AP/AFP

Kathmandu, Nepal — Shelter, fuel, food, medicine, power, news, workers �X Nepal’s earthquake-hit capital was short on everything Monday as its people searched for lost loved ones, sorted through rubble for their belongings and struggled to provide for their families’ needs. In much of the countryside, it was worse, though how much worse was only beginning to become apparent.

The death toll soared past 4,000, even without a full accounting from vulnerable mountain villages that rescue workers were still struggling to reach two days after the disaster.

Udav Prashad Timalsina, the top official for the Gorkha district, where Saturday’s magnitude 7.8 quake was centered, said he was in desperate need of help.

Aid group World Vision said its staff members were able to reach Gorkha, but gathering information from the villages remained a challenge. Even when roads are clear, the group said, some remote areas can be three days’ walk from Gorkha’s main disaster center.

Some roads and trails have been blocked by landslides, the group said in an email to The Associated Press. ��In those villages that have been reached, the immediate needs are great including the need for search and rescue, food items, blankets and tarps, and medical treatment.��

Timalsina said 223 people had been confirmed dead in Gorkha district but he presumed ��the number would go up because there are thousands who are injured.�� He said his district had not received enough help from the central government, but Jagdish Pokhrel, the clearly exhausted army spokesman, said nearly the entire 100,000-soldier army was involved in rescue operations.

He said the recovery was also being slowed because many workers �X water tanker drivers, electricity company employees and laborers needed to clear debris �X ��are all gone to their families and staying with them, refusing to work.��

As people are pulled from the wreckage, he noted, even more help is needed. ��Now we especially need orthopedic (doctors), nerve specialists, anesthetists, surgeons and paramedics,�� he said. ��We are appealing to foreign governments to send these specialized and smart teams.��

More than 6,300 people were injured in the quake, he said, estimating that tens of thousands of people had been left homeless. ��We have been under severe stress and pressure, and have not been able to reach the people who need help on time,�� he said.

Nepal police said in a statement that the country’s death toll had risen to 4,000 people. That does not include the 18 people killed in the avalanche, which were counted by the mountaineering association. Another 61 people were killed in neighboring India, and China reported 20 people dead in Tibet.