Shelter, fuel, food, medicine, power, news, workers — Kathmandu, Nepal's earthquake-hit capital, was short on everything Monday as 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 was only beginning to become apparent.

The official overall death toll soared past 4,000, even without a full accounting from vulnerable mountain villages that rescue workers were still struggling to reach two days after the disaster.

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.

"I've had reports of villages where 70 per cent 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.

Nepal Earthquake

Relief material for earthquake victims is loaded on a helicopter at the airport in Kathmandu, Nepal on Monday. (Altaf Qadri/Associated Press)

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 clearly exhausted army spokesman, said nearly the entire 100,000-soldier army was involved in rescue operations.

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

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.

All mountaineering on the Chinese side of Everest has now been cancelled because of the quake, with no word on when the ban might be lifted.

Aid on the way

Aid is coming from more than a dozen countries, including Canada, and from 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."

More than 7,180 people were injured in the quake, he said, estimating 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.

Canada has pledged money and resources to the effort. A shipment of emergency supplies and the first wave of specialized Disaster Assistance Response Team (DART) members departed CFB Trenton on Sunday evening — flying to Europe, Kuwait and then India, where they will wait until called into Nepal.

The need for aid has been complicated by the chaos that has reigned at Kathmandu's small airport since the earthquake, with the onslaught of relief flights causing major backups on the tarmac.

QUAKE-NEPAL/

A man fills water from a water tank near a collapsed temple in Kathmandu, Nepal on Sunday after the 7.9 magnitude earthquake devastated Kathmandu valley. (Navesh Chitrakar/Reuters)

Nepal police said in a statement that the country's death toll had risen to 4,010 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.

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

CBC videographer Glen Kugelstadt, who arrived in Kathmandu earlier Monday, said staff at the city's central Bir Hospital had been working non-stop since Saturday.

"The emergency room is completely full," he said. It contains the city's largest trauma centre.

As Kugelstadt spoke with doctors, police arrived with an 11-year-old girl, Kamala Tarmang, who had severe head injuries.

Rain on Sunday had given way to more pleasant weather Monday, he said, a welcome relief to thousands of people now living outdoors.

Tens of thousands of families have been sleeping outside since the quake, fearful of aftershocks that have not ceased. 

Those who slept outdoors woke to the sound of dogs yelping and jackhammers. As the dawn light crawled across toppled building sites, volunteers and rescue workers carefully shifted broken concrete slabs and crumbled bricks mixed together with humble household items: pots and pans; a purple notebook decorated with butterflies; a framed poster of a bodybuilder; so many shoes.

"It's overwhelming. It's too much to think about," said 55-year-old Bijay Nakarmi, mourning his parents, whose bodies recovered from the rubble of what once was a three-story building.

He could tell how they died from their injuries. His mother was electrocuted by a live wire on the roof top. His father was cut down by falling beams on the staircase.

He had last seen them a few days earlier — on Nepal's Mothers' Day — for a cheerful family meal.

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

"We don't feel safe at all. There have been so many aftershocks. It doesn't stop," said Rajendra Dhungana, 34, who spent Sunday with his niece's family for her cremation at the Pashuputi Nath Temple.

Acrid, white smoke rose above the Hindu temple, Nepal's most revered. "I've watched hundreds of bodies burn," Dhungana said.

Older buildings collapsed

The capital city is largely a collection of small, poorly constructed brick apartment buildings. The earthquake destroyed swaths of the oldest neighbourhoods, but many were surprised by how few modern structures collapsed in the quake.

Pierre-Anne Dube, a 31-year-old from Canada, has been sleeping on the sidewalk outside a hotel. She said she's gone from the best experience of her life, a trek to Everest base camp, to the worst, enduring the earthquake and its aftermath.

"We can't reach the embassy. We want to leave. We are scared. There is no food. We haven't eaten a meal since the earthquake and we don't have any news about what's going on," she said.

Emilie-Anne Leroux, a 28-year-old Montrealer working as an intern for the UN office in Kathmandu, said countries such as South Korea, China, India and Bangladesh have been working to get their nationals out of Nepal, but all she has received is an email from Canada's High Commission in New Delhi telling Canadians to be compliant with local authorities.

"I think, comparatively to many of the other countries that have foreign nationals here in Nepal, the Canadian government has been doing barely anything," Leroux said.

The earthquake was the worst to hit the South Asian nation in more than 80 years. 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.

Nepal earthquake

(Reuters)

With files from CBC, The Canadian Press