The overall death toll from Nepal‘s massive earthquake has surpassed 4,000, according to officials.

Nepalese people make themselves warm while they stay on open ground from fears of earthquake tremors in Kathmandu, Nepal, Monday, April 27, 2015.

Nepalese people make themselves warm while they stay on open ground from fears of earthquake tremors in Kathmandu, Nepal, Monday, April 27, 2015. Image by PA Wire

The figure does not include full accounting from vulnerable mountain villages which rescue workers are still struggling to reach two days after the disaster.

The earthquake-hit capital Kathmandu remains short on shelter, fuel, food, medicine and power as its people searched for lost loved ones, sorted through rubble for their belongings and struggled to provide for their families’ needs.

In much of the countryside, it was worse, though how much worse is only beginning to become apparent.

A man sits with a child on his lap as victims of Saturday's devastating earthquake in Nepal.

A man sits with a child on his lap as victims of Saturday’s devastating earthquake in Nepal. Image by PA Wire

Udav Prashad Timalsina, the top official for the Gorkha district, where Saturday’s magnitude-7.8 quake was centred, said he was in desperate need of help.

“There are people who are not getting food and shelter. I’ve had reports of villages where 70 percent of the houses have been destroyed,” he said.

Aid group World Vision said its staff members were able to reach Gorkha, but gathering information from the villages remained a challenge.

Even when roads are clear, the group said, some remote areas can be three days’ walk from Gorkha’s main disaster centre.

Some roads and trails have been blocked by landslides, the group said. “In those villages that have been reached, the immediate needs are great including the need for search and rescue, food items, blankets and tarps, and medical treatment.”

Damaged buildings lean to their sides in Kathmandu, Nepal, Monday, April 27, 2015. A strong magnitude 7.8 earthquake shook Nepal's capital and the densely populated Kathmandu Valley on Saturday, causing extensive damage with toppled walls and collapsed buildings.

Damaged buildings lean to their sides in Kathmandu, Nepal, Monday, April 27, 2015. A strong magnitude 7.8 earthquake shook Nepal’s capital and the densely populated Kathmandu Valley on Saturday, causing extensive damage with toppled walls and collapsed buildings. Image by (AP Photo/Wally Santana)

Speaking earlier, Mr Timalsina said 223 people had been confirmed dead in Gorkha district but he presumed “the number would go up because there are thousands who are injured”.

He said his district had not received enough help from the central government, but Jagdish Pokhrel, the army spokesman, said nearly the entire 100,000-soldier army was involved in rescue operations.

“We have 90% of the army out there working on search and rescue,” he said. “We are focusing our efforts on that, on saving lives.”

A helicopter prepares to rescue people from camp 1 and 2 at Everest Base Camp, Nepal on Monday, April, 27, 2015. On Saturday, a large avalanche triggered by Nepal's massive earthquake slammed into a section of the Mount Everest mountaineering base camp, killing a number of people and left others unaccounted for.

A helicopter prepares to rescue people from camp 1 and 2 at Everest Base Camp, Nepal on Monday, April, 27, 2015. On Saturday, a large avalanche triggered by Nepal’s massive earthquake slammed into a section of the Mount Everest mountaineering base camp, killing a number of people and left others unaccounted for. Image by (Azim Afif via AP)

Saturday’s earthquake spread horror from Kathmandu to small villages and to the slopes of Mount Everest, triggering an avalanche that buried part of the base camp packed with foreign climbers preparing to make their summit attempts.

Aid is coming from more than a dozen countries and many charities, but Lila Mani Poudyal, the government’s chief secretary and the rescue co-ordinator, said Nepal needed more.

He said the recovery was also being slowed because many workers – water tanker drivers, electricity company employees and labourers needed to clear debris – “are all gone to their families and staying with them, refusing to work”.

Students light candles and pray for people trapped in Nepal earthquake at the University of South China in Hengyang City, central China's Hunan Province.

Students light candles and pray for people trapped in Nepal earthquake at the University of South China in Hengyang City, central China’s Hunan Province. Image by (Cao Zhengping/Xinhua via AP

“We are appealing for tents, dry goods, blankets, mattresses, and 80 different medicines that the health department is seeking that we desperately need now,” Mr Poudyal told reporters. “We don’t have the helicopters that we need or the expertise to rescue the people trapped.”

As people are pulled from the wreckage, he noted, even more help is needed.

A child injured in Saturday's devastating earthquake in Nepal.

A child injured in Saturday’s devastating earthquake in Nepal. Image by PA Wire

“Now we especially need orthopaedic (doctors), nerve specialists, anaesthetists, surgeons and paramedics,” he said. “We are appealing to foreign governments to send these specialized and smart teams.”

More than 7,180 people were injured in the quake, police said. Mr Poudyal estimated that tens of thousands of people had been left homeless. “We have been under severe stress and pressure, and have not been able to reach the people who need help on time,” he said.

Volunteers help with rescue work at the site of a building that collapsed after an earthquake in Kathmandu, Nepal, Saturday, April 25, 2015.

Volunteers help with rescue work at the site of a building that collapsed after an earthquake in Kathmandu, Nepal, Saturday, April 25, 2015. Image by (AP Photo/ Niranjan Shrestha)

The arrival of relief flights has caused major backups at Kathmandu’s small airport.

Four Indian air force aircraft carrying aid supplies and rescue personnel were forced to return to New Delhi today because of airport congestion, Indian defence ministry spokesman Sitanshu Kar said. India planned to resend the planes later tonight when the situation was expected to have eased.

Nepal police said on their Facebook page that the country’s death toll had risen to 3,904 people. That does not include the 18 people killed in the avalanche, which were counted by the mountaineering association. Another 61 people were killed in neighbouring India, and China reported 25 people dead in Tibet.

U.S. citizen Michael Churton, 38, from New York, who was injured during an avalanche resulting from Saturday.

U.S. citizen Michael Churton, 38, from New York, who was injured during an avalanche resulting from Saturday. Image by PA Wire

Well over 1,000 of the victims were in Kathmandu, the capital, where an eerie calm prevailed today.

Tens of thousands of families slept outdoors for a second night, fearful of aftershocks that have not ceased. Camped in parks, open squares and a golf course, they cuddled children or pets against chilly Himalayan nighttime temperatures.

Kathmandu district chief administrator Ek Narayan Aryal said tents and water were being handed out at 10 locations in Kathmandu, but that aftershocks were leaving everyone jittery. The largest, yesterday, was magnitude 6.7.

“There have been nearly 100 earthquakes and aftershocks, which is making rescue work difficult. Even the rescuers are scared and running because of them,” he said.

A Nepalese man has food inside a tent as people stay on open ground from fears of earthquake tremors in Kathmandu, Nepal, Monday, April 27, 2015.

A Nepalese man has food inside a tent as people stay on open ground from fears of earthquake tremors in Kathmandu, Nepal, Monday, April 27, 2015. Image by PA Wire

The earthquake was the worst to hit the South Asian nation in more than 80 years. It and was strong enough to be felt all across parts of India, Bangladesh, China’s region of Tibet and Pakistan. Nepal’s worst recorded earthquake in 1934 measured 8.0 and all but destroyed the cities of Kathmandu, Bhaktapur and Patan.

The quake has put a huge strain on the resources of this impoverished country best known for Everest, the highest mountain in the world. The economy of Nepal, a nation of 27.8 million people, relies heavily on tourism, principally trekking and Himalayan mountain climbing.

(Press Association)

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