More than 200 people were killed and hundreds more feared dead on Monday after an earthquake struck parts of southeast Turkey, where rescue teams worked through the night to try to free survivors crying for help from under rubble.
Survivors and emergency service workers searched frantically through mounds of smashed concrete and other debris with shovels and their bare hands after the 7.2 magnitude quake toppled buildings and some roads on Sunday.
In the badly hit town of Ercis, rescuers tried to free one young boy, aged about 10, pinned beneath a concrete slab.
"Be patient, be patient," they pleaded as the boy whimpered. The lifeless hand of an adult, with a wedding ring, was visible just a few centimeters (inches) in front of his face.
Interior Minister Idris Naim Sahin said the quake had killed 120 people in the town and 100 more in the city of Van, some 100 km (60 miles) further south. The toll was expected to rise.
Sahin, who is overseeing emergency operations in Ercis, said 1,090 people had been wounded while hundreds more were unaccounted for.
Rescue efforts were hampered by power outages after the quake brought down power cables to towns and villages across much of the barren Anatolian steppe near the Iranian border.
As dawn broke the scale of devastation was clear.
At one crumpled four-storey building in Ercis, a team of firemen from the largest southeastern city of Diyarbakir tried to reach four children believed trapped deep in an apartment block.
Rescue workers carried two black body bags to a waiting ambulance, one of them small, apparently containing that of a child. An old woman wrapped in a headscarf walked alongside sobbing.
A man paced back and forth sobbing before running toward the rescue workers on top of the rubble. "That's my nephew's house," the man sobbed as workers tried to hold him back.
A group of women, some of their faces covered by their headscarves wept as they looked on.
Nearby, aid teams handed out parcels of bread and food, while people wrapped in blankets huddled around open fires after spending a cold night on the streets.
Prime Minister Tayyip Erdogan said there were an unknown number of people unaccounted for under the collapsed buildings of the stricken towns, and he feared the worst for villagers living in outlying rural areas, who had yet to be reached.
"Because the buildings are made of adobe, they are more vulnerable to quakes. I must say that almost all buildings in such villages are destroyed," Erdogan told a televised news conference in Van on Monday shortly after midnight.
More than 100 aftershocks have jolted the region in the hours since the quake struck for around 25 seconds at 1041 GMT (6:41 a.m. EDT) on Sunday.
U.N Secretary General Ban Ki-moon said he was deeply saddened by the loss of life and devastation. "He expresses his heartfelt sympathies to the government and people of Turkey at this time of loss and suffering," the United Nations said in a statement.
In Van, a bustling and ancient city on a lake ringed by snow-capped mountains and with a population of one million, cranes shifted rubble off a collapsed six-storey apartment block where bystanders said 70 people were trapped.
Erdogan visited Ercis earlier by helicopter to assess first hand the scale of the disaster. With 55 buildings flattened, including a student dormitory, the level of destruction in Ercis, a town of 100,000, was greater than in Van.
"We don't know how many people are in the ruins of collapsed buildings, it would be wrong to give a number," he said.
Newspapers said trauma had been piled on trauma in southeast Turkey. Kurdish militants killed 24 Turkish soldiers in an attack last week in Hakkari, south of Van.
"Homeland of Pain. Yesterday terrorism, today earthquake," said Radikal newspaper.
The Red Crescent said a team of about 100 expert personnel had arrived at the earthquake zone to coordinate operations. Some 4,000 tents and 11,000 blankets, stoves and food were being distributed to help fight off the cold.
At Van airport, a large Turkish Airlines cargo plane was offloading aid materials, which military vehicles were waiting to transport to the quake zone.
A tent city was being set up at the Ercis sports stadium. Access to the region was made more difficult as the earthquake caused the partial collapse of the main road between Van and Ercis, broadcaster CNN Turk reported.
Soldiers were deployed in Ercis to help rescuers and digging machines had also arrived to help. There was a constant wail of ambulance sirens ferrying the injured to hospitals.
Dogan news agency reported that 24 people were pulled from the rubble alive in the two hours after midnight.
One nurse told CNN Turk news channel the town's hospital was so badly damaged that staff were treating injured in the garden, and bodies were being left outside the building,
After visiting the quake zone, Erdogan returned to Ankara, where he is expected to chair a cabinet meeting to discuss the response to the disaster.
He said Turkey was able to meet the challenge itself, but thanked countries offering help, including Armenia and Israel, two governments that have strained relations with Ankara.