Major hospitals in Pakistan say they are being overwhelmed by a flood of patients three days after Saturday's earthquake. As roads open from the worst-hit areas, refugees and wounded are flowing into the town of Abbottabad, which was badly damaged by the quake.
Every hour scores of new patients are brought to the Ayub Medical Center in Abbottabad.
The hospital has become, by default, one of the primary treatment centers for the Northwest Frontier Province and Kashmir, the two areas hardest hit by Saturday's earthquake.
According to one U.N. estimate, the quake destroyed more than a thousand hospitals in the region.
The center in Abbottabad is no exception. Engineers declared much of the building unstable and nearly all the medical work is being done outdoors.
A torrential downpour has turned the recovery area into a muddy swamp and hundreds of patients have been forced under makeshift tarps to stay dry. The temperature at night is approaching freezing.
The hospital's chief surgeon, Dr. Tariq Mufti, says his staff is completely overwhelmed.
"We cannot take any more patients," the doctor said. "We have told all the other agencies that we cannot take anymore. The message is, to the government and non-governmental agencies: we cannot cope any more and you can see we cannot cope."
Despite the pouring rain, doctors continue to conduct surgery outside. A sheet of plastic keeps the rain off the operating table and the patients keep coming throughout the day.
The youngest victims are the top priority. Doctors say they have to amputate this baby's right hand just above the wrist but think she will survive.
Her mother and older brother did not.
The official death toll has now reached 23,000. Doctors here say it will be twice that high.
Dr. Sohail Sahibzada says aid, including cash and medicine, is reaching the hospital but more is needed.
"I mean a million-dollar donation is good but these people cannot eat dollars you know," the doctor noted. "They need external fixators to fix their wounds, they need bandages, they need shelter. And what we really need is good quality trauma surgeons who can come and try and help us with this trauma."
He says more than 4,000 patients have been treated since Saturday and more are on their way.