The death toll from Nepal's devastating earthquake could reach 10,000, the prime minister said on Tuesday.
“The government is doing all it can for rescue and relief on a war footing,” Prime Minister Sushil Koirala said. “It is a challenge and a very difficult hour for Nepal.”
Koirala did not say how he estimated the leap in the death toll, according to Reuters, but the government has said it has yet to establish contact with some remote regions.
“The death toll could go up to 10,000 because information from remote villages hit by the earthquake is yet to come in,” Koirala said.
Rescue efforts have intensified in Nepal as a stream of foreign aid reaches the capital, Kathmandu in, the wake of an earthquake that has killed more than 4,352 people and injured more than 8,000 others.
Police said that the death toll could increase as rescuers reach remote regions in the mountainous country of 28 million people and as bodies buried under rubble are recovered.
On Tuesday morning, the ground shook at 5 a.m. but measured only magnitude 4.5.
Smaller aftershocks are expected to continue for a month and Kathmandu residents could continue to feel tremors because the epicenter is close to the city.
Lok Bijaya Adhikari, chief of Nepal's National Seismological Center, says the number and strength of aftershocks have been receding. People remain jittery.
Officials, still unable to determine the full scope of the earthquake's toll in remote areas, are increasingly worried about a health crises among survivors who lack access to clean water.
Baburam Marasini, director of Nepal's Epidemiology and Disease Control Division, said Tuesday that the department is asking people to take precautions such as eating with a clean spoon and not with their hands as most people here normally do.
As food and medical supplies dwindle, the government has made arrangements to pick up food and supplies directly from factories and distribute them free in areas where necessary, said Naindra Prasad Upadhaya, an official at the Commerce and Supplies Ministry, on Tuesday.
Water has been the big issue. There will be more tankers bringing water to the areas where people are camped out in Kathmandu and surrounding areas, he said. Food will also be sent to the rural areas on helicopters, he said.
In Bhaktapur, there were reports of residents struggling to dig through the rubble with limited help from the government. Sporadic fights broke out over supplies of food, water and tents.
Meanwhile, aid efforts are being stepped up. The United Nations said on Monday that it would release $15 million from its central emergency response fund.
The funds will allow international humanitarian groups to scale up operations and provide shelter, water, medical supplies and logistical services, U.N. spokesman Farhan Haq said.
Citing government figures, Haq said an estimated 8 million people have been affected by the quake in 39 of Nepal's districts, and more than 1.4 million need food assistance, including 750,000 who live near the epicenter in poor quality housing.
The first nations to respond were Nepal's neighbors India, China and Pakistan — all of which have been jockeying for influence over the landlocked nation.
Nepal remains closest to India, with which it shares deep political, cultural and religious ties. Military cargo planes from India and Pakistan have landed at Kathmandu's small airport, which has been struggling to handle the volume of cargo and civilian planes flying in.
In Kathmandu, tens of thousands of people spent the night sleeping in parks or open squares, or on a golf course for the third night.
Among them was Prabina Mainali, a 26-year-old teacher who gave birth to a boy Monday in a Kathmandu hospital — a bit of good news in a sea of despair.
"It's hard that he can't be in his own home right now. He should be there, we should be there, but we aren't safe. We're afraid of the aftershocks," Mainali said, feeding the as-yet unnamed infant from a bottle as a half-dozen relatives cooked a meal on a gas cooker outside the tent in a grassy park.
"We're not safe at home," she said. "Here we have less to worry about."
Aid workers have warned that the situation could be far worse near the epicenter.
The U.S. Geological Survey said the quake was centered near Lamjung, a district about 50 miles northwest of Kathmandu. While it is not not far from the city, poor roads and steep mountains make Lamjung difficult to reach.
Overwhelmed authorities were trying to cope with a shortage of drinking water and food as well as the threat of disease. There were reports of water and vegetables being sold at inflated prices.
The sick and wounded were lying out in the open in Kathmandu, unable to find beds in the devastated city's hospitals. Surgeons set up an operating theater in a tent in the grounds of Kathmandu Medical College.
"We are overwhelmed with rescue and assistance requests from all across the country," said Deepak Panda, a member of the country's disaster management.
Most shops in Kathmandu, where more than 1,000 people have died, were closed after the government declared a weeklong period of recovery.
Anurag Acharya, a Kathmandu-based journalist, said that "people are furious and not allowing journalists in the devastated area [Durbar Square]," the capital's central square.
"Kathmandu's heritage buildings are almost completely lost," he told Al Jazeera.
Al Jazeera and wire services