Overwhelmed rescuers struggled to save people trapped under the rubble as the death toll from a devastating earthquake in Turkey and Syria approached 5,000 on Tuesday, with despair mounting and the scale of the disaster hampering relief efforts.
In the Turkish city of Antakya near the Syrian border, where 10-storey buildings had crumbled onto the streets, Reuters journalists saw rescue work being conducted on one out of dozens of mounds of rubble.
The temperature was close to freezing as the rain came down and there was no electricity or fuel in the city.
The magnitude 7.8 quake hit Turkey and neighbouring Syria early on Monday, toppling thousands of buildings including many apartment blocks, wrecking hospitals, and leaving thousands of people injured or homeless.
In Turkey, the death toll climbed to 3,381 people, Turkey's Disaster and Emergency Management Authority (AFAD) said.
The death toll in Syria, already devastated by more than 11 years of war, stands at more than 1,500, according to the Syrian government and a rescue service in the insurgent-held northwest.
Freezing winter weather hampered search efforts through the night. A woman's voice was heard calling for help under a pile of rubble in the southern Turkish province of Hatay. Nearby, the body of a small child lay lifeless.
Weeping in the rain, a resident who gave his name as Deniz wrung his hands in despair.
"They're making noises but nobody is coming," he said. "We're devastated, we're devastated. My God ... They're calling out. They're saying, 'Save us' but we can't save them. How are we going to save them? There has been nobody since the morning."
Families slept in cars lined up in the streets.
Ayla, standing by a pile of rubble where an eight-storey building once stood, said she had driven to Hatay from Gaziantep on Monday in search of her mother. Five or six rescuers from the Istanbul fire department were working in the ruins - a sandwich of concrete and glass.
"There have been no survivors yet. A street dog came and barked at a certain point for long, I feared it was for my mother. But it was someone else," she said.
"I turned on the lights of the car to help the rescue team. They took out only two bodies so far, no survivors.”
In Kahramanmaras, north of Antakya, families gathered around fires and wrapped themselves in blankets to stay warm.
"We barely made it out of the house," said Neset Guler, huddling with his four children. "Our situation is a disaster. We are hungry, we are thirsty. It's miserable."
Ankara declared a "level 4 alarm" that calls for international assistance, but not a state-of-emergency that would lead to mass mobilization of the military.