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In this handout picture released on April 27, 2015 an RAF C-17 is loaded with aid at RAF Brize Norton, north west of London to be flown to Nepal.STEVE LYMPANY/AFP / Getty Images

Unni Krishnan spent hours on the tarmac in Delhi Sunday afternoon before he learned his flight would be cancelled because of a massive aftershock in Kathmandu. While the 49-year-old aid worker managed to catch a different flight to the earthquake-shattered capital of Nepal the following morning, several of his colleagues remain stranded at airports, waiting for a seat on a flight they hoped would be able to land.

One colleague's plane touched down twice in Kathmandu before taking off again. "They need to find a balancing act between materials and people, because both are needed for the circumstances," said Mr. Krishnan, who is Plan International's head of disaster response and preparedness.

That backlog at the airport is one of many challenges for aid workers who are struggling to reach those most in need of help after a devastating earthquake shook the South Asian country on Saturday, killing more than 4,000 people. People in Nepal described chaotic scenes on Monday as thousands fled the capital and officials struggled to move supplies from the country's main airport to those left homeless by the earthquake.

Damaged buildings and violent aftershocks forced many Kathmandu residents into the streets, where they are enduring driving rain and chilly nighttime temperatures without shelter. And the effort to help those on the city streets and thousands of others in remote mountain villages is further hampered by unreliable communications, weak government structures and a lack of roads.

On Mount Everest, where the weekend quake triggered a deadly avalanche, rescue helicopters on Monday airlifted climbers from higher altitudes on the mountain where they were stranded above crevasses and ice falls.

The Globe in Nepal: Nathan VanderKlippe reports, the population struggles with physical devastation, psychological trauma

Ottawa has promised $5-million in aid to Nepal and says it will match donations from individual Canadians over a one-month period. The federal government also sent an assessment group from the military's Disaster Assistance Response Team, along with a search-and-rescue team and medical personnel. And Canadian aid agencies are moving into action, sending humanitarian workers and supplies to the damaged country of 31 million.

Relief supplies from emergency stockpiles in Mississauga and Dubai are also being sent, including blankets, jerry cans, kitchen sets and tarps, Ottawa said. The Ontario government also added $1-million on Monday to the Red Cross's relief efforts in Nepal.

Francois Audet, a professor at the University of Quebec at Montreal who has studied the international response to humanitarian disasters, said co-ordination among agencies and with local officials is always a challenge after a major event such as an earthquake. Those challenges can be amplified, he said, if aid organizations begin competing for donations and facing pressures to demonstrate that they are achieving results.

"It's a very fragile balance between co-ordination and running your operations," Prof. Audet said. In order to provide effective humanitarian aid and avoid undermining the local government, aid agencies need to be doing both.

Stephen Cornish, executive director for Médecins sans frontières Canada (MSF), said some of the biggest challenges in co-ordinating aid typically arise in the weeks after a disaster occurs. That's because the organizations that arrive first – and those already working in a country – are more experienced at working with others and tend to have better local contacts.

One Canadian MSF staff member is in Nepal now with one of several MSF teams that are working on the ground, and 10 more Canadians are currently preparing to go, Mr. Cornish said. MSF has worked in Nepal before and has been able to use existing contacts to help plan their efforts, he said.

Several Canadian aid agencies said the situation has improved since the introduction of the "cluster" system after the 2004 tsunamis. That system groups aid organizations into specific "clusters" of humanitarian aid – such as shelter and health – to ensure that the assistance being provided is reaching those who need it, and different groups' efforts aren't overlapping.

"You're always faced with trying to bring some order into chaos, without stifling peoples' and organizations' good intentaions," Unicef Canada president David Morley said. Unicef and others had stored supplies in Nepal in advance of the earthquake, such as vaccines, tents, blankets and tarps.

Aid agencies urged Canadians who want to help to donate money – rather than supplies – because most of the items people need can be purchased in the region. This also cuts down on transportation and other costs and supports the local economy.

The disaster has left many Canadians stranded as well, with some complaining that the federal government has not done enough to help. Ottawa said 464 Canadians had registered as being in Nepal, but that number could be higher because registration is voluntary. Canada has an honorary consul in Nepal but has struggled to get additional officials into the country to help.

Defence Minister Jason Kenney said Monday that more than 40 Canadian Armed Forces personnel were aboard a C-17 Globemaster aircraft that has already been deployed, including 18 DART assessment team members and others. Once the aircraft is unloaded, Mr. Kenney said, it could transport Canadians who want to leave to nearby India.

Canadians in Nepal or their friends and family can contact Foreign Affairs' Emergency response centre at 1-800-387-3124 or sos@international.gc.ca.

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