(Reuters) -- The death toll from Nepal's devastating earthquake could reach 10,000, the prime minister said on Tuesday, as residents frustrated by the government's slow response used their bare hands to dig for signs of their loved ones.
"The government is doing all it can for rescue and relief on a war footing," Prime Minister Sushil Koirala told Reuters. "It is a challenge and a very difficult hour for Nepal."
International aid has finally begun arriving in the Himalayan nation of 28 million people, three days after Saturday's 7.9 magnitude quake, but disbursement is slow. According to the home (interior) ministry, the confirmed death toll stands at 4,349, with more than 7,000 injured.
"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.
The United Nations said 8 million people were affected by the quake and that 1.4 million people were in need of food.
Nepal's most deadly quake in 81 years also triggered a huge avalanche on Mount Everest that killed at least 17 climbers and guides, including four foreigners, the worst single disaster on the world's highest peak.
All the climbers who had been stranded at camps high up on Everest had been flown by helicopters to safety, mountaineers reported on Tuesday.
A series of aftershocks, severe damage from the quake, creaking infrastructure and a lack of funds have slowed rescue efforts in the impoverished, mountainous country sandwiched between India and China. In the capital Kathmandu, youths and relatives of victims were digging into the ruins of destroyed buildings and landmarks.
"Waiting for help is more torturous than doing this ourselves," said Pradip Subba, searching for the bodies of his brother and sister-in-law in the debris of Kathmandu's historic Dharahara tower. The 19th century minaret collapsed on Saturday as weekend sightseers clambered up its spiral stairs.
"Our hands are the only machine right now," said the 27-year-old, part of a group of locals pulling out bricks and blocks of concrete with cloth masks over their faces to ward off the stench of rotting bodies. "There is just no one from the government or the army to help us."
Scores of people were killed in the collapse of the tower.
Elsewhere in the capital's ancient Durbar Square, groups of young men cleared rubble from around an ancient temple, using pickaxes, shovels and their bare hands. A few policemen stood by, watching.
Heavy rain later on Tuesday slowed down the rescue work.
The head of neighboring India's National Disaster Response Force (NDRF), one of the first foreign organizations to arrive in Nepal to help in the search and rescue effort, said finding survivors and the bodies of the dead would take time.
NDRF Director General O.P. Singh said heavy equipment could not fit through many of the narrow streets of Kathmandu.
"You have to remove all this rubble, so that will take a lot of time ... I think it's going to take weeks," he told Indian television channel NDTV late on Monday.
SLEPT IN THE OPEN
Many people across Nepal slept in the open for a third night, their homes either flattened or threatened by tremors that spread more fear among a traumatized population.
In Kathmandu, as elsewhere, thousands are sleeping on pavements, roads and in parks, many under makeshift tents.
Hospitals are full to overflowing, while water, food and power are scarce, raising fears of waterborne diseases.
There were some signs of normality on Tuesday, however, with fruit vendors setting up stalls on major roads and public buses back in operation.
But with aid slow to reach many of the most vulnerable, some Nepalis were critical of the government.
"The government has not done anything for us," said Anil Giri, who was with about 20 volunteers looking for two of his friends presumed buried under rubble. "We are clearing the debris ourselves with our bare hands."
Officials acknowledged they were overwhelmed by the scale of the disaster.
"The big challenge is relief," said Chief Secretary Leela Mani Paudel, Nepal's top bureaucrat.
"We urge foreign countries to give us special relief materials and medical teams. We are really desperate for more foreign expertise to pull through this crisis."
The situation is worse in remote rural areas. Highways have been blocked by landslides, and many villages and communities are without water and electricity, villagers surviving on salvaged food and with no outside help.
While aid has begun arriving in the capital, including food, medical supplies, tents and dogs trained for rescue efforts, the authorities are struggling to deliver relief further afield.
A crush at the main international airport, where relief material and rescue teams are flying in while thousands of residents are trying to leave, has slowed the flow of aid.
India and China were among the first contributors to an international effort to support Nepal's stretched resources.
On Monday, the United States announced an additional $9 million in aid for Nepal, bringing total U.S. disaster funding to $10 million.
U.S. and Australian military transport planes carrying search-and-rescue personnel and supplies were headed to Nepal.