Published: 08/12/2005 Volume 115 No. 5985 Page 38

As a member of the International Rescue Corps, Julie Ryan has seen more than her fair share of disaster. So she was well prepared for a recent trip to earthquake-hit Pakistan. Alexis Nolan reports Five days after the earthquake in Pakistan, and three and a half hours after a group of rescuers started moving rubble that had been a three-storey school in the remote mountain village of Kahori, Julie Ryan found herself looking at a foot connected to a teenage boy lying flat on his back. He was alive - and, incredibly, uninjured.

Minutes later the team found a second boy still alive.

After completing her search and rescue training 11 years ago, the York Hospitals trust day unit manager has gone on a world tour of earthquake disasters: Japan in 1995, Afghanistan in 1997 and Colombia in 1998. This is the first time she has personally found people alive:

two days after the earthquake struck a hand grabbed her wrist as she shone her torch into a hole cleared in a collapsed building.

Julie had received a call from one of her co-directors in non-governmental organisation International Rescue Corps two hours after the earthquake struck in Pakistan on 8 October.

The team was mobilised as part of a British effort co-ordinated by the Department for International Development by 11pm that night. The team was at East Midlands airport by 3pm the following day with their kit - including tents, listening devices, thermoimaging equipment, cutting tools and water purification systems. They arrived in Islamabad at 11am the next day.

From there, a small advance team of 12 people was picked to go to the nearby city of Muzaffarabad, the epicentre of the earthquake. Julie was one of them.

'We jumped onto the helicopter and flew up the valley, ' says Julie. 'I remember looking out the window and thinking, oh my God. The city was just completely destroyed. There is no other word for it.' She says houses in the main area of Muzaffarabad were 'strewn all over the place' and debris covered the banks of the river that runs through the city.

The team got straight into search work.

'We went to a school and the headmaster joined us, ' says Julie. 'He had the school register in his hand. He explained that the quake had hit at 9am, when the school's 700 pupils had been in class; he had only accounted for 200. That was what greeted us.' The team found no survivors, just dead bodies, 'including a teacher with a pen still in his hand, ' says Julie. 'There was nothing, no sign of life. We were hoping a second team would arrive, but they didn't get there until next day. We worked constantly for 36 hours - we didn't have anywhere to sleep... so we just kept on the go.' She says the team was 'dragged from pillar to post' by distraught locals in the search for survivors: 'This was a school.

This was a hospital. This was a prison.

This was a bank. But there was just rubble'.

The rescuers worked through the night trying to find survivors. Where they found the dead they put markers so that locals could retrieve the bodies.

'It sounds callous, but time is of the essence. You're almost looking for a miracle. By day three or four if people trapped are not injured and have access to water they can still survive, but the chances of that are a million to one. Most people are injured and do not have access to water, ' says Julie. 'As a rescuer you have to weigh up use of resources. Do you carry on looking for one person or do you look for other survivors?' After two days the UN co-ordinators asked the team to go further up the valley the next day, to remote villages that had not been searched to carry out a needs assessment for medicine, vaccines, food, water and evacuations.

They arrived at 11.30am and were due to be picked up again at 3.30pm. 'When we arrived we were just mobbed by locals, ' says Julie. 'One guy who spoke good English said he had heard voices in a school that had collapsed. So we went straight there.

'When we got there the team leader instructed me to crawl into this void as far as I could and shout. I got in and shouted and someone shouted back. I thought it was someone outside having a laugh. I told everyone to shut up and shouted again and two voices came back.

'But we didn't know where they were, what position they were in, whether they were injured or whatever. It was a threestorey school reduced to ground level.

The roof was at a slope and we were on stomachs removing rubble a bit at a time.' Three and a half hours later Julie found the first boy. 'He managed to wriggle towards us and we managed to get him out alive. He was uninjured but wouldn't get out the hole until we gave him a biscuit, which was the most ironic thing I had heard, ' says Julie. 'He was entombed in this building for five days and wouldn't come out unless we gave him a biscuit.

'The second was boy a bit older. He was covered head to foot in bodily fluids and blood. It wasn't his but his dead brother's.

Both boys, but particularly this one, were traumatised, exceptionally upset.' For Julie and the team there was a mixture of emotions. 'Once the two boys were out everybody was cheering and hugging each other, ' says Julie. 'It is elation and sadness, because you know there are plenty of others that haven't made it.' The boys went on the helicopter back to Muzaffarabad with the team for treatment. From there Julie went by road back to Islamabad and flew back to the UK on the Sunday, a week after she had arrived. By Tuesday she was back at work.