ALEPPO, Syria – After Monday’s earthquake brought down his family’s building in Syria’s battle-scarred second city of Aleppo, Youssef managed to reach one of his trapped relatives by phone, hearing voices despite a bad line.

Since then the 25-year-old has been standing in near-freezing weather by the rubble, unable to get through again.

“I have been waiting for news of my father, my mother, my brother, my sister and her son,” he said. “Nothing is known about them so far.

“I talked to them and heard their voices, but unfortunately, as you can see here, they’re very slow at work and they don’t have enough equipment,” he said of rescue efforts.

On the streets, men, women and children wrapped in blankets huddled on sidewalks around fires on Wednesday morning. Many slept in cars and vans parked near where their homes once stood. Others lay on the cold ground.

Aleppo, once famed for its labyrinthine covered souks, medieval minarets, domed bathhouses and imposing ancient citadel, was devastated by years of civil war fighting before the government recaptured a rebel stronghold there in 2016.

It is now among the Syrian cities worst hit by the 7.8 magnitude earthquake that has so far killed more than 11,000 people across Turkey and Syria, including 2,500 dead in Syria.

Local authorities said on Wednesday that at least 390 people have died and 750 have been injured in Aleppo province, with more than 50 buildings having collapsed.

Many Aleppo buildings had already been weakened by battles during the ongoing 12-year conflict and Youssef’s apartment was in Bustan al-Basha, a previously frontline district that was badly smashed up in the fighting.

The quake has also caused further damage to the pride of the city: the towering citadel listed by the U.N. cultural agency UNESCO as a world heritage site. It had sustained heavy damage during the civil war and the earthquake reduced some of the surviving structures inside it to rubble.

For Aleppo’s citizens, still only gradually rebuilding their shattered city years after the fighting there stopped, the earthquake brought new misery.

At al-Razi hospital, 27-year-old Bakr said he was one of only three survivors when his building caved in, killing his parents, a brother and six of his nieces and nephews.

“The building collapsed on top of us,” he said, lying injured in a hospital bed.

Rescue workers on both sides of the country’s frontlines say more than a decade of war has drained them of resources and they require massive aid and heavy equipment to facilitate search and rescue operations

Syria’s government has received help from a host of Arab countries, including Egypt and Iraq, as well as from its key ally Russia, which has sent rescue teams and deployed forces already in Syria to join relief work, including in Aleppo.

Little if any aid has made its way to the insurgent-held northwest.

– Reuters. Edited for style.