The 7.8-magnitude earthquake that struck southern Turkey and northern Syria in early February killed tens of thousands of people, flattened city blocks and sent the region, which was already grappling with a refugee crisis and over a decade of war, into a monumental recovery effort.

As of Feb. 11, the death toll in Syria and Turkey had surpassed 25,000. In Turkey, the national emergency management agency said that more than 22,000 people had died; in Syria, the death toll crossed 3,500, according to figures from Syria’s Health Ministry and the White Helmets civil defense group that operates in parts of the opposition-held northwest.

Thousands of buildings have been destroyed or rendered unstable, leaving hundreds of thousands of people without shelter in rain, snow and temperatures that often dip below freezing. Millions are in need of aid, according to relief agencies; in Syria alone, the United Nations said that the earthquake had affected 10.9 million people and that as many as 5.3 million might have lost their homes.

In the bitter cold, rescue workers have pulled thousands of survivors from the rubble, but experts say that the chances of rescuing more decline sharply a few days after a quake.

The situation for survivors in both Syria and Turkey is dire, with people reluctant to return to their homes and using bonfires of wreckage to stay warm, huddling in cars and suffering frequent power outages and shortages of fuel. They also face shortages of food and medical supplies.

Turkey has imposed a three-month state of emergency in 10 provinces, and the national emergency agency has mobilized more than 170,000 tents, 160,000 workers and 12,000 vehicles, including excavators, cranes and tow trucks. Dozens of countries have sent teams and supplies, and in some places the local authorities have contributed to rescue and relief efforts. A makeshift health care system has sprung up amid the devastation.

The quake zone in Turkey stretches across more than 200 miles, from the Mediterranean in the south across mountains and to the east-central highlands and into northwestern Syria. Snow-covered mountain passes, buckled highways and buildings that collapsed over roads have all delayed the arrival of rescue teams and aid.

Getting help to Syria has been complicated by the country’s civil war, the division of territory in its northwest, and the acrimonious relations between President Bashar al-Assad and many Western nations.

In the immediate aftermath of the earthquake, the only United Nations-approved crossing for transporting international aid into northwestern Syria was, for a time, not functioning because of damage in the area, according to U.N. officials.

But aid convoys soon started crossing with food, clothes, blankets and other supplies — received by exhausted and frustrated rescuers and doctors who say it is still not nearly enough, especially in a region where many people were displaced by war and struggling to survive before the earthquake.

Much of the international aid to Syria from the United Nations and other agencies flows through the capital, Damascus, allowing the government of Mr. al-Assad to limit what goes to opposition-held areas. United Nations agencies must get permission to then deliver some of the aid across front lines, to opposition-held areas, requests that are often denied.

U.N. officials have said they are negotiating with Syria’s government to make more deliveries, and the European Union has also said it would work with the United Nations to deliver aid.

The Syrian government has blamed U.S. sanctions for deepening the humanitarian disaster the country has suffered since the earthquake. Those sanctions do not target humanitarian aid, and the State Department has rejected calls to lift them, saying that aid efforts were not impeded by the policy and that Mr. al-Assad’s government should open more border crossings.

The 7.8-magnitude temblor, striking in the early hours of Feb. 6, is Turkey’s deadliest earthquake since 1939, when more than 30,000 people were killed, and among the deadliest worldwide in decades.

A powerful aftershock of magnitude 7.5 followed the earthquake, and experts warn that more could follow — posing potential risks to the structural integrity of unstable buildings in the earthquake zone.

Turkey’s two main fault zones, the East Anatolian and the North Anatolian, make it one of the most seismically active regions in the world, and more than 70 quakes of magnitude 6.5 or higher have been recorded in the region since 1900.

The epicenter of the earthquake was near the Turkish city of Gaziantep, where around half a million Syrian refugees were living, and much of the city was left in ruins. Much of Antakya, the capital of Turkey’s Hatay Province — known as Antioch to the people of ancient Greece and Rome — is destroyed, with whole neighborhoods in ruins, including the oldest part of the city. Rebuilding cities, where possible, will take years, at least a decade, experts say.

Reporting was contributed by Vivian Yee, Ben Hubbard, Cora Engelbrecht, Matina Stevis-Gridneff, Gulsin Harman, Safak Timur, Jin Yu Young, Raja Abdulrahim, Natasha Frost, Mike Ives, Hwaida Saad, Henry Fountain, Alan Yuhas and Farah Mohamed.

The New York Times

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