The death toll from Nepal's earthquake has jumped to 3,218, a police official said on Monday. The official said 6,538 people have been injured in Saturday's quake, the worst in the country in 81 years. Thousands of desperate Nepalese huddled under tents and sought scarce food and medical supplies on Monday, as overwhelmed authorities struggled to care for the wounded and homeless. The sick and wounded lay out in the open in the capital, Kathmandu, unable to find beds in the devastated city's hospitals. Surgeons set up an operating theatre inside 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. Across Kathmandu and beyond, exhausted families whose homes were either flattened or at risk of collapse laid mattresses out on streets and erected tents to shelter from rain. People queued for water dispensed from the back of trucks, while the few stores still open had next to nothing on their shelves. Crowds jostled for medicine at one pharmacy. A tourist makes his way through the debris of a temple after an earthquake in Kathmandu, Nepal | Reuters Photo

Avalanche Terror

In the Himalayas, hundreds of climbers felt tremors on Sunday powerful enough to send snow and boulders cascading towards them. Another was felt early on Monday.

The huge and deadly avalanche on Saturday triggered by the earthquake caused panic at the Everest base camp, a sprawling "city" of tents from where mountaineers set off for the world's highest peak.

"It was a monstrous sound, like the demons had descended on the mountain," Khile Sherpa, a Nepalese guide, told Reuters, recalling the moment the avalanche hit.

He was one of the lucky few airlifted to the relative safety of Kathmandu but the disaster has underlined the woeful state of Nepal's medical facilities.

Nepal has only 2.1 physicians and 50 hospital beds for every 10,000 people, according to a 2011 World Health Organization report.

"The earthquake has exposed that Nepal's best public hospital infrastructure has crumbled at a time when it should serve more people in a hurry," said Sarvendra Moongla, a senior surgeon at Bir Hospital's Trauma Centre in Kathmandu, which opened in February.

At the Tribhuvan University Teaching Hospital, bodies, including that of a boy aged about seven, were heaped in a dark room. The stench of death was overpowering.

Outside, a 30-year-old woman who had been widowed wailed: "Oh Lord, why did you take him alone? Take me along with him."

A woman's shoe lies among the debris of a collapsed house a day after an earthquake in Bhaktapur, Nepal | Reuters Photo

Counting the cost

Rajiv Biswas, Asia Pacific chief economist at business research firm IHS, said long-term reconstruction costs in Nepal using proper building standards for an earthquake zone could be more than $5 billion, or around 20 percent of the country's GDP.

"With housing construction standards in Nepal being extremely low ... the impact of the earthquake has been devastating based on initial reports," he said in an early analysis of the likely damage.

In crowded Kathmandu, many buildings were flattened or badly damaged.

Nepali army officer Santosh Nepal and a group of rescuers worked all night on Saturday to open a passage into a collapsed building in Kathmandu. They used pick axes because bulldozers could not get through the ancient city's narrow streets.

"We believe there are still people trapped inside," he told Reuters, pointing at concrete debris and twisted reinforcement rods where a three-storey residential building once stood.

Among the capital's landmarks destroyed in the earthquake was the 60-metre (200-foot) Dharahara Tower, built in 1832 for the queen of Nepal.