GAZIANTEP, Turkey (AP) — With hope fading to find survivors, stretched rescue teams toiled through the night in Turkey and Syria, searching for signs of life in the rubble of thousands of buildings toppled by a catastrophic earthquake. The death toll rose Wednesday to more than 11,000 in the deadliest quake worldwide in more than a decade.

Amid calls for the government to send more help to the disaster zone, President Recep Tayyip Erdogan was to travel to town of Pazarcik, the epicenter of the quake, and to the worst-hit province of Hatay on Wednesday.

Turkey now has some 60,000 aid personnel in the quake-hit zone, but with the devastation so widespread many are still waiting for help.

Nearly two days after the magnitude 7.8 quake struck southeastern Turkey and northern Syria, rescuers pulled a 3-year-old boy, Arif Kaan, from beneath the rubble of a collapsed apartment building in Kahramanmaras, a city not far from the epicenter.

With the boy’s lower body trapped under slabs of concrete and twisted rebar, emergency crews lay a blanket over his torso to protect him from below-freezing temperatures as they carefully cut the debris away from him, mindful of the possibility of triggering another collapse.

The boy’s father, Ertugrul Kisi, who himself had been rescued earlier, sobbed as his son was pulled free and loaded into an ambulance.

“For now, the name of hope in Kahramanmaras is Arif Kaan,” a Turkish television reporter proclaimed as the dramatic rescue was broadcast to the country.

A few hours later, rescuers pulled 10-year-old Betul Edis from the rubble of her home in the city of Adiyaman. Amid applause from onlookers, her grandfather kissed her and spoke softly to her as she was loaded on an ambulance.

But such stories were few more than two days after Monday’s pre-dawn earthquake, which hit a huge area and brought down thousands of buildings, with frigid temperatures and ongoing aftershocks complicating rescue efforts.

Search teams from more than two dozen countries joined the Turkish emergency personnel, and aid pledges poured in.

But with devastation spread multiple several cities and towns — some isolated by Syria’s ongoing conflict — voices crying from within mounds of rubble fell silent, and despair grew from those still waiting for help.

In the Turkish city of Malatya, bodies were placed side by side on the ground, covered in blankets, while rescuers waited for funeral vehicles to pick them up, according to former journalist Ozel Pikal who saw eight bodies pulled from the ruins of building.

Pikal, who took part in the rescue efforts, said he believes at least some of the victims may have frozen to death as temperatures dipped to minus 6 degrees Celsius (21 Fahrenheit).

“Today isn’t a pleasant day, because as of today there is no hope left in Malatya,” Pikal told the AP by telephone. “No one is coming out alive from the rubble.”

Pikal said a hotel building collapsed in the city, and more than a hundred people may be trapped.

There was a shortage of rescuers in the area he was in, and the cold hampered rescue efforts by volunteers and government teams, he said. Road closures and damage in the region have also impeded mobility and access.

“Our hands cannot pick up anything because of the cold,” said Pikal. “Work machines are needed.”

In Syria, the shaking toppled thousands of buildings and heaped more misery on a region wracked by the country’s 12-year civil war and refugee crisis.

On Monday afternoon in a northwestern Syrian town, residents found a crying newborn still connected by the umbilical cord to her deceased mother. The baby was the only member of her family to survive a building collapse in the small town of Jinderis, relatives told The Associated Press.

Turkey is home to millions of refugees from the war. The affected area in Syria is divided between government-controlled territory and the country’s last opposition-held enclave, where millions rely on humanitarian aid.

As many as 23 million people could be affected in the quake-hit region, according to Adelheid Marschang, a senior emergencies officer with the World Health Organization, who called it a “crisis on top of multiple crises.”

Many survivors in Turkey have had to sleep in cars, outside or in government shelters.

“We don’t have a tent, we don’t have a heating stove, we don’t have anything. Our children are in bad shape. We are all getting wet under the rain and our kids are out in the cold,” Aysan Kurt, 27, told the AP. “We did not die from hunger or the earthquake, but we will die freezing from the cold.”

Erdogan said 13 million of the country’s 85 million people were affected, and he declared a state of emergency in 10 provinces. More than 8,000 people have been pulled from the debris in Turkey, and some 380,000 have taken refuge in government shelters or hotels, authorities said.

Turkey’s disaster management agency said the country’s death toll had risen to 7,108, bringing the overall total to 9,638, including fatalities reported in neighboring Syria, since Monday’s earthquake and multiple aftershocks. Another 40,910 people have been injured.

The death toll in government-held areas of Syria has climbed to 1,250, with 2,054 injured, according to the Health Ministry. At least 1,280 people have died in the rebel-held northwest, according to volunteer first responders known as the White Helmets, with more than 2,600 injured.

In Syria, aid efforts have been hampered by the ongoing war and the isolation of the rebel-held region along the border, which is surrounded by Russia-backed government forces. Syria itself is an international pariah under Western sanctions linked to the war.

The United Nations said it was “exploring all avenues” to get supplies to the rebel-held northwest.

The region sits on top of major fault lines and is frequently shaken by earthquakes. Some 18,000 were killed in similarly powerful earthquakes that hit northwest Turkey in 1999.