A Pakistani paramedic, right, examines a young injured earthquake survivor at a hospital in quake-hit Shangla in Pakistan’s Khyber Pakhtunkhwa province on Wednesday.

Rescuers raced against time Wednesday to reach cold and hungry survivors of an earthquake that left entire communities in Afghanistan and Pakistan marooned in remote mountainous regions, as the death toll climbed to 370.

Rugged terrain, severed communication lines and an unstable security situation have impeded relief efforts since Monday’s 7.5 magnitude quake ripped through the region, triggering landslides and flattening buildings.

Desperate victims appealed for blankets, warm clothes and food after the quake levelled thousands of homes, forcing many to camp out in the open in freezing weather.

“No one came to help us. We are sitting in open area. There was rain yesterday and no one came to help us,” said Jamil Khan, a 24-year-old quake victim in Shangla, one of the worst-hit districts of Pakistan’s northwestern province of Khyber Pakhtunkhwa.

Pakistan’s confirmed death toll stood at 255 with nearly 1,700 people injured, and authorities warn that the number could spike with many isolated regions still cut off.

People were reported to be running out of food in many remote areas, with children and the elderly helping to dig through piles of rubble for survivors as they waited for aid to arrive.

“We lost everything. We could not save anything,” said another Shangla resident, 60-year-old Hakim Khan, adding that the only thing they had been able to retrieve from the rubble was the body of a boy.

Speaking during a trip to Khyber Pakhtunkhwa, which has seen the bulk of the casualties so far, Prime Minister Nawaz Sharif on Tuesday pledged compensation for those whose homes have been destroyed.

The military has been leading Pakistan’s rescue efforts, sending in medical teams, tents and rations and evacuating some people by helicopter.

“Shelter and hygiene will be most likely the main needs, as it is already snowing in some of the more mountainous areas,” said Shelagh Woods, country representative for medical charity MSF in Pakistan.

Afghan officials said 115 people were confirmed dead and hundreds more injured, with casualties reported from around half a dozen of the country’s 34 provinces, and more than 7,600 homes reported damaged.

Desperate survivors were left marooned on mountaintops in Badakhshan, the remote province where the epicenter was located, but Western charities said the Taliban presence there and in other quake-stricken areas was hindering relief efforts.

The insurgents on Tuesday urged aid organizations not to delay in delivering relief, and vowed their fighters would provide “complete help” in affected areas.

But there was no let-up in fighting despite those assurances.

The militants on Wednesday claimed to have overrun the remote district of Darqad in the quake-hit northern province of Takhar, underscoring the fragile security situation facing relief workers.

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