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Rescuers pulled out children on Friday from the rubble of the Turkey-Syria earthquake as the toll approached 23,000 and a winter freeze compounded the suffering for nearly one million people estimated to be in urgent need of food.

The stench of death hung over Turkey's eastern city of Kahramanmaras - the epicentre of the first 7.8-magnitude tremor that upturned millions of lives in a remote region filled with people displaced by war in the pre-dawn hours of Monday.

The United Nations warned that 874,000 people were now in urgent need of hot meals across Turkey and Syria.

Five days of grief and anguish have been slowly building into rage at the Turkish government's response in the face of the country's most dire disaster in nearly a century.

Turkish President Recep Tayyip Erdogan conceded for the first time Friday that his government was not able to reach and help the victims "as quickly as we had desired".

But miraculous rescues continued in pockets of Turkey more than 100 hours after the first tremor tore apart roads and flattened hundreds of buildings while a winter storm raged over southeastern Turkey and parts of Syria.

Turkish television showed rescuers pulling out a family of four - a mother and her three children - from the pile of rubble 108 hours after the disaster in the Syria-border province of Hatay.

People's survival chances fall greatly after the first 72 hours because of the cumulative effects of dehydration and cold.

Three-year-old Zeynep Ela Parlak was also rescued in the same province on Friday.

Rescuers pulled a 10-day-old baby and his mother out alive after 90 hours trapped in Hatay on Thursday.

The earthquake in Syria and Turkey has killed over 22,000 people.

Close to 19,000 were killed in Turkey, while 3,300+ were killed in Syria, say officials. Over 80,000 have been injured.

This is the deadliest quake since the 2010 Haiti earthquake which killed over 220k people.

— AJ+ (@ajplus)

Starting from scratch

A group of Turkish Black Sea coast coal miners - expert in rescuing their own colleagues - rushed in to help dig through the rubble of Hatay province's devastated city of Antakya.

"Our hearts couldn't take this," said miner Ismail Hakki Kalkan.

But much of Kalkan's work involved reaching the bodies of victims so that their family members could give them a proper burial and gain some inner peace.

"We must first find a place to bury them and then start from scratch," Nesibe Kulubecioglu said while guiding the coal miners to a spot where her 80-year-old mother and other family members vanished under rubble in Hatay province.

One of the single biggest tragedies involved 24 Cypriot children between the ages of 11 and 14 who were in Turkey for a volleyball tournament when the quake swallowed their hotel.

Ten of their bodies were repatriated to their homeland in northern Cyprus.

Turkish media reports that at least 19 people in the group - which included 15 accompanying adults - have now been confirmed dead.

The mourning of individual families has been accompanied by warnings for global institutions to the risks posed to many people displaced and traumatised by Syria's 12-year civil war.

The United Nations World Food Programme appealed for $77 million to provide food rations and hot meals for 874,000 people affected by the deadly quake.

The number in need of aid "includes 284,000 newly displaced people in Syria and 590,000 people in Turkey, which includes 45,000 refugees and 545,000 internally displaced people", it said.

Aid reaches rebel areas

"As this tragic event unfolds, people's desperate plight must be addressed," said International Committee of the Red Cross president Mirjana Spoljaric on a visit to quake-hit Aleppo in Syria.

The first international aid deliveries to rebel-held northwestern

Syria since the quake arrived on Thursday.

The Syrian government said it had also approved the delivery of humanitarian aid to quake-hit areas outside its control.

A decade of civil war and Syrian-Russian aerial bombardment had already destroyed hospitals and prompted electricity and water shortages.

UN Secretary-General Antonio Guterres urged the Security Council to authorise the opening of new cross-border humanitarian aid points between Turkey and Syria.

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

The winter freeze has left thousands of people either spending nights in their cars or huddling around makeshift fires that have become ubiquitous across the quake-hit region.

'Left to die'

Monday's quake was the most powerful and deadliest since 33,000 people died in a 7.8-magnitude tremor in 1939.

Officials and medics said 19,388 people had died in Turkey and 3,377 in Syria. The confirmed total now stands at 22,765.

Anger has mounted over the Turkish government's handling of the disaster.

"People who didn't die from the earthquake were left to die in the cold," Hakan Tanriverdi told AFP in Adiyaman province.

Erdogan conceded for the first time on Friday that his government did not respond as quickly as it would like in the first critical days of the disaster.

"So many buildings were damaged that unfortunately, we were not able to speed up our interventions as quickly as we had desired," he said during a visit to Adiyaman province.

He said rescuers had been slowed by a winter storm over the area that had made some roads impassable.