"Communication is down in many areas. Widespread destruction, rubble and landslides are preventing access to provide aid in many villages."

   Mike Bruce, regional communications manager for the Plan International aid organisation, said many areas -- both rural and in some of the larger towns -- had suffered landslides and roads were blocked.

   Although mobile networks appeared to be being restored by mid-afternoon on Sunday, he said, coverage remained sporadic.

   "People are sleeping on the streets and cooking outside for the most part. And we are talking about very, very poor areas of Nepal -- areas that are already suffering a great deal," said Bruce.

   Other aid organisations relayed fears that stocks of essential supplies were rapidly running out, and described the fearsome effects of the quake.

   "We witnessed terrible scenes of destruction -- hospitals were evacuated with patients being treated on the ground outside, homes and buildings demolished and some roads cracked wide open," said Eleanor Trinchera, Caritas Australia programme coordinator for Nepal, who was an hour outside the capital when the quake struck.

   A lack of electricity would soon be complicated by a scarcity of water, aid groups said, with medical supplies also dwindling, while Oxfam told AFP morgues were reaching capacity.

   "Communication systems are congested and hospitals are crowded and are running out of room for storing dead bodies," Helen Szoke, the charity's Australia chief executive, told AFP.

   Survivors also slept in the open in Kathmandu overnight, braving the cold for fear of being crushed by teetering buildings.

   Hundreds of structures, including office blocks and a landmark nine-storey tower, crashed to the ground at around midday on Saturday when the 7.8-magnitude quake struck.


Millions pledged in aid

   As Nepal began to take stock of the devastation, a US disaster response team was en route and an initial $1 million in aid to address immediate needs had been authorised, the US Agency for International Development said.

   Australia and New Zealand together pledged more than $4.5 million, and South Korea promised $1 million in humanitarian aid.

   India dispatched two military transport planes as it emerged that at least 53 people had died there from the effects of the massive quake.

   Russia said two of its planes would fly out Sunday, carrying specialist rescuers, doctors and psychologists as well as equipment including helicopters and drones.

   Sri Lanka said a military C-130 aircraft carried a 48-member medical and relief team along with medicines, bandages, water and power generators, while a second aircraft would take more doctors and nurses.

   Pakistan said two C-130 aircraft carrying equipment for a 30-bed hospital, food and search and rescue teams had arrived in Nepal.

   A 62-member Chinese search and rescue team with sniffer dogs was on the ground in Kathmandu and a medical team would be mobilised and work started on an emergency aid plan, state news agency Xinhua reported.

   Eighteen people were killed by the earthquake in Tibet.

   A Singaporean search and rescue team was also heading for Nepal, while Japan's own 70-strong emergency services team departed on Sunday.

   A 45-strong team of rescue experts, doctors and other experts, from Belgium, Germany and Luxembourg, was leaving on a Belgian military plane.

   France's foreign ministry said it had dispatched a rescue team carrying essential supplies.


'Urgent need' for assistance 

   Germany, Britain and Spain also pledged support and assistance, with Norway promising to provide 30 million krone ($3.9 million, 3.5 million euros) in humanitarian aid.

   Israel said it was sending an aid delegation to Nepal, including a team of paramedics and doctors.

   Charity Christian Aid launched an appeal for funds and said it was working with partner agencies to reach the worst hit areas, describing an "urgent need" for emergency shelters, food, clean drinking water and warm clothing.

   Numerous aid groups and NGOs also announced help. Medecins Sans Frontieres (Doctors Without Borders) was dispatching an inflatable hospital with a 60-80 bed capacity. (AFP)