Living for years in a tent camp for displaced people in Syria’s rebel-held northwest, Ali Abu Yassin used to envy friends and relatives who had brick walls around them and solid ceilings over their heads.

The situation was turned on its head after Monday’s devastating 7.8 magnitude earthquake hit Turkey and Syria, killing more than 23,000 people, collapsing and damaging tens of thousands of buildings and potentially leaving millions displaced.

More than 20 of Abu Yassin’s relatives were killed when their apartment buildings collapsed from the quake in the nearby village of Bisnya, he said, including one cousin’s entire family of 14.

Abu Yassin made it to the village to help with rescue efforts.

“It took us two days to pull out their bodies and bury them in a mass grave,” Abu Yassin said by telephone from the rebel-held province of Idlib. From the tent he had once wished to leave, the father of three said, “I am so lucky. It’s God’s will.”

Before the earthquake, Syria's 12-year-old uprising-turned-civil war had already displaced half the country’s pre-war population of 23 million. Abu Yassin was among them, fleeing from his home in another part of Idlib years ago.

Now the earthquake has caused a new wave of displacement.

The swath of destruction included the rebel-held enclave, centered on Idlib province, as well as heavily populated government-held cities like Aleppo, Hama and Latakia. The U.N. refugee agency, UNHCR, said Friday that as many as 5.3 million people in Syria may have been left homeless.

For many, this is their second displacement.

Wassim Jaadan left his house in the rebel-held village of Zardana in Idlib, then under bombing by government forces, and fled to Lebanon with his family in 2013. Nine years later, after Lebanon collapsed into a protracted economic crisis and they could no longer afford rent, Jaadan brought his wife and four children home to Zardana.

“The economic situation was better than Lebanon, and we had our family, our parents here,” he said.

When the earthquake struck on Monday, the family was awoken by a light shaking that quickly became more violent. They escaped before the building fell and crumbled to rubble.

The family now lives in a tent, which is nearly empty since all their possessions were destroyed. “We are about to die from the cold,” Jaadan said. “I am unable to think because of the shock.”

UNHCR said in a statement that it is trying to ensure that shelters housing displaced people have adequate facilities, as well as tents, plastic sheeting, thermal blankets, sleeping mats and winter clothing.

However, aid has been slow to reach many areas. The first earthquake-related aid convoy of 14 trucks crossed through Turkey into northwestern Syria on Friday, a U.N. spokesperson told The Associated Press. The road to the Bab al-Hawa border crossing was obstructed for days following the earthquake due to road damage and debris from collapsed buildings.

In the rural areas of northwest Syria, there are “tens of thousands of displaced people staying under olive trees in freezing temperatures,” Raed Saleh, head of the opposition’s Syrian Civil Defense, also known as White Helmets, said during a news conference Friday. Saleh said 500 buildings in northwest Syria have been completely destroyed, 1,400 partially crumbled and tens of thousands of homes were damaged.

In other earthquake-damaged areas, displaced people crowded into temporary shelters in churches and mosques, schools, hotels and gyms.

On Friday, in his first visit to areas hit by the earthquake, President Bashar Assad and his wife Asma visited two shelters in the northern city of Aleppo and a kitchen preparing 3,000 meals a day for displaced people.

In the coastal city of Latakia, a base of support for Assad, some 2,000 people on Friday evening crammed into the city's sports center.

Under a banner with Assad’s face and a Syrian flag, the floor of the center’s basketball court was crowded with mattresses and sleeping bags. Families huddled in winter jackets to stay warm and ate hot meals provided by a local aid organization.

Wardah al-Hussein, a 67-year-old mother of nine, said she has been sleeping in the stadium since the earthquake. Originally from Aleppo, she was now starting her second displacement.

“We fled from our city and our house was destroyed, and we came here,” she said. “Now because of the earthquake we went through it all again.”

Those whose homes were spared have opened them to relatives and neighbors.

A resident of the rebel-held northwestern town of Atmeh, Mustafa Ali, said that already two families of relatives moved in with his family in his three-room apartment while they wait to see if experts will make sure their own homes are suitable for living.

“What people urgently need now is tents” as well as warm clothes and baby formula, Ali said.

An aid worker based in northern Syria, who spoke on condition of anonymity because he was not authorized to speak to the media, said eight sprawling facilities, including a center where coronavirus patients were once kept, have been opened to host the displaced in the region.

Adding to the troubles of the displaced, he said, food prices are going up in the wake of the earthquake due to limited supplies.

“Our conditions are miserable,” he said. “I need aid now.”