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Ünal Boybey and his family were left on their own to dig the bodies of their relatives out of the rubble in the devastated Turkish city of Adıyaman. Then they also dug the graves.

“Normally municipal workers would do this,” said the 63-year-old as he watched two younger relatives shovel clumps of rust red earth at the city’s overflowing New Cemetery. “But they don’t have enough people. And there are so many bodies. We’re having to do it all on our own.”

Adıyaman, a city of 300,000 people set against snowy mountains, has suffered appalling damage from the huge 7.8 magnitude earthquake that struck Turkey and neighbouring Syria on Monday. Countless buildings have been flattened, thousands have been killed and food and shelter is in short supply. The state is struggling to cope.

At the university teaching hospital, bodies lay on trolleys outside the main entrance as people waited for relatives to bring vehicles to pick them up.

An exhausted surgeon wearing blood-flecked scrubs said he and his colleagues were running short of medicine and equipment, and had resorted to amputating limbs of quake victims — he estimated about 100 so far this week — using a metal-cutting saw. “There’s no Afad,” he said, referring to the government-run disaster agency. “There’s no state.”

That is not quite true. In the city centre, state-owned ambulances zigzagged their way through the rubble. Soldiers from a local barracks had been put in charge of directing traffic on the main boulevard, where almost every building had either suffered damage or collapsed.

Even at the cemetery, where more than 50 cars serving as makeshift hearses were queueing to enter, there were a few municipal vehicles for carrying corpses. Hacı Yıldırım, the driver of one of them, broke down in tears as he watched four more bodies being unloaded. “I can’t tell you how many I’ve brought,” said the 48-year-old. “We’re in a very bad way.”

In a country with a large and active state, many have been left shocked and enraged by the sudden vacuum. Adıyaman’s governor was confronted by angry citizens who shouted: “Where’s the aid?” and “Adıyaman is all alone”. Later, the country’s transport minister, who was visiting the quake-hit city, was confronted by a furious crowd.

President Recep Tayyip Erdoğan this week conceded there had been problems in delivering aid but insisted these were now solved. He also warned against listening to “provocateurs” — taken by some to mean those in the media and opposition who have criticised his government’s response.

Yet in Adıyaman, experienced relief workers were stunned by the lack of co-ordination.

A trained search and rescue volunteer from Istanbul said that, when he arrived in the city on Monday, 14 hours after the quake, he sought guidance from Afad on where to go first — and was met with a shrug. “How’s that possible?” he said with disbelief.

A municipal worker from another Turkish province who led the delivery of 10 diggers said the vehicles had waited on the back of a truck for three hours because it was unclear what to do with them.

The man, who like the rescue worker asked not to be named, said: “In those three hours, how many lives have been could be saved? The local government here is very weak and disorganised.”

In the absence of the state, it has been left to more informal networks to attempt to fill the gap.

In one street, a chef, a student and a packaging producer from Ankara were handing out pasta, noodles and nappies from the back of a van that they had driven 800km from the Turkish capital after heeding the call of a religious foundation. In another, volunteers from an Islamic charity in the province of Isparta gave out blankets, mattresses and children’s clothes.

But such sights were sporadic, and many were having to manage without outside help.

Ayfer Vural, a 42-year-old teacher, took shelter with friends and neighbours in a makeshift tent made out of scavenged materials — including a wood-burning stove. “We tried to get one from Afad but they said there weren’t enough,” she said. Local people had knocked down the walls of supermarkets and grocery stores, she added, to get hold of enough food and water.

The leader of Turkey’s largest opposition party has sharply criticised the government’s response to the crisis, claiming the destruction is the result of “profiteering” by Erdoğan and his allies in the construction sector, whom he accused of misusing taxes intended to support earthquake preparedness.

In Adıyaman — which is deeply conservative and backed Erdoğan with 67 per cent of the vote in 2018 elections — it remained unclear whether frustration at the response would translate into anger at the Turkish president, who faces a re-election bid in just three months.

Many chided private contractors for scrimping on buildings materials or ignoring planning rules. Some laid the blame at the feet of the local authorities. Others argued that, with a huge area affected and more than 14,000 killed in Turkey alone, even the best-organised state would be overwhelmed.

Asked about the political ramifications of the past few days, a woman sitting beside four long rows of freshly dug graves at the New Cemetery expressed exasperation at the lack of help in reaching trapped relatives.

But she said she did not blame the president for the response to the disaster. “This isn’t Erdoğan’s fault,” she said. “It came from God.”

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