Sharmila Chadara, 25, gave birth to a baby girl just days before a powerful earthquake devastated her neighborhood in Nepal's Jajarkot district on November 3.

Her family survived the quake, but their house — made of mud, stone and wood — was destroyed, rendering them homeless.

Authorities moved them to a temporary shelter, and provided them with food, a makeshift tent and a blanket. They, along with many other quake survivors, spent nights in the cold. 

At the camp, Chadara faced health complications and was admitted to a hospital. But days after she was discharged and returned to the shelter, she died.

Tek Bahadur Nepali, a neighbor, believes her life could have been saved had she received proper care and warm shelter.

Deadliest quake since 2015

The 6.4-magnitude quake killed over 150 people and injured many more. It left thousands homeless when it struck just before midnight.

The tremor triggered landslides and collapsed homes in Jajarkot district, a mountainous region which is located about 500 kilometers (300 miles) west of the capital, Kathmandu, and where many villages are scattered among remote hills.

The neighboring Western Rukum district was also hit by the quake.

The earthquake was the deadliest since 2015 when about 9,000 people were killed in two earthquakes in the Himalayan country.

Data from local authorities show that at least 34 quake survivors, including a month-old infant and a new mother, have died after spending weeks under makeshift tents.

Bir Bahadur Oli, a senior police official in the quake-hit Karnali province, told DW that many survivors have succumbed to health problems like asthma and pneumonia.

Health and relief workers have said pregnant women, infants, new mothers, the elderly and those with preexisting health conditions are particularly vulnerable. They warn that the situation could worsen further as peak winter approaches, bringing with it heavy snowfall and freezing temperatures. 

Government assistance lacking, say survivors

Nawaraj KC, a doctor at the Karnali Care Hospital who is actively engaged in rescue and relief efforts, said while many deaths were not directly caused by the cold weather, living in tents in the open has exacerbated the situation.

He also pointed to other health risks for children and aging people, like diarrhea and pneumonia, due to poor hygiene at the shelters.

"The locals are facing various problems due to a lack of enough warm clothes in mountainous regions. There is also a possibility of a cholera outbreak," Manish Regmi, a doctor who recently returned after serving in the quake-hit area, told the local Republica newspaper.

The problems are compounded by the fact that the quake struck some of the most isolated and economically disadvantaged parts of the country.

Nepalese Prime Minister Pushpa Kamal Dahal and President Ram Chandra Poudel have visited the hard-hit areas and pledged prompt relief and reconstruction. Other politicians, officials and social activists also rushed to the affected regions in the immediate aftermath, but their visits have yielded little in terms of concrete help.  

Many survivors have complained that the 50,000 Nepali rupees (about €340/$375) in assistance announced by the government for every affected family, is far from enough.

Calls for increased relief 

Juna Shahi, an information officer at Nalgad municipality, where 56 people were killed by the quake, said the government lacks enough human resources to relocate all the affected people to warmer shelters.

"Despite limitations, our priority is to replace the makeshift tents as soon as possible," she told DW by phone.

Authorities have said they're mobilizing security forces to hasten relief efforts. 

Meenakshi Ganguly, deputy Asia director at Human Rights Watch, recently urged the Nepali government and its international partners to intensify efforts to provide warm shelters, sanitation and other necessities "so people survive the winter."

Hanaa Singer-Hamdy, the UN resident coordinator in Nepal, told DW that all UN agencies in the country have been aiding families hit by the earthquake. The UN is also working toward building the resilience of affected communities, she said, adding that the global body is facing resource constraints.

"In any humanitarian response, financing is always a challenge, particularly with the newly emerging humanitarian crises in 2023," she pointed out.

"For the response to the Nepal earthquake, resources for humanitarian assistance were mobilized in-country and the UN is repurposing funds and resources from existing programs as there was no international appeal by the government, which limited the scale of assistance to affected households."

Edited by: Srinivas Mazumdaru