The 7.8-magnitude quake struck both countries early Monday, toppling entire apartment blocks, destroying hospitals and leaving thousands injured or homeless.
Freezing winter weather hampered search efforts for survivors overnight into Tuesday.
Beneath a pile of rubble in the southern province of Hatay, a woman’s voice could be heard calling for help. Nearby, the body of a small child lay lifeless.
Crying in the rain, a local resident who gave her name as Deniz wrung her hands in despair.
“They are making noises but no one comes,” he said. “We are devastated, we are devastated. My God… They are screaming. They are saying, ‘Save us,’ but we can’t save them. How are we going to save them? There hasn’t been anyone since morning.
Temperatures dropped to near freezing overnight, worsening conditions for people trapped under the rubble or left homeless.
In Kahramanmaras, north of Hatay, entire families gathered around campfires and wrapped themselves in blankets to keep warm.
“We barely made it out of the house,” said Neset Guler, huddled around the fire with her four children. “Our situation is a disaster. We are hungry, we are thirsty. It is miserable.”
The quake, which was followed by a series of aftershocks, was the largest recorded worldwide by the US Geological Survey since a tremor in the remote South Atlantic in August 2021.
In Turkey, the death toll stood at 2,316, the Emergency and Disaster Management Authority (AFAD) said, making it the country’s deadliest quake since a similar-magnitude quake in 1999 that killed more than 17,000. More than 13,000 were injured in Monday’s quake.
At least 1,444 people have been killed in Syria and some 3,500 injured, according to figures from the Damascus government and rescue workers in the insurgent-controlled northwestern region.
Poor internet connections and damaged roads between some of the hardest-hit cities in southern Turkey, home to millions of people, hampered efforts to assess and address the impact.
Turkish President Tayyip Erdogan, who was preparing for a tough election in May, called the quake a historic disaster and said authorities were doing everything they could.
“Everyone is putting their heart and soul into the effort, although the winter season, the cold weather and the earthquake that occurs overnight makes things more difficult,” he said. He said 45 countries had offered to help search and rescue efforts.
In the Turkish city of Iskenderun, rescuers have climbed a huge pile of rubble that was once part of the intensive care unit of a state hospital in search of survivors. Health workers did what they could to deal with the new rush of injured patients.
“We have a patient who was taken to surgery but we don’t know what happened,” said Tulin, a woman in her 30s, standing outside the hospital, wiping away tears and praying.
In Syria, the effects of the earthquake were compounded by the destruction of more than 11 years of civil war.
A senior UN humanitarian official said fuel shortages and harsh winter weather were also creating obstacles to their response.
“The infrastructure is damaged, the roads we used to use for humanitarian work are damaged, we have to be creative to reach people… but we are working hard,” UN Resident Coordinator El-Mostafa Benlamlih told Reuters. . in an interview via video link from Damascus.
In the government-controlled city of Aleppo, images on Twitter showed two neighboring buildings collapsing one after the other, filling the streets with dust.
Two residents of the town, which was badly damaged in the war, said buildings had collapsed in the hours after the quake, which was felt as far away as Cyprus and Lebanon.
Raed al-Saleh of the Syrian White Helmets, a rescue service in rebel-held territory known for pulling people out of the ruins of buildings destroyed by airstrikes, said they were in “a race against time to save the lives of those under the rubble.” .”