Tens of thousands of people who lost their homes in a catastrophic earthquake huddled around campfires in the bitter cold and clamored for food and water Thursday, three days after the temblor hit Turkey and Syria and killed more than 19,300.

Emergency crews used pick axes, shovels and jackhammers to dig through twisted metal and concrete — and occasionally still pulled out survivors. But in some places, their focus shifted to demolishing unsteady buildings.

While stories of miraculous rescues briefly buoyed spirits, the grim reality of the hardship facing survivors cast a pall over devastated communities. The number of deaths surpassed the toll of a 2011 earthquake off Fukushima, Japan, that triggered a tsunami, killing more than 18,400 people.

In northwest Syria, the first U.N. aid trucks to enter the rebel-controlled area from Turkey since the quake arrived, underscoring the difficulty of getting help to people in the country riven by civil war. In the Turkish city of Antakya, dozens scrambled for aid in front of a truck distributing children’s coats and other supplies.

One survivor, Ahmet Tokgoz, called for the government to evacuate people from the region. Many of those who have lost their homes found shelter in tents, stadiums and other temporary accommodation, but others have slept outdoors.

“Especially in this cold, it is not possible to live here,” he said. “If people haven’t died from being stuck under the rubble, they’ll die from the cold.”

Winter weather and damage to roads and airports have hampered the response in both Turkey and Syria. Some in Turkey have complained the response was too slow — a perception that could hurt President Recep Tayyip Erdogan at a time when he faces a tough battle for reelection in May.

In the Turkish town of Elbistan, rescuers stood atop the rubble from a collapsed home and pulled out an elderly woman.

Teams urged quiet in the hopes of hearing stifled pleas for help, and the Syrian paramedic group known as the White Helmets noted that “every second could mean saving a life.”

But more and more often, the teams pulled out dead bodies. In Antakya, over 100 bodies were awaiting identification in a makeshift morgue outside a hospital.

With the chances of finding people alive in the rubble dwindling, teams in some places began demolishing buildings.

In Adiyaman, Associated Press journalists saw a resident plead with rescuers to look through the rubble of a building where relatives were trapped. The crew refused, saying there was no one alive there, and they had to prioritize areas where there may be survivors.

A man, who gave only his name as Ahmet out of fear of government retribution, later asked the AP: “How can I go home and sleep? My brother is there. He may still be alive.”

In Nurdagi, throngs of onlookers — mostly family members of people trapped inside — watched as heavy machines ripped at one building that had collapsed, its six floors pancaked together.

Mehmet Yilmaz watched from a distance, estimating that around 80 people were still beneath the rubble but that it was unlikely any would be found alive.

“There’s no hope,” said Yilmaz, 67, who had six relatives, including a 3-month-old baby, trapped inside. “We can’t give up our hope in God, but they entered the building with listening devices and dogs, and there was nothing.”

Authorities called off search-and-rescue operations in the cities of Kilis and Sanliurfa, where destruction was not as severe as in other impacted regions.

Across the border in Syria, assistance trickled in. The U.N. is authorized to deliver aid through only one border crossing, and road damage has prevented that thus far. U.N. officials pleaded for humanitarian concerns to take precedence over wartime politics.

The scale of loss and suffering remained massive. Turkish authorities said Thursday that the death toll had risen to more than 16,100 in the country, with more than 64,000 injured. In Syria, which includes government-held and rebel-held areas, more than 3,100 have been reported dead and more than 5,000 injured.

It was not clear how many people were still unaccounted for in both countries.

Among the missing were members of a high-school volleyball team from northern Cyprus, as well as teachers and parents who had been staying in a hotel that collapsed, said Nazim Cavusoglu, the education minister in the breakaway Turkish Cypriot north, on Turkey’s NTV television.

Turkey’s disaster-management agency said more than 110,000 rescue personnel were now taking part in the effort and more than 5,500 vehicles, including tractors, cranes, bulldozers and excavators had been shipped. The Foreign Ministry said 95 countries have offered help. More than half of that number have sent a total of nearly 6,500 rescuers. Another 2,400 more are still expected to arrive.

International aid for Syria was far more sparse. Efforts there have been hampered by the civil war and the isolation of the rebel-held region along the border that is surrounded by Russia-backed government forces. Syria itself is an international pariah under Western sanctions linked to the war.

Erdogan, who continued touring devastated areas Thursday, has sought to deflect criticism of the response and said it was improving. He renewed a promise to quake survivors that destroyed homes would be rebuilt within a year. He has said the government will distribute 10,000 Turkish lira ($532) to affected families.

(AP)