CHAUTARA, Nepal—The immensity of the Nepal earthquake did not really hit me until i crossed the Dholaghat River, about 40 kilometers east of Kathmandu, and made my way into the hills—the “mid-hills” as they are called in this Himalayan nation. The river here carves a deep chasm with sheer cliffs on both sides. Fresh landslides cover partial sections of the hairpin road.

A path of utter destruction begins here. Over 30 miles of mangled houses, wood and brick structures collapsed in unforgiving mounds, concrete two-story buildings literally lifted up and then pushed back into the earth, and everywhere just rubble. Women and children sit listless under the sacred, ubiquitous Pipal trees or on the sides of the road. It is a land devoid of young men—many of them are in the Middle East working menial jobs.

In one hamlet, Pawakot, I am greeted by Pamphagiri, 72, who is barely five feet tall and distraught as she tells me she is alone. One daughter was buried when her house collapsed, and the other is in a hospital. Aid has yet to arrive here. The smell of rotting animal meat, cows and goats that have been buried in a collapsed structure, envelops us. I give her some money. We touch foreheads and we hug before I move on, heading to the district capital of Sindhupalchok, a town called Chautara.

The path of destruction continues among leveled hamlets in all directions, the piled debris on the road ruins of houses visible across the mountainsides.

Chautara sits on the long spine of a steep ridge, winding along the hilltop. Nepal police and army are here in small numbers but there is no sign of foreign aid with the exception of a Dutch and Korean search and rescue teams, but they are sitting and waiting on the outskirts. Their mission is no longer to find survivors. That frantic rush is over, now, one week since the 7.8 quake hit. Their mission is to help extract the dead. The official number is now past 6,000 and will continue to grow.

No one stops me as I walk through town. Some buildings are just crumbled mounds; others lean into the road. One school is intact, but a block away another is destroyed. Residents are digging for belongings and food. One man has climbed to the second floor to saw the metal bars off his windows and pull out his dried corn, rice and cooking utensils. A tanker brings water and women rush to fill plastic jugs, the line curling around a corner. But there is no visible sign of outside help.

Just yesterday, desperate Nepalis from nearby villages commandeered jeeps with food aid, saying no aid was coming to their isolated hamlets. Police tried to interfere but ultimately pulled back and left the aid.

Only now, after a week, has news begun to trickle in from the outlying districts. Nepali authorities in Kathmandu have declared the search for buried victims to be over and several of the search and rescue teams have gone home.

The government, much to the dismay of the international community, has created a Prime Minister’s Relief Fund, requiring all donations from outside Nepal to be filtered through and coordinated by the government, which may sound logical on its face, but not here. There has been massive pushback from Nepalis as well as from overseas donors who see this as a ploy for the Nepali Congress Party to use the funds to strengthen its political base.

While the bickering goes on, thousands are still deprived of tents and food. Such trucks as we saw carrying aid were not from the government or the international community but from Nepalis in the capital rushing as best they could to help those in the countryside. So far little western aid has trickled out of the capital despite relentless arrivals of aid-filled planes.

There seems to be little motivation from the government to change this picture. In a recent meeting with international donors, Nepal’s prime minister steered the conversation towards the impasse of constitution writing rather than earthquake relief.

So, here’s the bottom line after seven days:

This quake is not just about Kathmandu’s ancient temples. This is not just about the avalanche on Mt. Everest. This is about the vast majority of Nepalis living in the mid-hills who have lost their livelihoods and lost their homes.

Western aid has arrived in Kathmandu but has not yet moved into the outlying districts. International attention is waning. As we walked through Chautara we met two TV crews: German ARD and Nepali TV. But no other sing of a foreign presence except a camera drone flying overhead like a buzzing mosquito.

This is a town filled with loss and dread and the unknown. For the people of Sindhupalchok , the emergency is not over, it is just beginning .