Seven more people have been rescued eight days after a massive earthquake hit Turkey and Syria, but hopes of finding further survivors of what the World Health Organization called the worst natural disaster in 100 years in its 53-country Europe region are dwindling. As a UN aid convoy entered stricken north-west Syria through a new crossing, the combined death toll rose to nearly 38,000, including 31,974 in Turkey and at least 5,714 in rebel-held and government-controlled Syria – a figure that is expected to continue to increase. Among those recovered on Tuesday was Muhammed Cafer, 18, who could be seen moving his fingers as he was lifted from rubble in Kahramanmaraş, Turkey. Muhammed Yeninar, 17, and his brother Baki, 21, were found alive in the same region. Turkey’s TRT Haber reported a 35-year-old woman had also been pulled alive from the ruins of a block of flats in the southern Hatay province, 205 hours after the 7.8-magnitude quake, which was followed by a powerful aftershock, struck early on Monday. However, some teams are winding down operations as subzero temperatures reduce the already slim chances of survival. The UN’s aid chief, Martin Griffiths, said the rescue phase was “coming to a close”, with the focus turning to shelter and food. At a field hospital in Antakya, Turkey, one doctor, Yilmaz Aydin, told Agence France-Presse it was now “a miracle to find a patient still alive”, and that those who were rescued would be “in a more critical condition. The majority will need life-saving treatment.” Across swaths of southern Turkey, whole cities have become ghost towns after most of their residents fled. In Antakya, entire streets of ancient stone homes and mosques, churches and a synagogue have been reduced to piles of rubble and the few local people still in the city said they had only stayed to protect what remained of their homes from looting. Cats and pigeons roamed among the ruins searching for food, and soldiers with automatic weapons patrolled the empty streets. “We decided not to leave the city as we must protect it. If we leave, someone else will come,” said Özgen Cemil Kürü, guarding the entrance to his block of flats, almost blocked by a pile of stones from a nearby building. He added: “We will repair this. Our people are strong, we’ll get through it. I believe our wounds will heal.” Hans Kluge, the WHO’s Europe director with responsibility for an area stretching from Greenland to the Pacific coast of Russia’s far east, said relief workers were facing “the worst natural disaster in the region for a century”, adding that with 26 million people needing assistance across both countries the full magnitude was still hard to assess and recovery would take “a phenomenal effort”. Kluge said three charter flights with emergency medical kits had been dispatched to Syria and Turkey – enough to treat 400,000 people – and 22 teams from 19 countries deployed in the largest operation of its kind in the organisation’s 75-year history. More than a week after the quakes, there were “growing concerns over emerging health issues linked to the cold weather, hygiene and sanitation, and to the spread of infectious diseases, with vulnerable people especially at risk”, he said. The UN on Tuesday launched an appeal for $397m (£325m) to help earthquake victims in Syria. The organisation’s secretary general, António Guterres, added that the world body was in the “final stages” of a similar appeal for Turkey. In Turkey alone, an estimated 1 million people are living in tents and temporary shelters, while at least 80,000 people have been hospitalised. Up to 5 million people may be homeless in Syria, many already internally displaced after fleeing civil war. The UN children’s agency, Unicef, said on Tuesday that more than 7 million children had been affected by the quake and “many thousands” had died. “Even without verified numbers, it is tragically clear that numbers will continue to grow,” a spokesperson said. “Tens of thousands of families are exposed to the elements when temperatures are bitingly cold, and snow and freezing rain are common,” the spokesperson told reporters in Geneva, adding that the final death toll would be “mind-boggling”. A UN aid convoy of 11 trucks crossed into rebel-held north-western Syria from Turkey through a newly opened crossing, Bab al-Salameh, on Tuesday, and the first UN delegation to visit the war-torn area since last week’s quake arrived, AFP said. The team aimed to assess humanitarian and food needs in an area where 90% of the population – about 4 million people – were dependent on aid even before the disaster. A Saudi plane carrying aid landed in Aleppo, with two more expected later this week. Activists and relief teams in opposition-controlled north-west Syria, however, have decried the UN’s slow response to the quake in rebel-held areas, contrasting it with the planeloads of aid delivered to government-controlled airports. The UN said it welcomed a decision by the Syrian president, Bashar al-Assad, to open two more border crossings with Turkey for at least three months so more aid could reach the north-west, where 12 years of bitter fighting have complicated the international relief effort. The head of the White Helmets rescue group, Raed al-Saleh, said the search for survivors in the north-west would soon come to an end. “The indications we have are that there are not any, but we are trying to do our final checks and on all sites,” he said. In Turkey, the vice-president, Fuat Oktay, on Tuesday denied reports of food and aid shortages. There were “no problems with feeding the public” and “millions of blankets are being sent to all areas”, he said. Survivors and rescue workers have strongly criticised a lack of emergency supplies and equipment including water, food, medicine, body bags and cranes in the days after the quake, with many decrying a slow and inadequate response by Turkey’s disaster agency. “People are not dead because of the earthquake, they are dead because of precautions that weren’t taken earlier,” Said Qudsi, who travelled to Kahramanmaraş to bury his uncle, aunt and their two sons, told Reuters news agency. The Turkish president, Tayyip Recep Erdoğan, who faces a tight election this year, has acknowledged problems in the early response, but initially blamed fate for the disaster and insisted the situation was now under control. In a speech on Tuesday, Erdoğan promised to launch an ambitious reconstruction plan for the entire destruction zone – even before the streets were cleared of rubble. “Turkey is immediately starting construction of 30,000 homes at the beginning of next month,” he said. A leading Turkish business association, Türkonfed, estimated that the earthquake could cause losses of $84bn (£69bn) to the Turkish economy.