More than 2,200 confirmed dead in Nepal earthquake

Aftershock Complicates Nepal's Rescue and Relief Efforts

KATHMANDU, Nepal (AP) - A powerful aftershock shook Nepal on Sunday, making buildings sway and sending panicked Kathmandu residents running into the streets a day after a massive earthquake left more than 2,200 people dead.

The cawing of crows mixed with terrified screams as the magnitude 6.7 aftershock pummeled the capital city early Sunday afternoon. It came as planeloads of supplies, doctors and relief workers from neighboring countries began arriving in this poor Himalayan nation.

"The aftershocks keep coming ... so people don't know what to expect," said Sanjay Karki, Nepal country head for global aid agency Mercy Corps. "All the open spaces in Kathmandu are packed with people who are camping outdoors. When the aftershocks come you cannot imagine the fear. You can hear women and children crying."

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More than 2,200 confirmed dead in Nepal earthquake
BHAKTAPUR, NEPAL - 2015/05/02: Nepali residents sift through rubble to recover keys, coins, and other small items from the rubble of their home in Bhaktapur, Nepal on May 2, 2015. On April 25, 2015, Nepal suffered a magnitude 7.8 earthquake killing over 6,000 people and injuring thousands more. (Photo by Taylor Weidman/LightRocket via Getty Images)
A Nepalese policeman walks among earthquake debris in the Nepalese capital Kathmandu on April 28, 2015. Hungry and desperate villagers rushed towards relief helicopters in remote areas of Nepal on April 28, begging to be airlifted to safety, four days after a monster earthquake killed nearly 4,500 people. AFP PHOTO / Nicolas ASFOURI (Photo credit should read NICOLAS ASFOURI/AFP/Getty Images)
A man carries a woman injured in an earthquake in Kathmandu on April 28, 2015. Hungry and desperate villagers rushed towards relief helicopters in remote areas of Nepal on April 28, begging to be airlifted to safety, four days after a monster earthquake killed nearly 4,500 people. AFP PHOTO / MANAN VATSYAYANA (Photo credit should read MANAN VATSYAYANA/AFP/Getty Images)
French rescue workers (back) and Spanish rescue workers (front) talk among earthquake debris in the Nepalese capital Kathmandu on April 28, 2015. Hungry and desperate villagers rushed towards relief helicopters in remote areas of Nepal on April 28, begging to be airlifted to safety, four days after a monster earthquake killed nearly 4,500 people. AFP PHOTO / Nicolas ASFOURI (Photo credit should read NICOLAS ASFOURI/AFP/Getty Images)
Nepalese Military Police officials search through rubble in the earthquake damaged area of Bhaktapur on the outskirts of Kathmandu on April 28, 2015. Hungry and desperate villagers rushed towards relief helicopters in remote areas of Nepal, begging to be airlifted to safety, four days after a monster earthquake killed nearly 4,500 people. AFP PHOTO/MENAHEM KAHANA (Photo credit should read MENAHEM KAHANA/AFP/Getty Images)
KATHMANDU, NEPAL - APRIL 26: Local people and soldiers inspect debris of destroyed buildings after a powerful earthquake hits Katmandu, Nepal on April 26, 2015. The death toll in Nepal climbed towards 2,500 on Sunday as rescuers unearthed the victims of a powerful earthquake. There have been 773 people killed in Nepals densely-populated capital Kathmandu, while the Himalayan nations central region, close to the epicenter of Saturdays 7.8-magnitude quake, has seen 1,055 deaths. (Photo by Sunil Pradhan/Anadolu Agency/Getty Images)
Nepalese residents walk past road damage following an earthquake in Kathmandu on April 26, 2015. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, 2015, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. As the death toll surpassed 2,000, the US together with several European and Asian nations sent emergency crews to reinforce those scrambling to find survivors in the devastated capital Kathmandu and in rural areas cut off by blocked roads and patchy phone networks. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
Nepalese residents mourn the death of a relative following an earthquake, at a mass cremation at Pashupatinath in Kathmandu on April 26, 2015. Aid groups and governments worldwide intensified efforts April 26 to help earthquake-hit Nepal, but blocked roads, downed power lines and overcrowded hospitals posed formidable challenges in an already poor country. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
A Nepalese resident mourns the death of a relative following an earthquake, at a mass cremation at Pashupatinath in Kathmandu on April 26, 2015. Aid groups and governments worldwide intensified efforts April 26 to help earthquake-hit Nepal, but blocked roads, downed power lines and overcrowded hospitals posed formidable challenges in an already poor country. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
KATHMANDU, NEPAL - APRIL 26: A motorbike is buried under debris of destroyed buildings in Katmandu, Nepal on April 26, 2015. The death toll in Nepal climbed towards 2,500 on Sunday as rescuers unearthed the victims of a powerful earthquake. There have been 773 people killed in Nepals densely-populated capital Kathmandu, while the Himalayan nations central region, close to the epicenter of Saturdays 7.8-magnitude quake, has seen 1,055 deaths. (Photo by Bulent Doruk/Anadolu Agency/Getty Images)
A Nepalese resident reacts after identifying the body of a relative in a mortuary at a city hospital in Kathmandu on April 26, 2015. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, 2015, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. As the death toll surpassed 2,000, the US together with several European and Asian nations sent emergency crews to reinforce those scrambling to find survivors in the devastated capital Kathmandu and in rural areas cut off by blocked roads and patchy phone networks. AFP PHOTO / PRAKASH SINGH (Photo credit should read PRAKASH SINGH/AFP/Getty Images)
KATHMANDU, NEPAL - APRIL 26: Destroyed buildings seen after a powerful earthquake in Katmandu, Nepal on April 26, 2015. The death toll in Nepal climbed towards 2,500 on Sunday as rescuers unearthed the victims of a powerful earthquake. There have been 773 people killed in Nepals densely-populated capital Kathmandu, while the Himalayan nations central region, close to the epicenter of Saturdays 7.8-magnitude quake, has seen 1,055 deaths. (Photo by Bulent Doruk/Anadolu Agency/Getty Images)
