Rescues provide glimmer of hope among earthquake ruins as toll tops 21,000

Rescue crews pulled several people from the rubble of collapsed buildings during the night, including a 10-year-old boy saved with his mother, four days after a huge earthquake wrought death and destruction across southern Turkey and northwest Syria.

The confirmed death toll from the deadliest quake in the region in decades stood at 21,000 in both countries on Friday morning. Hundreds of thousands more people have been left homeless and short of food in bleak winter conditions, desperate for a multi-national relief effort to alleviate their suffering.

Syrian President Bashar al-Assad made his first reported trip to affected areas since the quake, visiting a hospital in Aleppo, Syrian state media reported.

Turkey's President Tayyip Erdogan was also expected to tour the disaster zone in his country again on Friday amid criticism from survivors and the political opposition that his government's response to the catastrophe was slow and poorly organised – accusations he rejects as he bids for re-election in May. That election may now be postponed due to the disaster.

Rescuers, including specialist teams from dozens of countries, toiled through the night in the ruins of thousands of wrecked buildings in Turkey. In freezing temperatures, they regularly called for silence as they listened for any sound of life from mangled concrete mounds.

In the Samandag district of Hatay province, a 10-year-old boy was saved with his mother after being entombed for 90 hours. Also in Hatay, a seven-year-old girl named Asya Donmez was rescued after 95 hours and taken to hospital, state-owned Anadolu news agency reported. In Diyarbakir to the east, Sebahat Varli, 32, and her son Serhat were rescued and taken to hospital on Friday morning, 100 hours after the first quake.

But hopes were fading that many more would be found alive. In the Syrian town of Jandaris, Naser al-Wakaa sobbed as he sat on the pile of rubble and twisted metal that had been his family's home, burying his face in the baby clothes that had belonged to one of his children. "Bilal, oh Bilal," he wailed, shouting the name of one of his dead children.

Rabie Jundiya, a rescue worker in Jandaris, said: "The civil defence teams will not withdraw ... until the last corpse is recovered from under the rubble."

The death toll from the 7.8 magnitude earthquake and several powerful aftershocks across both countries has surpassed the more than 17,000 killed in 1999 when a similarly powerful earthquake hit northwest Turkey. It now ranks as the seventh most deadly natural disaster this century, ahead of Japan's 2011 tremor and tsunami and approaching the 31,000 killed by a quake in neighbouring Iran in 2003.

The death toll in Turkey rose to 18,342 by Friday morning and the number injured rose to 74,242, the disaster management authority AFAD said. In Syria, more than 3,300 have been killed, though rescuers have said many more people remain under the rubble.

Some 24.4 million people in Syria and Turkey have been affected, according to Turkish officials and the United Nations, in an area spanning roughly 450 km from Adana in the west to Diyarbakir in the east. In Syria, people were killed as far south as Hama, 250 km from the epicentre.

Many people have set up shelters in supermarket car parks, mosques, roadsides or amid the ruins. Survivors are often desperate for food, water and heat, and working toilets are sparse in hard-hit areas.

Political fallout

The disaster has cast doubt on whether the May 14 Turkish election will go ahead on time. A Turkish official said on Thursday it posed "very serious difficulties" for the vote in which Erdogan has been expected to face his toughest challenge in two decades in power. With anger simmering over delays in the delivery of aid and getting the rescue effort underway, the disaster is likely to play into the vote if it goes ahead.

Erdogan's opponents have accused the government of a tardy and inadequate response. Erdogan has called for solidarity and condemned what he has described as "negative campaigns for political interest". Kemal Kilicdaroglu, head of Turkey's main opposition party, criticised the government response late on Thursday, citing an AFAD report about a tremor in the northwest in November. "The earthquake was huge, but what was much bigger than the earthquake was the lack of coordination, lack of planning and incompetence," Kilicdaroglu said in a video statement.

The northwestern province of Duzce was hit by a 5.9 magnitude earthquake on 23 November last year, killing nobody but injuring 96 people and AFAD prepared an impact analysis on it.

U.N. urges more Syria access

Relief efforts in Syria have been complicated by the 11-year-long civil war that has partitioned the country. The United States on Thursday called on Damascus to immediately allow aid in through all border crossings. Syrians have also voiced despair at the slow response including in areas controlled by Assad, who is shunned by the West.

United Nations assistance began flowing again into the insurgent-held northwest on Thursday after the aid lifeline, critical to some 4 million people, was severed. The U.S. State Department said Washington would continue to demand unhindered humanitarian access to Syria and urged Assad's government to immediately allow aid through all border crossings.

U.N. Secretary-General Antonio Guterres on Thursday called for more humanitarian access to Syria, saying he would be "very happy" if the United Nations could use more than one border crossing to deliver help.

The Syrian government, which is under Western sanctions, has appealed for U.N. aid while saying all assistance must be done in coordination with Damascus and delivered from within Syria, not across the Turkish border. Damascus views the delivery of aid to rebel-held areas from Turkey as a violation of its sovereignty.

The presidency shared images of Assad and his wife visiting people in Aleppo who were injured in the quake.    (Reuters)