DHADING, Nepal (Reuters) - Barely any sign of an organised relief effort was visible outside Nepal's capital on Sunday, as aid agencies struggled to fly and truck relief supplies to a country stricken by its worst earthquake in eight decades.
In Dhading district 80 km outside Kathmandu, people camped in the open, the hospital was overflowing, the power was off and shops were closed.
Rocks were strewn across the lightly-travelled single road running west from the capital.
"Many people have lost their homes. Many people have died,"said English teacher Chandra Lama, whose home village lies two hours' drive further west. The crops in his village ruined, Lama was hunting for rice and pulses to feed his family.
"We are waiting to see what the government will do."
More than 1,100 people - or half of the total confirmed dead in Nepal - were in the Kathmandu Valley, a crossroads of the ancient civilisations of Asia and economic hub of the Himalayan nation of 28 million.
Indian military helicopters airlifted some injured to local hospitals but their operations were hampered by bad weather. With thousands sleeping in the open and heavy rain forecast, fears mounted of a humanitarian disaster.
Charity CARE International said that the death toll could run into the thousands, with hundreds of thousands homeless.
"Almost everyone has slept outside and they are creating temporary shelters with what they have," said CARE's emergency response coordinator in Kathmandu, Santosh Sharma.
CARE said shelter and washing facilities were a priority, as well as food. "There is no electricity, and soon there will be a scarcity of water."
Aid agencies held a first meeting with the Nepali government on Sunday to coordinate the relief effort.
British charity Save the Children said hospitals in the Kathmandu Valley were overcrowded, running out of room to store dead bodies and short on emergency supplies.
"Thousands of people have to stay outside of their homes, which have been damaged or destroyed by the earthquake. Shelter assistance is urgently needed," said Save the Children's Peter Olyle, who is based in Kathmandu.
Charity Medecins sans Frontieres was struggling to get relief supplies including thousands of blankets and shelter in from India's northern state of Bihar - also hit by Saturday's quake - because landslides had made roads difficult to navigate.
Strong aftershocks further hampered aid and caused panic after the Saturday's midday quake, which measured 7.8 and flattened buildings, opened cracks in roads and knocked out phone networks.
At the Dhading district hospital, patients were crammed in three to a bed and some being treated in the open. Officials reported 24 dead in the nearby village of Kumpur. Two babies were delivered overnight.
Three people lay on stretchers in a hospital corridor waiting for treatment. Bins were filled with used bandages and medical equipment as the hospital ran short of supplies. "No, I didn't sleep last night," said Rashila Amatya, medical superintendent at the hospital. New patients were being brought in from outlying areas on Sunday.
"For this new batch of patients there will probably not be enough medicine to last for today."
Basudev Ghimire, head of the local rescue unit, said that more than 130 people had been killed in the district but the number of injured ran into the thousands.
The Indian military, he said, had brought more than 100 people by helicopter to the district hospital or to Kathmandu. But they had brought no supplies; only evacuated people.
Meanwhile locals prepared for another night outside.
Officials on motorcycles rode through the town, telling residents through loudhailers that it was not safe to go indoors because of the risk of aftershocks. People were building tents with bamboo and sheets, with at least 1,000 ready to spend the night in several makeshift camps.