Roads leading out of the mountain valley city of one million were jammed with people, many with babies in their arms, trying to climb onto buses or hitch a ride aboard cars and trucks.

Many said they had slept in the open since Saturday's  quake, either because their homes were flattened or they were terrified that the aftershocks would bring them crashing down.

"We are escaping," cited Krishna Muktari, who runs a small grocery store in Kathmandu city.

Overwhelmed authorities were trying to cope with a shortage of drinking water and food, as well as the threat of disease.

The sick and wounded were lying out in the open in  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 laid mattresses out on streets and erected tents to shelter from rain.

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