A teenager was pulled largely unscathed from beneath the rubble of a collapsed building in the Turkish city of Gaziantep early Friday, but four days after a catastrophic earthquake killed more than 20,000 the possibility of finding more survivors was rapidly shrinking.

The 7.8 magnitude earthquake hit the border region between Turkey and Syria, an area home to more than 13.5 million people, early Monday morning. With morgues and cemeteries overwhelmed, bodies lay wrapped in blankets, rugs and tarps in the streets of some cities.

Temperatures remain below freezing across the large region, and many people have no place to shelter. The government has distributed millions of hot meals, as well as tents and blankets, but was still struggling to reach many people in need.

Mustafa Turan rushed to his hometown of Adiyaman from Istanbul hours after the quake struck to check on his relatives. He counted 248 collapsed buildings between the airport and the city center.

The journalist said Friday that 15 of his relatives had been killed, and scores of people were sleeping outside or in tents.

“At night, about 4 a.m., it got so cold that our drinking water froze,” he said.

Turkey’s disaster management agency said 18,342 people had been confirmed killed in the disaster so far in Turkey, with nearly 75,000 injured. No figures have been released on how many have been left homeless, but the agency said more than 75,000 survivors have been evacuated to other provinces.

More than 3,300 have been confirmed killed on the other side of the border in war-torn Syria, bringing the total number of dead to more than 21,600.

Before dawn in Gaziantep, near the epicenter of the quake in Turkey, rescuers pulled Adnan Muhammed Korkut from the basement where had been trapped since the temblor struck Monday. The 17-year-old beamed a smile at the crowd of friends and relatives who chanted “Adnan,” “Adnan,” clapping and crying tears of joy as he was carried out and put onto a stretcher.

“Thank God you arrived,” he said, embracing his mother and others who leaned down to kiss and hug him as he was being loaded into an ambulance. “Thank you everyone.”