BHAKTAPUR, NEPAL - APRIL 26: Relatives of a victim of the earthquake that hit Nepal yesterday cry while walking to the cremation site on April 26, 2015 in Bhaktapur, Nepal. A major 7.8 earthquake hit Kathmandu mid-day on Saturday, and was followed by multiple aftershocks that triggered avalanches on Mt. Everest that buried mountain climbers in their base camps. Many houses, buildings and temples in the capital were destroyed during the earthquake, leaving thousands dead or trapped under the debris as emergency rescue workers attempt to clear debris and find survivors. (Photo by Omar Havana/Getty Images)
The mass cremation of earthquake victims takes place Bhaktapur on the outskirts of Kathmandu on April 26, 2015. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. AFP PHOTO/PRAKASH SINGH (Photo credit should read PRAKASH SINGH/AFP/Getty Images)
Residents stand in the street outside their homes following an earthquake, in Siliguri on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. Witnesses and media reports said the quake tremors lasted between 30 seconds and two minutes and were felt across the across the border in India, including in the capital New Delhi. AFP PHOTO / Diptendu DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
Indian police and bystanders look at a collapsed house following an earthquake, in Siliguri on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. Witnesses and media reports said the quake tremors lasted between 30 seconds and two minutes and were felt across the across the border in India, including in the capital New Delhi. AFP PHOTO / Diptendu DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
Indian bystanders look at a collapsed house following an earthquake, in Siliguri on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. Witnesses and media reports said the quake tremors lasted between 30 seconds and two minutes and were felt across the across the border in India, including in the capital New Delhi. AFP PHOTO / Diptendu DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
Nepalese people walk past collapsed buildings at Lalitpur, on the outskirts of Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
Nepalese people sit in an open area following an 7.9 earthquake, at Lalitpur on the outskirts of Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
Nepalese rescue members and onlookers gather at the collapsed Dharahara Tower in Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
Nepalese people wheel an injured man into an open area following an 7.9 earthquake, at Lalitpur on the outskirts of Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
BHAKTAPUR, NEPAL - APRIL 26: A relative of one of the victims of the earthquake that hit Nepal yesterday cries on April 26, 2015 in Bhaktapur, Nepal. A major 7.8 earthquake hit Kathmandu mid-day on Saturday, and was followed by multiple aftershocks that triggered avalanches on Mt. Everest that buried mountain climbers in their base camps. Many houses, buildings and temples in the capital were destroyed during the earthquake, leaving thousands dead or trapped under the debris as emergency rescue workers attempt to clear debris and find survivors. (Photo by Omar Havana/Getty Images)
Nepalese rescue members move the body of a victim from the collapsed Dharahara Tower in Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
Nepalese people stand amidst debris of a collapsed building in Kathmandu on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. AFP PHOTO / PRAKASH MATHEMA (Photo credit should read PRAKASH MATHEMA/AFP/Getty Images)
An Indian shopkeeper checks the damage inside his office following an earthquake, in Siliguri on April 25, 2015. A powerful 7.9 magnitude earthquake struck Nepal, causing massive damage in the capital Kathmandu with strong tremors felt across neighbouring countries. Witnesses and media reports said the quake tremors lasted between 30 seconds and two minutes and were felt across the across the border in India, including in the capital New Delhi. AFP PHOTO / Diptendu DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
BHAKTAPUR, NEPAL - APRIL 26: A member of police forces walk down a street covered in debris after buildings collapsed on April 26, 2015 in Bhaktapur, Nepal. A major 7.8 earthquake hit Kathmandu mid-day on Saturday, and was followed by multiple aftershocks that triggered avalanches on Mt. Everest that buried mountain climbers in their base camps. Many houses, buildings and temples in the capital were destroyed during the earthquake, leaving thousands dead or trapped under the debris as emergency rescue workers attempt to clear debris and find survivors. (Photo by Omar Havana/Getty Images)
Nepalese residents walks past road damage following an earthquake in Kathmandu on April 26, 2015. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, 2015, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. As the death toll surpassed 2,000, the US together with several European and Asian nations sent emergency crews to reinforce those scrambling to find survivors in the devastated capital Kathmandu and in rural areas cut off by blocked roads and patchy phone networks. AFP PHOTO / PRAKASH SINGH (Photo credit should read PRAKASH SINGH/AFP/Getty Images)
Indian residents rest and sleep in a football field in Siliguri on April 26, 2015 after a 7.8 magnitude earthquake hit the region on April 25 in Nepal. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. AFP PHOTO / DIPTENDU DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
Indian residents rest and sleep in a football field in Siliguri on April 26, 2015 after a 7.8 magnitude earthquake hit the region on April 25 in Nepal. International aid groups and governments intensified efforts to get rescuers and supplies into earthquake-hit Nepal on April 26, but severed communications and landslides in the Himalayan nation posed formidable challenges to the relief effort. AFP PHOTO / DIPTENDU DUTTA (Photo credit should read DIPTENDU DUTTA/AFP/Getty Images)
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The earthquake centered outside Kathmandu, the capital, was the worst to hit the South Asian nation in over 80 years. It destroyed swaths of the oldest neighborhoods of Kathmandu, and was strong enough to be felt all across parts of India, Bangladesh, China's region of Tibet and Pakistan. By Sunday afternoon, authorities said at least 2,169 people had died in Nepal alone, with 61 more deaths in India and a few in other neighboring countries. At least 721 of them died in Kathmandu alone, and the number of injured nationwide was upward of 5,000. With search and rescue efforts far from over, it was unclear how much the death toll would rise.

