The death toll（死亡人數(shù)） in the Nepal earthquake rose to more than 3,600 on Monday and could climb higher as fears grow for the fate of people living in remote villages that remain out of the reach of search and rescue teams.

The earthquake – Nepal’s worst in more than 80 years – also injured more than 6,500 people and left thousands sleeping in the open while authorities battled against time to rescue anyone still alive beneath the rubble.

The death toll may rise once rescue and aid teams are able to reach remote mountain villages near the epicentre of the quake(震中), where the damage is thought to be far worse than in the capital.

“There are people who are not getting food and shelter. I’ve had reports of villages where 70% of the houses have been destroyed,” he said.Reports received so far by the government and aid groups suggest that many communities perched on mountainsides are devastated or struggling to cope. Udav Prashad Timalsina, the top official for the Gorkha district, one of the worst-hit areas, said he was in desperate need of help.

Police on Monday said the death toll was at least 3,617 in Nepal. Another 66 were killed across the border in India and at least another 20 in Tibet, China’s state news agency said.

The devastation caused by the quake, which struck just before noon on Saturday, is stretching medical services in this impoverished and unprepared Himalayan nation to breaking point.

“We are overwhelmed with rescue and assistance requests from all across the country,” said Deepak Panda, a member of the country’s disaster management agency.

A damaged house is brought down during the search for victims trapped inside collapsed houses following Saturday’s earthquake in Bhaktapur, Nepal. Photograph: NAVESH CHITRAKAR/REUTERS

Unicef said that nearly one million children have been “severely affected” by the disaster and warned of an increased risk of waterborne and infectious diseases.

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“What we know that at this point is there are nearly a million children who are severely affected. Our biggest concern for them right now is going to be access to clean water and sanitation, we know that water and food is running out,” Unicef’s Christopher Tidey said.

Hospital beds in the capital, Kathmandu, are already full, forcing other sick and injured people to seek makeshift （臨時的）treatment in the street alongside thousands of displaced（流離失所的）survivors whose homes were destroyed or are in imminent danger of collapse after being weakened by the M7.8 quake.

Outside Kathmandu, details of the extent of the damage and the numbers of killed and injured are still sketchy.

Only a few reports have come out of the Gorkha district. The mountainous region, located in the centre of the country, is home to roughly 270,000 people, in the middle of the country. The district of Lamjung is also thought to have been badly affected.

（這是特別地道的用法，某地有多少人，xx is home to 多少人/ 也可以說 China is home to 56 ethnic groups.)

）

On Mount Everest, hundreds of climbers remained trapped after a huge avalanche(雪崩) flattened the base camp, killing 17 and injuring 61 in the worst disaster to hit the mountain. The death toll on the mountain is likely to rise as no one knows how many people were at base camp and in the vicinity.（在附近）

Many of the dead are locals, making this the second year running that the sherpa and other communities have been hit hard on Everest. Only one of the major expeditions has its camp intact and it seems very unlikely anyone will be continuing any climb on the peak.

While survivors wait for aid, rescue teams are continuing the frantic search for survivors, despite being exhausted by two nights of ceaseless work.

“The rescue workers are in a really bad shape. We are all about to collapse. We have worked two straight nights（兩整夜）,” said home ministry official Laxmi Prasad Dhakal.

Rescuers used their bare hands, with no protective gear or heat detectors, in their optimistic search for survivors in remains of the Dharahara tower.

The narrow alleys would stop cranes, earthmovers or diggers reaching most of the houses that have collapsed, even if the aftershocks hadn’t scared workers out of even trying, said Shyam Adhikari, the local police chief.

“Anyway, there’s not much point. There are some entire families buried. We know because no one reported them missing. No one is alive under the rubble,” he told the Guardian.

With so many people sleeping in the open with no power or water and downpours （傾盆大雨）forecast, there were mounting fears of major food and water shortages.

“There is no electricity, no water. Our main challenge and priority is to restore electricity and water,” Dhakal at the home ministry said. “The next big challenge is the supply of food. Shopkeepers are unable to go in and open their shops. So people are facing difficulty buying food.”

The disaster has prompted a huge international relief operation, although local reports suggest that much of the aid has yet to materialise on the ground due to strong aftershocks that closed Kathmandu’s main airport several times on Sunday.

India flew in medical supplies and members of its disaster response force, while China sent a 60-strong emergency team.

Pakistan’s army said it was sending four C-130 aircraft with a 30-bed hospital, search and rescue teams and relief supplies.

A US military aircraft with 70 personnel was due to arrive in Kathmandu on Monday. Australia, Britain and New Zealand said they were sending specialist urban search-and-rescue teams to Kathmandu. Britain was also delivering supplies and medics.

The immediate aftermath of earthquake has underlined Nepal’s inability to cope with a disaster of this scale.

The country of 28 million has only 2.1 doctors and 50 hospital beds for every 10,000 people, according to the World Health Organization.

“The earthquake has exposed that Nepal’s best public hospital infrastructure has crumbled at a time when it should serve more people in a hurry,” said Sarvendra Moongla, a senior surgeon at Bir Hospital’s Trauma Centre in Kathmandu.