Many survivors of Morocco's most powerful earthquake in over a century were struggling in makeshift shelters on Tuesday after a fourth night outside, with rescuers yet to reach remote mountain villages which suffered some of the worst devastation.
The death toll from the 6.8 magnitude quake that struck in the High Atlas Mountains late on Friday stood at 2,862, with 2,562 people injured, but those figures looked likely to rise.
Rescuers from Spain, Britain and Qatar were helping Morocco's search teams, while Italy, Belgium, France and Germany said their offers of assistance had yet to beapproved.
Hopes of finding survivors under the rubble were fading, not least because many of the traditional mud brick houses that are common in the mountain villages crumbled to earthen rubble without leaving air pockets.
With the worst-hit area located in rugged, isolated terrain, the picture on Tuesday was patchy, with some organised tent camps being set up and supplies being airlifted in, while in other locations no aid at all had arrived due to roads being blocked by rocks and earth dislodged by the quake.
Some survivors had camped out in the open with hastily packed bundles along the Tizi n'Test road, which connects remote valleys to Marrakech, after fleeing their destroyed villages.
"The authorities are focusing on the bigger communities and not the remote villages that are worst affected," said Hamid Ait Bouyali, 40, waiting on the roadside. "There are some villages that still have the dead buried under the rubble."
Many villagers have had no power or telephone network since the earthquake struck and have said they had to rescue loved ones and pull out dead bodies buried from under their crushed homes without any assistance.
In the hard-hit town of Talat N'Yaaqoub, dozens of Moroccan troops, search-and-rescue workers and medical personnel were looking for buried people and assisting survivors.
Ordinary citizens were also volunteering to help, like Brahim Daldali, 36, who had come from Marrakesh on his motorbike to distribute food, water, clothes and blankets donated by friends.
"They have nothing and the people are starving," he said.
In Amizmiz, a large village at the foot of the mountains that has turned into an aid hub, some people made homeless by the quake had been provided with yellow tents by the authorities, but others were still sheltering under blankets.
"I am so scared. What will we do if it rains?" said Noureddine Bo Ikerouane, a carpenter, who was camping with his wife, mother-in-law and two sons, one of whom is autistic, in an improvised tent fashioned from blankets.
Omar Aneflous, a tailor, said even those whose homes were still standing were too scared to return because of the risk of collapse.
Some aid offered but not taken
The epicentre of the quake was about 72 km (45 miles) southwest of Marrakech, where some historical buildings in the old city, a UNESCO World Heritage Site, were damaged. The quake also caused major damage to the historically significant 12th-century Tinmel Mosque.
More modern parts of Marrakech largely escaped unscathed, including a site near the airport earmarked for IMF and World Bank meetings, due to be held next month.
Over 10,000 people are expected at the meetings, which the government wants to go ahead, sources said.
Morocco has accepted offers of aid from Spain and Britain, which both sent search-and-rescue specialists with sniffer dogs, and from the United Arab Emirates and Qatar. Algeria said it had allocated three planes to transport rescue personnel and aid.
State TV said the Moroccan government might accept relief offers from other countries later.
Italy and Belgium joined France and Germany in saying Morocco had not taken up their offers to send help.
Germany said it did not think the decision was political, but Italian Foreign Minister Antonio Taji told radio station Rtl that Morocco had chosen to receive aid only from countries with which it had close relations.
Caroline Holt, global director of operations at the International Federation of the Red Cross and Red Crescent Societies (IFRC), which launched an emergency appeal on Tuesday for quake victims, defended Morocco's decisions.
"I think that the Moroccan government is taking careful steps with regards to opening up, accepting bilateral offers of support from governments. And really, as we've seen, focusing on that search-and-rescue window before that window unfortunately closes, which is in the coming hours," she said.
Others expressed frustration at not being allowed in to help.
Arnaud Fraisse of Secouristes Sans Frontieres (Rescuers Without Borders), a French NGO specialising in earthquakes, said it had offered the Moroccan embassy in Paris a team of nine who were ready to go but no response had come from Rabat.
"Now, four days later, it is too late to leave because we are here to work urgently, to save people under the rubble, not to discover corpses," he said. "This breaks our hearts."