The primary cargo of worldwide support reached the exhausted residents of opposition-held northwestern Syria on Thursday, a small triumph for the a whole lot of 1000’s who had waited days for assist to dig out individuals buried within the rubble, discover safe lodging and acquire meals.

However survivors, rescuers and medical doctors expressed frustration that it was too little, too late. The six vans of support from the United Nations, organized earlier than the quake hit, didn’t include a number of the most urgently wanted provides, comparable to meals, and as an alternative introduced much less crucial gadgets.

“Had worldwide rescue groups come into Syria within the first hours and even the second day, there was an enormous hope that these individuals who had been beneath the ruins might have been introduced out alive,” mentioned Mohamed al-Shibli, a member of the White Helmets, a civil protection group that operates in opposition-held elements of Syria.

He demanded that the United Nations and international leaders ship rescue staff and heavy equipment for shifting rubble, dismissing the help that had reached the area as ineffective to residents who had resorted to digging for survivors and our bodies of family members with their naked palms.

“What is going to youngsters beneath the rubble do with diapers?” he mentioned, preventing again tears.

Monday’s earthquake affected a big swath of Syria’s northwest, spanning each areas managed by the Syrian authorities and others held by opposition forces backed by neighboring Turkey. These territorial divisions, and a bunch of different political obstacles stemming from a 12-year civil struggle which has nonetheless not ended, posed formidable challenges and deadly delays in getting worldwide assist to those that want it most.

Rescue teams, which have been working nonstop since Monday, have fanned out throughout the nation in a race towards time to avoid wasting lives.

“Some individuals beneath ruins are sharing their wills with the group,” Mr. al-Shibli mentioned. “Beneath the rubble, they ask them to convey messages, they share names of their family members, then they die.”

The U.N. support convoy into Syria had been stalled by street injury from the earthquake, which additionally affected native staff who confirm and transport the help.

The convoy entered Syria from Turkey, utilizing the Bab al-Hawa border crossing, which for years has been the one passage for United Nations support into areas held by opposition forces preventing the regime of Bashar al-Assad, the nation’s authoritarian chief. The vans carried shelter supplies and nonfood gadgets, in response to a spokesman for the U.N. Workplace for the Coordination of Humanitarian Affairs.

“This primary cargo is a check,” mentioned Jens Laerke, a United Nations spokesman, meant to make sure that the roads had been satisfactory. The group hopes to get as a lot support into the northwest as attainable as quickly as attainable, he mentioned.

Greater than 3,300 individuals in Syria died within the quake, in response to the U.Okay.-based Syrian Observatory for Human Rights — a toll that has been steadily rising since Monday and is anticipated to maintain climbing. Of these deaths, greater than 2,000 had been within the opposition-held elements of northwestern Syria, in response to The White Helmets.

In Turkey, the loss of life toll surpassed 17,500 and was additionally anticipated to rise. Whereas waves of worldwide search and rescue groups, utilizing life-detecting canine, are pouring into Turkey, native rescuers and volunteers are the one ones looking by mounds of rubble and particles within the opposition-held elements of Syria.

Almost 11 million individuals in Syria have been affected by the earthquake, about 4 million of them reliant on support companies for fundamental humanitarian wants comparable to clear water and meals, in response to the United Nations.

The White Helmets rescuers have been working since Monday in a diminishing window to avoid wasting as many individuals as attainable earlier than time runs out, usually with their naked palms.

The pleas for extra and quicker support had been echoed by Syrian medical doctors, lots of whom discover themselves caught in a contemporary humanitarian disaster after weathering greater than a decade of civil struggle, which has devastated the nation’s well being care system.

“We had shortages of provides earlier than the earthquake — now our want has solely elevated,” mentioned Dr. Mohamed al-Abrash, a 60-year-old surgeon within the northern metropolis of Idlib the place he has obtained a whole lot of wounded since Monday.

Earlier than the quake, Dr. al-Abrash mentioned his hospital employees had been already in want of crucial medical provides like working tables and bandages. Now, they wanted extra refined tools comparable to dialysis machines to deal with an inflow of sufferers affected by renal failure from extreme accidents.

Many survivors had been refusing to return house as buildings continued to break down, he mentioned. Residents had been constructing their very own shelters within the streets, braving freezing temperatures.

“There are kids dying from hypothermia,” he mentioned. “We’re pressured to attend as individuals die within the streets,” he added. “We do not know what’s going on. We want politics put aside — we’re in catastrophe.”

Many hospitals in northwestern Syria had been too badly broken by the earthquake to function, and sufferers had been stranded, in response to different support teams like Docs With out Borders, which have additionally jumped in to assist. Its groups had supplied medical gadgets and kits to 23 native hospitals and clinics in Idlib Province, close to the epicenter, and handled greater than 3,400 injured individuals because the quake.

“The huge penalties of this catastrophe would require an equally large worldwide response,” mentioned Avril Benoît, the group’s govt director in the US.

Syria was already affected by a extreme nationwide gasoline scarcity earlier than the quake struck. The widespread energy outages afterward have pressured many hospitals to depend on mills for energy, which generally run on ever-scarce diesel gasoline and gasoline, in response to the United Nations. Snowfall has additional impeded rescue efforts.

Greater than 1,500 individuals, many who had already misplaced their properties through the earthquake, had been pressured to flee a flooded village in Idlib province after a dam there collapsed on Thursday within the aftermath.

Earlier than the quake, the United Nations had been sending every day support convoys into the opposition-held northwest.

The earthquake has refocused consideration on the continued civil struggle in Syria, which started in 2011 as a preferred revolt towards the Assad regime. The preventing has largely ceased and the struggle is basically a stalemate.

However the ongoing battle complicates the move of support into Syria, as most of it passes by Damascus, the capital, which is in government-held territory. The majority of it comes through United Nations companies, which despatched $2.13 billion to Syria final 12 months, in response to figures launched by the group’s support company.

As a result of the Assad authorities tightly controls what support goes to opposition-held areas, the cross-border support deliveries from Turkey have been a lifeline for opposition-held areas within the north for years.

The European Union mentioned Wednesday that it will work with the U.N. Workplace for the Coordination of Humanitarian Affairs to get support to each opposition- and government-controlled areas of Syria after Syria’s authorities lodged a proper request for support with the bloc. The E.U., a significant donor of humanitarian support to Syria, mentioned it was dedicated to serving to Syrians although it has sanctions in place towards the nation.

Balazs Ujvari, a spokesman for the European Fee, mentioned E.U. sanctions had been designed with exceptions for humanitarian support in thoughts.

Syrian officers have known as for a lifting of Western sanctions, which they mentioned had been obstructing support deliveries to Syria — a declare that the E.U. rejected.

“We wish tools,” Khaled Hboubati, the pinnacle of the Crimson Crescent in Syria, mentioned at a information convention on Tuesday. “We want fireplace vans. We don’t have heavy tools for evacuation.”

Mr. Assad’s regime has opposed efforts to ship support on to opposition-controlled areas from Turkey, insisting that every one support ought to undergo the federal government in Damascus.

Nonetheless, it’s not solely opposition-held areas which are struggling.

Dr. Ghassan Fandi, head of a syndicate of medical doctors in regime-held areas of Syria, mentioned worldwide sanctions had been stopping medical tools from reaching Syrian hospitals, particularly spare elements for Western-made equipment.

However a variety of international locations pleasant with the Syrian authorities have despatched support to Damascus because the earthquake, together with Iraq, Lebanon and Iran, which despatched a airplane on Monday evening with 70 tons of meals, tents and medication.

Farnaz Fassihi and Matina Stevis-Gridneff contributed reporting.