In an eerie confirmation of reports from the National Earthquake Information Center that there was a 1 in 3 chance of a massive aftershock in Nepal following a 7.9 magnitude earthquake Saturday, the region was struck by a 6.7 magnitude aftershock Sunday.

The U.S. Geological Survey said the quake struck only six miles deep strengthening the damaging impact of the quake.

“The aftershocks keep coming … so people don’t know what to expect,” said Sanjay Karki, Nepal country head for global aid agency Mercy Corps. “All the open spaces in Kathmandu are packed with people who are camping outdoors. When the aftershocks come you cannot imagine the fear. You can hear women and children crying.”

Officials said that at least 2,500 people have been confirmed dead as of Sunday night but the death toll is likely to rise significantly over the next few days when more rescuers reach the region to examine collapsed structures and areas buried in landslides.

Officials say that over 700 deaths have been confirmed in the capital of Kathmandu alone.

Residents of the city say that the majority of collapsed buildings were older structures made of brick.  Modern buildings toward the business area of the city did not collapse leading officials to confirm the death toll was lower than it could have been at this point because those buildings stayed up.

International relief group World Vision said that many villages outside the capital are on mountains and they were not prepared for this massive quake and aftershock.

Villages near the epicenter “are literally perched on the sides of large mountain faces and are made from simple stone and rock construction. Many of these villages are only accessible by 4WD and then foot, with some villages hours and even entire days’ walks away from main roads at the best of times,” the group’s local staff member, Matt Darvas, said in a statement to the Associated Press.

Residents of the area who had returned to their homes are now back in the streets following the massive aftershock.  Makeshift tent cities have been created in open spaces such as school playgrounds, courtyards and even the traffic islands in streets shut down because of damage.

Hospitals have been overwhelmed with injuries.

“Both private and government hospitals have run out of space and are treating patients outside, in the open,” Nepal’s envoy to India, Deep Kumar Upadhyay, told the AP.

Pakistan confirmed they are sending a 30-bed temporary hospital to the capital along with doctors and surgeons.   They are also sending at least 2,000 ready to eat meals and drinking water.

Disaster experts Sunday admitted they had been in Kathmandu last week investigating ways to better prepare the region for a massive earthquake similar to the 1934 quake that leveled the city. 

“It was sort of a nightmare waiting to happen,” said seismologist James Jackson, head of the earth sciences department at the University of Cambridge in England. “Physically and geologically what happened is exactly what we thought would happen.”

“I was walking through that very area where that earthquake was and I thought at the very time that the area was heading for trouble,” said Jackson, lead scientist for Earthquakes Without Frontiers, a group that tries to make Asia more able to bounce back from these disasters and was having the meeting.