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The epicenter of the killer quake, which struck shortly before noon, was 80 kilometers northwest of Kathmandu and about 15 kilometers below the surface.
The death toll climbed rapidly through the day as the army and police launched a rescue effort.
VOA's correspondent in southeast Asia, Steve Herman, said there were reports of people trapped in buildings and panicking in the streets. Eyewitnesses told him that newer buildings in Kathmandu were still standing, but that most of the older buildings had apparently collapsed in the center of the city.
Only a stump and a pile of rubble was left of Kathmandu's 60-meter-tall, 19th-century Dharara tower, a UNESCO world heritage site. At least 180 people were reported killed in the structure's collapse. Several other heritage buildings, including ancient temples, were also damaged or destroyed.
The director of the Nepal Tourism Board, Aditya Baral, said the old area of Kathmandu could have suffered the worst damage.
“Old houses in the narrow lanes of the main city core area might have been devastated. There are not proper building structures, designs — they are almost 100 years old,” said Baral.
Some residents dug through rubble using bare hands, searching for survivors. Hundreds crowded outside hospitals, ferrying the injured and trying to help in other ways. Many people with broken limbs lay on the street, waiting for help. Others spent hours on the roads as aftershocks rumbled through the country, spreading fear.
The earthquake also triggered an avalanche at the Mount Everest Base Camp, killing several guides and mountaineers and flattening many tents. Romanian climber Alex Gavan tweeted, “Running for life from my tent.” Thousands of foreign nationals were reported to be in Nepal for the spring trekking season.