Many survivors of Morocco’s earthquake were struggling in makeshift shelters on Tuesday after a fourth night outside, while villagers in devastated mountain areas voiced frustration at having received no help from the authorities. The death toll from the 6.8 magnitude quake that struck in the High Atlas Mountains late on Friday rose to 2,901, while the number of people injured more than doubled to 5,530, state television reported.

It was Morocco’s deadliest earthquake since 1960 and its most powerful in more than a century.

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 be approved.

The situation was most desperate for people in remote areas cut off by landslides triggered by the earthquake that blocked access roads, while in accessible locations relief efforts were stepping up.

Mehdi Ait Bouyali, 24, was camping in the open along the Tizi n’Test road, which connects remote valleys to Marrakech, with a few other survivors who had also fled their destroyed villages. He said the group had received food and blankets from people driving by but nothing from the state.

“The villages of the valley have been forgotten,” he said. “We need any kind of help. We need tents,” he said.

Hamid Ait Bouyali, 40, was also camping on the roadside.

“The authorities are focusing on the bigger communities and not the remote villages that are worst affected,” he said.