But outside of the oldest neighborhoods, many in Kathmandu were surprised by how few modern structures - the city is largely a collection of small, poorly constructed brick apartment buildings - collapsed in the quake. While aid workers cautioned that many buildings could have sustained serious structural damage, it was also clear that the death toll would have been far higher had more buildings caved in.

On a flight into Kathmandu on Sunday morning, an AP correspondent was unable to spot any collapsed buildings.

Aid workers also warned that the situation could be far worse near the epicenter. The U.S. Geological Survey said the quake was centered near Lamjung, about 80 kilometers (50 miles) northwest of Kathmandu, in the Gorkha district.

Roads to that area were blocked by landslides, hindering rescue teams, said chief district official Prakash Subedi. Teams were trekking through mountain trails to reach remote villages, and helicopters would also be deployed, he said by telephone.

The aid group World Vision said in a statement that remote mountain communities, including in Gorkha, were totally unprepared for the level of destruction caused by the earthquake.

Villages near the epicenter "are literally perched on the sides of large mountain faces and are made from simple stone and rock construction. Many of these villages are only accessible by 4WD and then foot, with some villages hours and even entire days' walks away from main roads at the best of times," the group's local staff member, Matt Darvas, said in the statement.

He said he was hearing that many of the villages may have been completely buried by rock falls.

"It will likely be helicopter access only for these remote villages," he said.

Nepal's worst recorded earthquake in 1934 measured 8.0 and all but destroyed the cities of Kathmandu, Bhaktapur and Patan.

With people fearing more quakes, tens of thousands of Nepalese spent Saturday night outside under chilly skies, or in cars and public buses. They were jolted awake by strong aftershocks early Sunday.

