“It was like a giant hammer underneath the ground, thumping beneath us – boom, boom, boom.” Ana Sarasan, a care worker, held her hand to her heart as if reliving the monstrous thuds that jolted her awake just after 3.30am. “I don’t know where to go,” she said in tears as she surveyed the ruins of her flat. “My home is destroyed.”

The 1970s block of flats remains standing, but opposite, the Hotel Duca degli Abruzzi, built about the same time, is no more. The main section and one wing are a tangle of girders, bricks and glass. Outside the hotel, the flags of all nations still flutter in the breeze.

“It collapsed like a pack of cards,” said Petra Böhmig, a German-born dentist who lives three floors above Ms Sarasan. “It’s appalling. You can understand the medieval buildings falling down, but more recent ones should have been earthquake-proof.”

Ms Böhmig’s own flat is a mess. “Everything fell down – wine bottles, olive oil, everything. The cupboard doors all flew open, and out it all came. Everything was smashed. We have no water, no gas, no electricity.”

Would she spend the night in one of the emergency tent cities set up on sports pitches? “No. I shall sleep in my new Fiat Cinquecento, with my dog for company. At least it’s not winter.”

Ambulances, fire engines, police and civil protection vehicles roared through the town, sirens wailing. Further up the hill a bulldozer was attacking the mountain of rubble that had once been a house. Rescue workers pulled at the debris with their hands and picks and shovels.

“There is someone under there,” said a policeman, a dust mask around his neck. How did he know? “Sniffer dogs. They sense when there is a human being there.” Dead or alive? He shrugged. “No idea. Alive when the dogs sensed him, or her. All we can do is hope.”

Firefighters pulled a woman covered in dust from the debris of her four-storey home. Rescue crews listened for signs of life from those still trapped. One team tried to pinpoint the sound of a crying baby.

A man in his underwear wept as he was pulled from the debris and embraced. Near by, a body lay on the pavement, covered by a white sheet.

The town’s hospital had been damaged, and the patients – their numbers swollen by those wounded in the quake – were ushered outside while the wards were patched up.

The athletics track was filled with blue civil protection tents and portable toilets, but injured people were still waiting. An elderly man and his wife, lying on a stretcher with a leg injury, were waiting for more tents. Their home had been in the historic quarter. “It was a modern block. It should have stood up to the earthquake,” he said.

The football stadium had become a home for students, refugees from a dormitory that had partially collapsed. Isabella Giovannoli, a psychology student, was waiting to be taken back to Pescara, her hometown. “I was lucky – I was in a ground-floor room,” she said. “I ran out of the building when the earthquake struck.”

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