Joy and sadness prevail in earthquake-hit provinces of Türkiye as rescue teams hail, pulling someone still alive from debris in one building while bodies are removed from another.

Nearly two days after the magnitude 7.7 earthquake struck southeastern Türkiye and northern Syria, rescuers pulled a 3-year-old boy, Arif Kaan, from beneath the rubble of a collapsed apartment building in Kahramanmaraş, 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, Ertuğrul Kisi, who had been rescued earlier, sobbed as his son was pulled free and loaded into an ambulance. "For now, the name of hope in Kahramanmaraş 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 Betül Edis from the rubble of her home in Adıyaman. Amid applause from onlookers, her grandfather kissed her and spoke softly to her as she was loaded into an ambulance.

But such stories were few more than two days after Monday's pre-dawn earthquake, which hit a vast 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 more than 24,000 Turkish emergency personnel, and aid pledges poured in.

But with devastation spread to multiple 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. The shaking toppled thousands of buildings in Syria 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 (AP). Türkiye 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), who called it a "crisis on top of multiple crises."

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

President Recep Tayyip Erdoğan said 13 million of the country's 85 million people were affected and declared a state of emergency in 10 provinces. More than 8,000 people have been pulled from the debris in Türkiye, and some 380,000 have taken refuge in government shelters or hotels, authorities said.

In Syria, aid efforts have been hampered by the ongoing war and the isolation of the opposition-held region along the border, 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 opposition-held northwest.

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