"There were at least three big quakes at night and early morning. How can we feel safe? This is never-ending and everyone is scared and worried," said Kathmandu resident Sundar Sah. "I hardly got much sleep. I was waking up every few hours and glad that I was alive."

As day broke, rescuers aided by international teams set out to dig through rubble of buildings - concrete slabs, bricks, iron beams, wood - to look for survivors.

In the Kalanki neighborhood of Kathmandu, police rescuers finally extricated a man lying under a dead person, both of them buried beneath a pile of concrete slabs and iron beams. Before his rescue, his family members stood nearby, crying and praying. Police said the man's legs and hips were totally crushed.

Hundreds of people in Kalanki gathered around the collapsed Lumbini Guest House, once a three-story budget hotel and restaurant frequented by Nepalese. They watched with fear and anticipation as a single backhoe dug into the rubble.

Police officer RP Dhamala, who was coordinating the rescue efforts, said they had already pulled out 12 people alive and six dead. He said rescuers were still searching for about 20 people believed to be trapped, but had heard no cries, taps or noises for a while.

Most areas were without power and water. The United Nations said hospitals in the Kathmandu Valley were overcrowded, and running out of emergency supplies and space to store corpses. Plumes of smoke, meanwhile, rose above the capital as friends, relatives and others gathered by the river to quickly cremate loved ones' remains.

Most shops in Kathmandu were shut; only fruit vendors and pharmacies seemed to be doing business. Karki, of Mercy Corps, said there were long lines outside pharmacies because people fear they will run out of medicine.

Fruit seller Shyam Jaiswal vowed not to raise prices, though stocks were fast running out.

"This is all we will have for awhile. We don't expect any more shipments for at least a week. More people are coming now. They cannot cook so they need to buy something they can eat raw. We try to help everyone. But we are not raising prices. That would be illegal, immoral profit. That would be wrong," Jaiswal said.

The quake will likely 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.

With Kathmandu airport reopened, the first aid flights began delivering aid supplies. The first to respond were Nepal's neighbors - India, China and Pakistan, all of which have been jockeying for influence over the landlocked nation. Still, Nepal remains closest to India with which it shares deep political, cultural and religious ties.

Indian air force planes landed Sunday with 43 tons of relief material, including tents and food, and nearly 200 rescuers, India's External Affairs Ministry spokesman Vikas Swarup said. The planes were returning to New Delhi with Indian nationals stranded in Kathmandu. More aid flights were planned for Sunday.

India suffered its own losses from the quake, with at least 61 people killed there and dozens injured. Sunday's aftershock was also widely felt in the country, and local news reports said metro trains in New Delhi and Kolkata were briefly shut down when the shaking started.

A 62-member Chinese search and rescue team also arrived Sunday. Other countries sending support Sunday included the United Arab Emirates, Germany and France.

Pakistan prepared to send four C-130 aircraft, carrying a 30-bed temporary hospital comprising army doctors, surgeons and specialists. An urban search and rescue team was also sent with ground-penetrating radars, concrete cutters and sniffing dogs. Pakistan was also sending 2,000 ready-to-eat meal packs, water bottles, medicines, 200 tents, 600 blankets and other necessary items.

When the earth first shook, residents fled homes and buildings in panic as walls tumbled, trees swayed, power lines came crashing down and large cracks opened up on streets. After the chaos of Saturday - when little organized rescue and relief was seen - there was more order on Sunday as rescue teams fanned out across the city.

Workers were sending out tents and relief goods in trucks and helicopters, said disaster management official Rameshwar Dangal. He said government and private schools have been turned into shelters.

Mukesh Kafle, the head of the Nepal Electricity Authority, said power has been restored fully to main government offices, the airport and hospitals.

Among the destroyed buildings in Kathmandu was the nine-story Dharahara Tower, a Kathmandu landmark built by Nepal's royal rulers as a watchtower in the 1800s and a UNESCO-recognized historical monument. It was reduced to rubble and there were reports of people trapped underneath.

The Kathmandu Valley is listed as a World Heritage site. The Buddhist stupas, public squares and Hindu temples are some of the most well-known sites in Kathmandu, and now some of the most deeply mourned.

The head of the U.N. cultural agency, Irina Bokova, said in a statement that UNESCO was ready to help Nepal rebuild from "extensive damage, including to historic monuments and buildings of the Kathmandu Valley."

Nepali journalist and author Shiwani Neupane tweeted: "The sadness is sinking in. We have lost our temples, our history, the places we grew up."

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Associated Press writers Muneeza Naqvi and Tim Sullivan in New Delhi contributed to this report.

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