A powerful 7.8 magnitude earthquake hit southern Turkey and northern Syria early Monday, toppling buildings and triggering a frantic search for survivors in the rubble in cities and towns across the area. At least 207 were killed and hundreds injured, and the toll was expected to rise.

On both sides of the border, residents were jolted out of sleep by the tremors several hours before dawn and rushed outside in a cold, rainy and snowy winter night. Dozens of buildings collapsed in cities across the border region.

Rescue workers and residents frantically searched for survivors under the rubble of crushed buildings in multiple cities on both sides of the border, working through tangles of metal and chunks of concrete.

In the Turkish city of Adana, witnesses said they heard one person calling for help from beneath the rubble of a building. “I don’t have the strength to carry on,” the person cried. Further east in Diyarbakir, cranes and rescue teams worked at a mountain of pancaked concrete floors that was once an apartment building.

On the Syrian side of the border, the quake smashed opposition-held regions that are packed with some 4 million people displaced from other parts of Syria by the country’s long civil war. Many of them live in decrepit conditions with little health care. At least 11 were killed in one town, Atmeh, and many more were buried in the rubble, a doctor in the town, Muheeb Qaddour, told The Associated Press by telephone.

“We fear that the deaths are in the hundreds,” Qaddour said, referring to the rebel-held northwest. “We are under extreme pressure.”

The quake, felt as far away as Cairo, was centered about 90 kilometers (60 miles) from the Syrian border, just north of the city of Gaziantep, a major Turkish provincial capital of more than 2 million people. The region has been shaped by more than a decade of war in Syria. Millions of Syrian refugees live in Turkey. The swath of Syria affected by the quake is divided between government-held and opposition-held areas.

At least 20 aftershocks followed, some hours later during daylight, the strongest measuring 6.6, Turkish authorities said.

Turkish President Recep Tayyip Erdogan said on Twitter that “search and rescue teams were immediately dispatched” to the areas hit by the quake.

“We hope that we will get through this disaster together as soon as possible and with the least damage,” he wrote.

Turkey’s Disaster and Emergency Management agency said at least 76 people in seven Turkish provinces. The agency said 440 people were injured. The death toll in government-held areas of Syria climbed to 111 with at least 516 injured, according to Syrian state media. Earlier, 20 people were reported killed in rebel-held areas.

Buildings were reported collapsed in a swath from Syria’s cities of Aleppo and Hama to Turkey’s Diyarbakir, more than 330 kilometers (200 miles) to the northeast.

In Turkey, people trying to leave the quake-stricken regions caused traffic jams, hampering efforts of emergency teams trying to reach the affected areas. Authorities urged residents not to take to the roads. Mosques around the region were being opened up as a shelter for people unable to return to damaged homes amid temperatures that hovered around freezing.

In Diyarbakir, rescue teams called for silence as they tried to listen for survivors under the wreckage of an 11-story building. Rescue workers pulled out one man, carrying him on a stretcher through a dense crowd of hundreds of people anxiously watching the rescue efforts. A gray-haired woman wailed before being escorted away by a man, while a rescue worker wearing a white helmet tried to calm a crying girl, who was also being cuddled by two friends.

In northwest Syria, the opposition’s Syrian Civil Defense described the situation in the rebel-held region as “disastrous” adding that entire buildings have collapsed and people are trapped under the rubble. The civil defense urged people to evacuate buildings to gather in open areas. Emergency rooms were full of injured, said Amjad Rass, president of the Syrian American Medical Society.

The U.S. Geological Survey said the quake was centered about 33 kilometers (20 miles) from Gaziantep. It was centered 18 kilometers (11 miles) deep.

In Damascus, buildings shook and many people went down to the streets in fear.

The quake jolted residents in Lebanon from beds, shaking buildings for about 40 seconds. Many residents of Beirut left their homes and took to the streets or drove in their cars away from buildings.

The earthquake came as the Middle East is experiencing a snowstorm that is expected to continue until Thursday.

Turkey sits on top of major fault lines and is frequently shaken by earthquakes.

Some 18,000 were killed in powerful earthquakes that hit northwest Turkey in 1999.

AP