaster in Pakistan's history," said the chief Army spokesman, Maj. Gen. Shaukat Sultan.

The earthquake of Oct. 8 could be a crucial test of both the military-dominated government of President Pervez Musharraf, as well as renewed peace efforts between India and Pakistan, who both claim the quake-ravaged state of Kashmir. President Musharraf, who took power in a bloodless coup in 1999, has built his reputation as a man of competence, mobilizing resources of a well-trained military apparatus without debate; making fast decisions under conditions of stress. Now he faces a crisis of major proportions at a time when his leadership is coming under growing pressure from both Islamists and democracy advocates.

At his office in the mountainous city of Murree, coordinating relief efforts in the worst-affected areas of Kashmir, Brig. Iftikhar Ali Khan has spent the better part of the past two days taking calls on four separate phones on his desk, often with a phone pressed to each ear.

He says he understands public frustration at the Army's inability to move faster, but he adds, "you have to understand that we have never seen such a thing before. Most of the soldiers in my area were deployed on the front lines."

"We needed additional forces and they had to come by helicopters, not C-130s," said Brigadier Khan, commander of a 6,500-square-mile sector of Pakistani Kashmir, including Muzaffarabad.

Khan estimates that between 60 percent and 70 percent of Pakistani Kashmir has been "destroyed." In Muzaffarabad itself, "all medical facilities have been razed to the ground," Khan says.

Capt. Farooq, an Army surgeon recently returned from mobile hospitals in Muzaffarabad, confirms that all local hospitals have been destroyed. There is a crucial need for medicines, especially antibiotics, he says. "There is not one hospital left," says Captain Farooq, who declined to give his first name. "We are operating in the fields, we are operating under tents. Every kind of trauma injury you can imagine is there."

The Pakistani Army has begun moving heavy equipment up the Kashmir Highway, from Islamabad toward Muzaffarabad, but whole sections of the road have been rendered almost impassable by landslides. As of Monday afternoon, only light vehicles were getting through. Busloads of young men, including green-turbaned volunteers from Islamic parties, headed in. Busloads and trucks full of women, children, families, and injured people headed out.

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