Rain is complicating relief efforts and worsening conditions for survivors in Myanmar, where state media reported that the death toll from a powerful earthquake has risen to nearly 3,500.

The 7.7-magnitude earthquake, which struck on March 28, caused widespread destruction, toppling buildings, cutting off power, and damaging roads and bridges, especially in Sagaing and Mandalay, the country’s second-largest city.

State media now report 3,471 confirmed deaths, 4,671 injuries, and 214 people still missing. Many survivors in Mandalay have been forced to sleep outdoors in tents, as their homes either collapsed or remain too unsafe to enter.

When rain and wind began battering the temporary shelters on Saturday evening, survivors had to choose between seeking refuge in unstable buildings or braving the elements outdoors.

“People are trying to rebuild their lives now,” said UN aid chief Tom Fletcher in a video posted on social media Sunday. “They need food. They need water. They need the power back on.”

Fletcher described the scale of damage as “epic” and emphasized the urgent need for tents and other aid for those rebuilding their lives.

Aid experts warn that the combination of rain and scorching heat heightens the risk of disease outbreaks in makeshift camps.

Myanmar has been under military rule since a 2021 coup, complicating international relief efforts due to damaged infrastructure and ongoing civil conflict. Even before the earthquake, the country’s humanitarian crisis had displaced 3.5 million people, according to the UN.

In addition to the quake, the military junta continues to launch attacks against rebel groups, with at least 16 reported since the government announced a temporary ceasefire.

Aftershocks have continued, including a 4.7-magnitude tremor just south of Mandalay late Friday, according to the United States Geological Survey.