The quake could exacerbate hunger and disease outbreaks in a country that was already one of the world’s most challenging places for humanitarian organizations to operate because of civil war, aid groups and the United Nations warned.

The 7.7 magnitude quake hit Friday, with the epicenter near Myanmar’s second-largest city of Mandalay. It damaged the city’s airport, buckled roads and collapsed hundreds of buildings along a wide swath down the country’s center.

Relief efforts are further hampered by power outages, fuel shortages and spotty communications. A lack of heavy machinery has slowed search-and-rescue operations, forcing many to search for survivors by hand in daily temperatures above 40 degrees Celsius (104 Fahrenheit).

Rescue workers at Mandalay’s collapsed U Hla Thein monastery said they were still searching for about 150 of the dead monks.

Some 700 Muslim worshipers attending Friday prayers were killed when mosques collapsed, said Tun Kyi, a member of the steering committee of the Spring Revolution Myanmar Muslim Network. He said some 60 mosques were damaged or destroyed. Videos posted on The Irrawaddy online news site showed several mosques toppling.

It was not clear whether those numbers were already included in the official toll.

Myanmar state MRTV reported that the leader of the military government, Senior Gen. Min Aung Hlaing, told Pakistan’s prime minister during a call that 2,065 people were killed, with more than 3,900 injured and about 270 missing.

Relief agencies expect those numbers to rise sharply, since access is slow to remote areas where communications are down.

The United Nations’ Myanmar country team called for unimpeded access for aid teams.

“Even before this earthquake, nearly 20 million people in Myanmar were in need of humanitarian assistance,” said Marcoluigi Corsi, the U.N. resident and humanitarian coordinator.

Devastation’s full extent is not clear

“We’re really not clear on the scale of the destruction at this stage,” Lauren Ellery, deputy director of programs in Myanmar for the International Rescue Committee, told The Associated Press. “They were talking about a town near Mandalay where 80% of the buildings were reportedly collapsed, but it wasn’t in the news because telecommunications have been slow.”

Groups the IRC works with have reported that some places are cut off by landslides, she said.

The World Health Organization said it has reports of three hospitals destroyed and 22 partially damaged in the region.

“There is an urgent need for trauma and surgical care, blood transfusion supplies, anesthetics, essential medicines and mental health support,” it said.

More than 10,000 buildings are collapsed or severely damaged in central and northwest Myanmar, the U.N. humanitarian agency said. One preschool classroom building collapsed in Mandalay district, killing 50 children and two teachers, it said.

An artificial intelligence analysis of satellite images of Mandalay by Microsoft’s AI for Good Lab showed 515 buildings with 80% to 100% damage and another 1,524 with 20% to 80% damage. It was not clear what percentage of the city’s buildings that represented.

Civil war had displaced millions

Rescue efforts are also complicated by the civil war. In 2021, the military seized power from the elected government of Aung San Suu Kyi, sparking what has turned into significant armed resistance.

While one group has declared a partial unilateral ceasefire, the government and other armed groups have not stopped fighting.

Government forces have lost control of much of Myanmar, and many places were dangerous or impossible for aid groups to reach even before the quake. More than 3 million people have been displaced by the fighting, according to the U.N.

Ellery with the International Rescue Committee noted that the area worst hit by the earthquake was seriously damaged by flooding last year, and many displaced people sought refuge there.

Since the earthquake, many people have been sleeping outside, either because homes were destroyed or out of fear of aftershocks.

Monsoon rains start in May and finding people shelter will be a major challenge, she said.

Myanmar’s neighbors and allies send aid

International rescue teams from several countries are on the scene, including from Russia, China, India and several Southeast Asian countries.

On Monday, an Indian team jackhammered through slabs of fallen concrete at one site in Mandalay. They could be seen bringing out one body.

The European Union, Britain, Australia, New Zealand, South Korea and others have announced millions of dollars in aid.

Despite massive cuts and firings at the U.S. Agency for International Development — the body charged with delivering humanitarian assistance overseas — the U.S. Embassy said a team of experts was on its way to Myanmar. The embassy said it would provide up to $2 million through local organizations.

Looking for survivors in Bangkok

A small number of U.S. military personnel were sent to assist in Bangkok, where the earthquake killed at least 18 people, many at a construction site where a partially built high-rise collapsed. Another 33 have been reported injured and 78 missing, primarily at the construction site near the popular Chatuchak market.

On Monday, heavy equipment was temporarily shut down at the site and authorities urged onlookers to be silent as they used machines to try and detect signs of life.

Bangkok Governor Chadchart Sittipunt told reporters that signs had been detected Sunday night, though experts could not determine whether it had been machine error.

Watching the crews at work, Naruemon Thonglek said she had “made some peace” with the fact that her partner and five friends there were unlikely to be found alive.

“A part of me still hope they will survive,” she said.