The number of deaths in Turkey rose to 24,617 on Sunday while more than 4,500 have been killed in Syria. According to Syrian government-controlled media, at least 1,408 people were killed & 2,341 injured – while the White Helmets reported 3,100 people dead and 5,070 injured in opposition-controlled areas, the humanitarian group told Al Jazeera.

United Nation relief chief Martin Griffiths said he expected the death toll to at least double after he arrived in southern Turkey on Saturday to assess the damage.

Tens of thousands of rescue workers are scouring flattened neighbourhoods despite freezing weather that has deepened the hardship of millions now in desperate need of aid.

“The air is thick with smoke and dust. There’s no sanitation. People are still buried under the rubble and are sleeping out in the open … there are some tents here in Antakya … but they still aren’t enough yet,” said Al Jazeera’s Bernard Smith, reporting from Antakya in Turkey.

The UN has warned that at least 870,000 people urgently need hot meals across Turkey and Syria.

In Syria alone, up to 5.3 million people may have been made homeless, the UN esimated.

Tens of millions impacted

Nearly 26 million people have been affected by the earthquake and dozens of hospitals are damaged across both countries, the World Health Organization (WHO) said as it launched a flash appeal on Saturday for $42.8m to cope with immediate, towering health needs.

Turkey’s disaster agency said more than 32,000 people from Turkish organisations are working on search-and-rescue efforts. There are also 8,294 international rescuers.

There have also been some reports of gunfire in various locations, causing Austrian soldiers and German rescue workers to call off their searches for several hours on Saturday in Hatay, citing difficult security amid firing between local groups.

The UN human rights office tweeted on Friday a call by High Commissioner Volker Turk “for immediate ceasefire in Syria, and full respect of #humanrights & humanitarian law obligations so help can reach everyone”.

Meanwhile, the outlawed Kurdistan Workers’ Party, considered a “terrorist” group by Ankara and its Western allies, has announced a temporary halt in fighting to ease recovery work.

On Saturday, a border crossing between Armenia and Turkey also opened for the first time in 35 years to allow five trucks carrying food and water into the quake-hit region.

Medical aid for Aleppo

Aid has been slow to arrive in northwestern Syria, where years of conflict have ravaged the healthcare system as government forces targeted the parts of the country that remain under rebel control.

Damascus said it had approved the delivery of humanitarian assistance to quake-hit areas outside its control in Idlib province and a convoy was expected to leave on Sunday. The delivery was later postponed without explanation.

WHO chief Tedros Adhanom Ghebreyesus took a flight full of emergency medical equipment into the government-controlled Syrian city of Aleppo, which was hit hard by the quakes, on Saturday.

Tedros toured damaged areas of the city and met two children who lost their parents in the earthquake.

“There are no words to express the pain they are going through,” he tweeted.

The transport ministry said 57 aid planes had landed in Syria this week.

Meanwhile, the European Union’s envoy to Syria urged Damascus not to politicise issues of humanitarian aid, rejecting accusations that the bloc had failed to provide sufficient help to Syrians after Monday’s earthquakes of magnitude 7.8 and 7.6 and their major aftershocks.

“It is absolutely unfair to be accused of not providing aid when actually we have constantly been doing exactly that for over a decade and we are doing so much more even during the earthquake crisis,” Dan Stoenescu told Reuters news agency.

Western nations have largely shunned President Bashar al-Assad during the Syrian civil war that began in 2011.

UN Secretary-General Antonio Guterres has urged the Security Council to authorise the opening of new cross-border aid points between Turkey and Syria. The council will meet to discuss Syria, possibly in the coming days.

Turkey said it was working on opening two new routes into rebel-held parts of Syria.