Nepal earthquake death toll rises above 3,400

KATMANDU, Nepal — Each time this city shuddered with aftershocks from the earthquake that convulsed Nepal, Samaj Gautam felt an urge to join the millions of residents who fled to safety outdoors. But working in a hospital emergency ward inundated with the wounded, and their broken limbs, fractured skulls and other physical traumas, Dr. Gautam said Sunday night, he and his colleagues had to suppress their fears and stick to treating patients.

“I’m feeling exhausted but also scared because the tremors have been by the dozens,” Dr. Gautam said as he worked through his own exhaustion in the emergency ward of Bir Hospital in Katmandu, where he had been since soon after the earthquake hit Saturday. “But the most worrying thing to me is the aftereffect. Sanitation, disease, these are also serious worries.”

By Monday afternoon, Nepalese authorities had sharply raised the death toll to more than 3,400, but the full extent of the devastation and death was still unclear. It was that uncertainty, over what the earthquake had wrought and what the future might hold, that spread fear and anxiety across Nepal. The true extent of disasters like the one that hit Saturday often become clear only in the days and weeks afterward, as the digging-out gains momentum and crews work through the rubble of lives upended.

But for now, getting through the day — and night — is the immediate challenge as aftershock after aftershock continues to rattle this country and its unnerved people. In the capital, Katmandu, as if the powerful earthquake were not enough of a test, heavy rains pelted the thousands who sought safety in the streets, cowering under leaking tarpaulins and makeshift tents, wondering what had become of homes, lives and livelihoods thrown into limbo by the quake.

“We don’t have anyplace to go,” said Mohammed Kabil, one of a dozen or so men who were warming themselves near a smoky campfire as the drizzle turned to rain. They sat near the remains of the Dharahara Tower, a revered monument that was toppled by the quake.

“We don’t have any clothes, we don’t have enough food, we don’t have medicine, we don’t know when we can go back into our homes,” he said.

At the international airport in Katmandu, hundreds of frightened people tried to book flights out early Monday morning.

Sitting atop a major tectonic fault, Nepal is accustomed to the tremors of the earth. But this time it has been overwhelmed by a powerful quake that killed thousands and destroyed some of the country’s most treasured temples. Past and present were destroyed all at once, making digging out and rebuilding that much more daunting.

On Sunday afternoon, the streets of Katmandu were filled with people carrying bedrolls and pillows to any open space they could find, including a military parade ground that has been transformed into a giant tent city. Few people seemed willing to sleep inside, fearful that the next shock might make their homes pancake. There seemed an arbitrariness to the destruction, one building collapsing and entombing its occupants, while another nearby withstood the shock.

That, too, added to the uncertainty, the sense that sleeping in the street, in the rain, was the only hedge against the randomness of fate.

“Everyone is scared,” said Samir Thapa, a 30-year-old security guard who, like thousands of other residents, slept in the tent city. “Everyone is saying it will come again. No one is going to sleep at home.”

As the government of Nepal struggles to gain its bearings, an international relief effort has begun to shift into gear. The United States, India and China were among countries initiating their own relief efforts, but aid officials said they were finding it difficult to get out to rural areas where some of the greatest devastation is feared.

Even getting aid and relief workers into Katmandu is complicated, with fewer than a fifth of the regular daily flights now arriving, with airlines concerned about the effects of powerful aftershocks.

The government also pleaded with its own workers to help in local rescue efforts rather than going to their usual jobs.

There is an urgency to the need, knowing well how devastation can spread its roots beyond the immediate crisis. The crammed encampments, for instance, are almost certain to pose a health risk in the days ahead, Dr. Gautam said, as unsanitary conditions could allow disease to spread. “Even some patients prefer to stay in the open field because they’re afraid of being inside.”

On Mount Everest, helicopter rescue operations began Sunday morning to take wounded climbers off the mountain, where at least 18 climbers were killed and 41 others injured. At least three Americans were among the dead: Marisa Eve Girawong, a physician assistant working for Madison Mountaineering of Seattle; Dan Fredinburg, a Google engineer; and, according to Reuters, Tom Taplin, a 61-year-old filmmaker from Colorado.

Hundreds of foreign and Nepalese climbers remained trapped on the mountain, according to the news agency.

Public frustration over the hardships brought by the disaster could grow into ire with the government, if its response is seen as too little too late.

“We feel we are helpless,” said Biraj Bikram Shah, a pilot who wandered through his neighborhood darkened by a power blackout. “We can do nothing.”

He and his family slept in their garden despite the rain. Pedestrians seemed to do everything in their power to stay away from buildings. They walked in the street instead of on sidewalks.

The government announced that schools would remain closed for at least five days.