World leaders and charities are preparing emergency aid for the survivors as they try to grasp the scope of the earthquake that devastated tiny, mountainous Nepal - but worrying how to make sure it gets there.
With internet and mobile phone communications spotty and many damaged roads closed, the outside world scrambled for a clear picture of what most was needed following the magnitude 7.8 quake.
They know they need to hurry and a key development in aid efforts was the reopening of Kathmandu's airport.
"We know the damage is extensive and that access into rural areas will be very, very difficult for everybody," said Ben Pickering, Save the Children's humanitarian adviser in Britain.
"Children will be affected in many ways. Physical injuries. Separated from families."
Doctors Without Borders said four teams were leaving for Nepal from Bihar state in India, close to the Nepal border. The organisation is also sending 3,000 kits including medical supplies.
Habitat for Humanity International, which has worked in Nepal for years, said it would immediately begin distributing 20,000 emergency shelter kits as it evaluated the scope of the damage and determined construction plans.
AmeriCares sent a team from India and was preparing shipments of medical aid and relief supplies. Handicap International, which had 47 workers in Nepal before the earthquake, was already busy with the emergency response.
French aid group Doctors of the World (Medecins du monde) said it had mobilised its workers in Nepal and was sending more staffers and medical aid to the region immediately.
Mercy Corps said it was checking on the safety of the large team it already had on the ground in Nepal and assessing conditions.
As countries around the globe pledged aid, Pope Francis offered prayers for the victims and those working to save them.
A 62-member Chinese search and rescue team, plus six dogs, is expected to arrive in Kathmandu by chartered plane, the country's state-run Xinhua News Agency said.
The US embassy in Nepal announced one million dollars in initial aid, and the US Agency for International Development activated an urban search and rescue team. The US State Department set up an email address and phone number for anyone who knows of American citizens needing assistance in Nepal.
The European Union was considering "some budget support" to Nepal, according to a joint statement by the EU's foreign policy chief, development chief and humanitarian chief.
British prime minister David Cameron said on Twitter that Britain "will do all we can to help those caught up in it". Germany, Norway, Italy, France, Monaco and Mexico also pledged help.
In a neighbourhood in New York where many Nepalese people live, there was grief and concern.
Hari Acharya, owner of the Delhi Heights restaurant, said relatives including his mother, wife and children were safe but some friends had been killed. He said the building where several relatives lived had collapsed and the family was sitting outside.
"It's a really bad thing," he said. "It's a legitimate disaster."
In New York, Uma Mysorekar, president of the Hindu Temple Society of North America, said the disaster required "global assistance".
"We fear the deaths and casualty numbers could go up for days," she said. "We from the temple society will be collecting funds and forwarding them - as soon when we know where to send them."
Canada's government is sending a disaster aid team to Nepal and contributing five million dollars to relief efforts.
of the base camp packed with foreigners at the end of the climbing season.
The magnitude 7.8 earthquake, which originated outside the capital Kathmandu, was the worst to hit the poor Himalayan nation in over 80 years. It destroyed the historic part of the city and was strong enough to be felt across the northern part of neighbouring India, Bangladesh, China's region of Tibet and Pakistan, where a total of 60 people died.
"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 Sundar Sah. "I hardly got much sleep. I was waking up every few hours and glad that I was alive."
When the earth first shook, residents fled homes and buildings in panic. Walls tumbled, trees swayed, power lines came crashing down and large cracks opened up on streets and walls.
After yesterday's chaos - when little organised rescue and relief was seen - there was relatively more order as rescue teams fanned out across the city. At one place in the Kalanki neighbourhood, police rescuers tried to extricate a man lying under a dead person, crushed by a pile of concrete slabs and iron beams. His family members stood nearby, crying and praying.
Police said the man's legs and hips were crushed.
"We are digging the debris around him, cutting through concrete and iron beams. We will be able to pull him out but his body under his waist is totally crushed. He is still alive and crying for help. We are going to save him," said police officer Suresh Rai.
Most areas were without power and water, but with Kathmandu airport reopened, the first aid flights began delivering aid supplies. Workers were sending out tents and relief goods in trucks and helicopters, said disaster management official Rameshwar Dangal. He said schools had been turned into shelters.
Roads to Gorkha district, the site of the epicentre, were blocked by landslides, hindering rescue teams, chief district official Prakash Subedi said. Teams were trekking on foot through mountain trails to reach remote villages, and helicopters would also be deployed, he said.
Mukesh Kafle, head of Nepal Electricity Authority, said power had been restored to the main government office, the airport and hospitals. But the damage to the electricity cables and poles was making it difficult to restore power across many parts of the country.
"We have to make sure all cables are secure before turning the power on. Our technicians have been working round the clock to restore power to the people," he said.
More than two dozen aftershocks jolted Nepal yesterday and more continued today. Forecasts predicted for rain and thunder today and the temperatures were in the mid-50s (14 Celsius), cold enough to make camping outside uncomfortable.
Nevertheless thousands of people spent the night at Tudikhel, a vast open ground in the middle of Kathmandu, next to the old city that is lined with historic buildings and narrow lanes. Now it is in ruins.
"We hardly slept through the night. It was cold and it rained briefly and it was uncomfortable, but I am glad I brought my family out to the open," said Ratna Singh, a vegetable seller huddled under a blanket with his wife and son.
"At least I knew my family was safe. Every time the ground shook at night, I thanked God my family was there with me and safe. I don't think I am going to be sleeping inside the house any time soon. We are all petrified."
The quake will put a huge strain on the resources of Nepal, best known for Everest, the highest mountain in the world. The economy of the nation of 27.8 million people relies heavily on tourism, principally trekking and Himalayan mountain climbing.
The world reacted with alacrity to the disaster, offering aid in the form of money, relief material, equipment, expertise and rescue teams.
Among the first to move in was Nepal's giant neighbour India, with which it has close political, cultural and religious ties. Nepal is the world's only Hindu nation and majority of Indians are Hindus, although it does not have an official religion.
Indian air force planes landed with 43 tons of relief material, including tents and food, and nearly 200 rescuers. The planes were returning to New Delhi with Indian nationals who were stranded in Kathmandu. More aid flights are planned.
Hospitals in the Kathmandu Valley were overcrowded, running out of room for storing dead bodies and running out of emergency supplies, the United Nations said.
Officials said an avalanche after the quake swept base camp where expeditions were preparing to scale Everest, flattening tents and killing at least 17 climbers and guides and injuring 61. Their nationalities were not immediately known. An unknown number were missing.