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28 April 2015, 07:08 | Updated: 28 April 2015, 07:33
A Birmingham charity with a team of doctors in Nepal has told Heart help still hasn't reached some areas.
International Nepal Fellowship has 300 people on the ground helping.
Their chief executive John Reynolds says the conditions are tough.
He said: "People have been sleeping on the streets in fear of going back into buildings.
Mr Reynolds added that it's not encouraging that the death toll keeps on rising.
He said: "It rose very steeply in the first day - it still hasn't stopped.
"Regretably and sadly we do think more people will add to that toll and it will grow."
Nothing's been heard from some villages in days. Two people from the West Midlands listed as missing, Evan Mark Williams, 51, from Wolverhampton and Fiona Lamont, 26 from Staffordshire are believed safe - while the status of a missing man from Warwickshire, Martin James Edmonds Gattuso, 38 and woman from Nuneaton, Mary Magdelina Claus, 64, is still unknown.
West Midlands Ambulance Service has also told Heart two of its paramedics and a doctor are heading to the country as part of the disaster relief effort.