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“Looking at the stats, looking at the remoteness and the topography, which is extremely challenging and remote, we think potentially the impacted individuals could go into the hundreds of thousands.”
These are the words of Indrika Ratwatte,UN humanitarian coordinator in Afghanistan, speaking from Kabul on the impact of Sunday's powerful magnitude 6 earthquake.
And they were spoken before another 5.2 earthquake struck Afghanistan on Tuesday - in almost the same place.
The epicentre was once again close to Jalalabad City in Nangarhar province.
Sunday's quake, according to the country's Taliban government, has already killed more than 1,400 people, injured more than 3,000 and destroyed more than 5,400 houses.
Now, as residents across the country's eastern mountains try to process what they have lost, and the recovery that lies ahead, they have been shaken once more.
Amid the existing trauma, there are now fears of further damage and destruction.
Resident of Kunar province Mir Salam Khan has lost his wife, his son, his daughter and his home.
“In these days, we need everything because our house has been destroyed. Now, if it rains, where will we sit? Where will the remaining people live? We have no place to stay at all.”
The majority of Afghans live in low-rise, mud-brick homes that are vulnerable to collapse, killing or suffocating those inside.
Too scared to sleep indoors after two quakes and multiple tremors, many of those who still have homes are choosing to sleep in the desert.
A volunteer called Nameerullah described the situation as "very bad", the dead still lying on the ground.
“Here, people are in need of everything, especially medicine. Shelter is also needed — people have no place to stay. The houses you see are all destroyed. The earth is still shaking. Every 5 to 10 minutes there is a tremor. People are terrified and have left their homes, staying out in the open. Everyone who has survived is living in fear.”
After decades of conflict, Afghanistan is one of the world's poorest countries, with minimal resources and supplies.
Due to funding cuts, many health facilities have closed. Those that remain open are overwhelmed, while makeshift camps and centres attempt to coordinate aid and rescue efforts.
The Taliban's restrictive policies on women and girls make the operation harder - they're banned from working for NGOs.
Dr Faheem Ullah Dilawar, a medical superintendent at Nangarhar Hospital, said medical staff were struggling to keep up with demand.
“Since yesterday we have received 600 patients, of which 339 were admitted. And as for those who needed surgery, we performed 136 surgeries, and we have given blood transfusions to 200 patients.”
The Taliban government has deployed helicopters to evacuate the injured, and release search and rescue teams and medical supplies.
Where helicopters cannot land, commandos are simply air-dropped to try to help.
Mr Ratwatte said the landscape and isolation in some areas made rescue operations almost impossible.
“This is extremely mountainous, and due to the earthquake, there's been lots of landslides, rockfalls etc and access has been very limited to everybody in the first 24 hours so this has posed a huge challenge to us as we deploy.”
He added that Afghanistan is already facing a protracted humanitarian crisis made worse by deep funding cuts, a weak economy, a severe drought and the influx of millions of Afghans forcibly returned from neighbouring Pakistan and Iran in recent years.
“We've been dealing with multiple crises. We had 1.7 - plus million refugees and returnees come back to this country, just this year.”
UN refugee agency spokesman Babar Baloch said around 70 per cent of Afghans who have returned from Pakistan since April have passed through the Torkham border crossing, which is close to the epicentre of the earthquake.
And 24 per cent of them had chosen to settle in Nangarhar province.
After two earthquakes in as many days, these people, already with very little resources, are now living in a disaster zone.
