International Desk: A powerful 7.8 magnitude earthquake rocked wide swaths of Turkey and Syria early Monday, toppling hundreds of buildings and killing more than 1,300 people. Hundreds were still believed to be trapped under rubble, and the toll was expected to rise as rescue workers searched mounds of wreckage in cities and towns across the area.

On both sides of the border, residents jolted out of sleep by the pre-dawn quake rushed outside on a cold, rainy and snowy night. Buildings were reduce to piles of pancaked floors, while major aftershocks, some nearly as strong as the first, continued, reports The Associated Press.

Rescue workers and residents in multiple cities searched for survivors, working through tangles of metal and concrete. A hospital in Turkey collapsed, and patients, including newborns, were evacuated from facilities in Syria.

In the Turkish city of Adana, one resident said three buildings near his home were toppled. “I don’t have the strength anymore,” one survivor could be heard calling out from beneath the rubble as rescue workers tried to reach him, said the resident, journalism student Muhammet Fatih Yavus.

“Because the debris removal efforts are continuing in many buildings in the earthquake zone, we do not know how high the number of dead and injured will rise,” Turkish President Recep Tayyip Erdogan said. “Our hope is that we recover from this disaster with the least loss of life possible.”