SINDHUPALCHOK, Nepal -- Crumbled, devastated buildings line the narrow roads of Sindhupalchok, a Himalayan foothill district where the death count from Saturday’s magnitude-7.8 earthquake has just surpassed that of the capital, Kathmandu. Relief workers have only just begun to address the scale and scope of need in the district, which lies around 40 miles (65 km) northeast of Kathmandu. But for many villagers, the lack of government assistance over the past five days has provoked vocal and visible anger.

“We haven’t received anything,” said Rachana Sahi, 25, as she helped her family members dig through pieces of their destroyed house for remnants of their belongings. “We’ll get help after we die.”

The earthquake destroyed some 80 percent of the 60,000 houses in Sindhupalchok. So far, 1,746 deaths have been confirmed there, said Sitaram Joshi, the leader of the Nepal Red Cross’s national disaster response team. In Kathmandu Valley, which has so far been the center of relief efforts, 1,448 people have been confirmed dead to date, according to the National Emergency Operation Center. Joshi also estimated that the number of dead in Sindhupalchok could rise as high as 5,000 in the coming weeks as more bodies are discovered.

Sindhupalchok’s terrain, with villages scattered across steep mountains and narrow, twisting roads, has drastically slowed rescue efforts, so that vehicles taking the 40-mile journey from Kathmandu need about three hours to get there. Meanwhile, electricity and communication lines have been cut off across the district, leaving residents even more isolated. Civilians do with their own hands the work of rescuers who haven't arrived yet. In one village, members of one family drilled through the floor of a pink apartment building leaning diagonally on the building next door, trying to pull out a dead relative. A few steps away, others made neat piles of blankets, framed photos and other possessions they managed to retrieve from the piles of dust and stone.

In the village of Sangachok, where 183 people have been confirmed dead, the smell of carrion from livestock still buried under piles of rubble lingered in the air. The survivors there are living off food salvaged from their shops -- packages of biscuits and dried noodles -- that many expect will last perhaps another week. Their supply of clean water is fast running out, heightening fears of a looming onslaught of water-borne diseases. Children have already begun to suffer from diarrhea. The residents have been too focused on day-to-day survival to devise plans for when their remaining supplies run out.

“People are not thinking. They are just afraid,” said Suraj Giri, a 22-year-old science teacher in Sangachok. Giri lost his house, his uncle was killed, and the school where he worked was also destroyed in the earthquake. The villagers buried their dead themselves, with no means to hold any funerals. 

“Nepal has gotten help from other countries like America, China, India,” Giri said. “Supplies are coming in to the airport in Kathmandu. But they are not bringing it here.”

Local officials -- the chief district officer and local development officer -- haven’t been seen at all in Sangachok, fueling rumors that they had fled the district altogether for the capital. However, relief workers and army personnel said they had been meeting with the officials in Chautara, the administrative headquarters, to discuss the emergency response. But the government representatives have stayed out of the public eye as anger from residents swelled.

On Wednesday, dozens of people crowded in front of the administrative office in Chautara, demanding that officials deliver more tarps to earthquake survivors sleeping without shelter. “The government has tents, but they’re not giving them out,” said K.C. Netra, a villager who had joined the crowd.

“Some tents are coming in, and they’re trying to distribute them to people, but when someone gets one and others don’t, people get angry,” said Nil Birram Tamang, a driver for the district administrative office. “There just aren’t enough materials.”

Some villagers in Sindhupalchok have taken their desperation to the roads, blocking supply vehicles in an effort to take and distribute tarps that were on their way to the district headquarters. In Kathmandu, riot police have also reportedly rushed to quell the anger of earthquake survivors who lashed out after they couldn't board a bus out of the capital city. 

Chautara has been the district’s nerve center for medical aid and assistance. Nepal’s army and police have been ferrying patients with serious injuries to the army camp there. At the camp, they decide where to transport them for treatment. Workers from Nepal’s Department of Health and Sanitation were also at the scene to assess the risks posed by the water shortage. Relief workers from Oxfam International, the International Committee for the Red Cross and Nepal Red Cross also arrived in the area in recent days to deliver tents and ready-made meals, assemble rescue teams for the remote villages and arrange for the delivery of clean water.

But the need there and across Sindhupalchok has still been overwhelming. “There are about 2,000 people camping out here without basic amenities,” said Sajjad Mohammad Sajid, the regional humanitarian coordinator for Oxfam’s Asia region. Doctors have run out of hand sanitizer for treatments, and exposure to cold and rain has spread colds and fevers around the encampments. Oxfam has requested additional supplies from Kathmandu and worked with army soldiers to bring in more water for the meantime.

But while the relief workers are hurrying to distribute services to the villages in the outer parts of the district, desperation and frustration are only continuing to grow as the wait for help stretches on, and anger against government officials is only intensifying.

“The ministers aren’t coming here. They come to the village for election time. But now, no ministers,” Giri said. 

Brianna Lee reported from Nepal with travel provided by the International Reporting Project (IRP).