By Jane Elliott BBC News health reporter

Dr Ahmad was moved by the plight of survivors

Because the injuries were old many of the bones had set themselves in awkward positions and so before the team could do any repair work they had to break them.

Not only was this extremely distressing for the patients, it also made the medical team's workload more complicated.

Dr Ahmad was faced with a daily queue of patients during her stay at the Holy Family Hospital in Rawalpindi.

Her first five days were spent working from 8.30am to past midnight trying to clear the backlog.

No anaesthetics

The need is not over. People are coming back from the brink and are now assessing what there needs are and they are very basic needs Dr Rubina Ahmad

"The hospital had run out of pain killers and anaesthetics, but luckily we had brought some," she told the BBC News website.

"We did about four or five cases each day, we could not do more because we had to break the bones which had reset before we could repair them.

"We also had patients who needed wounds or fractures dressing and they had been doing that without anaesthetics.

"Once I was standing in the corridor trying to arrange something and I heard a child screaming.

"They were trying to do a dressing. I gave them the anaesthetics and pain relief and showed them how to do it.

"Being there was unimaginable. The disaster was on a scale that was unrecognisable."

Much needed aid

Dr Ahmad, a staff grade anaesthetist, from Frimley Park Hospital in Surrey, travelled out with an independent team, which included four paramedics, an orthopaedic surgeon and a physician.

They took with them one and a half tonnes of much needed medical aid and basic supplies.

Many of the hospitals the team visited had run out of supplies, and without the new stocks that they brought over their job would have been almost impossible.

This week the military in Pakistan criticised the West's continuing aid effort saying enough has been given and it had turned the people of the area into 'beggars'.

The families need basic care

Dr Ahmad hotly disputes this. The need, she said, is still great.

She is about to return to the area to work for another two weeks, laden with more aid.

Dr Ahmad and her colleagues are supplying basic hospital equipment, along with food to people who are existing on scraps.

But she says the horrific sights she witnessed have inspired her and others to do even more.

They also hope to set up orphanages for the many children left without parents.

That is just one of the longer-term issues that Dr Ahmad knows must be addressed sooner or later.

"What happens to those loads of amputee children? What happens to all those young paraplegics?," she said.

"What happens to all those hundreds of children who belong to nobody?

"The need is not over. People are coming back from the brink and are now assessing what there needs are and they are very basic needs."

"Needs like blankets and quilts to keep them warm in their tents, where they are not able to have heaters."

Red-tape

Dr Ahmad said that although she was impressed with the work at a local level that she felt the bureaucracy of Pakistan was hampering some relief work.

She and her self-funding team lost vital work days waiting to get their medical supplies released by customs.

"Because of that we lost two days work. They were very obstructive."

As well as their work in Rawalpindi, the team visited Muzzaffarabad's main hospital and the Thuri tent village, where more than 200 families are sheltering.

Here they found even the most basic supplies, such as blankets, clothes, and medical supplies were still needed.

They visited the tent city

Women who had given birth had no spare clothes to wear and Dr Ahmad was worried about cross-infection when they returned to their tents.

"I spoke to one doctor who said she had just given a lady an episiotomy, stitched her up and then after two hours she had gone back to her tent.

"I asked why she had allowed her to go back to the tent so early, and the doctor said that the lady had three children of her own to look after as well as a neighbours' child.

"She said there had been no clothes and she had to send her back to the tent in the clothes that she was wearing - back to those children.

"We left them a box of clothes. We also left them blankets and bought electric heaters for the hospital wards.