Rescuers endured chilly darkness, tremors, and crumbling buildings and searched for survivors buried by a series of earthquakes that killed at least 4,800 people in Turkey and Syria on Tuesday.

The destruction of thousands of structures in cities across a broad border region, according to disaster relief organizations, has added agony to a region already troubled by conflict, insurgency, refugee crises, and a recent cholera outbreak.

Throughout the night, survivors picked through the mangled remains of multi-story apartment buildings with their bare hands in an effort to save loved ones, friends, and anyone else who was sleeping there when the first powerful 7.8-magnitude earthquake struck early Monday.

A terrified seven-year-old girl was recovered from a fallen building in Hatay, Turkey, asking for her mom as her face, hair, and pajamas were covered in dust.

Residents had a difficult time understanding the scope of the catastrophe, which contributed to a general feeling of astonishment.

“We believed it to be the end of the world," Melisa Salman, a 23-year-old reporter in Kahramanmaras, a city in southeast Turkey, said.

Near the epicenter of the earthquake, between Kahramanmaras and Gaziantep, a city of two million people where entire blocks now lie in ruins under accumulating snow, some of the worst destructions took place.

Another building fell nearby as locals worked to clear the mound of brick, plasterboard, and furniture that had once been a multi-story structure, sending crowds running and shouting for safety.

Many terrified and worn-out survivors spent the night outside because they were too afraid to go inside as aftershocks continued to tremble the neighborhood.

Others covered themselves in plastic to protect themselves from the cold rain, huddled under bus shelters, and others burnt rubbish to stay warm.

Mustafa Koyuncu, a 55-year-old man, piled his wife, their five kids, and their belongings into their parked car, stating that they couldn’t go home because everyone was afraid.

The latest confirmed death toll in Turkey alone was 3,381 according to the rescue organization AFAD, increasing the total in both Turkey and Syria to 4,890.

With up to 20,000 possible fatalities, according to World Health Organization authorities, there are worries that the death toll may continue to increase steadily.