In a hospital in earthquake-hit northwest Syria, 8-year-old Hanaa keeps asking for news of her family, unaware she is the sole survivor among her immediate relatives.

Her father, mother and 4-year-old sister were among the nearly 40,000 people killed in the twin 7.7 and 7.6-magnitude quakes that struck Türkiye and Syria on Feb. 6.

After years of war and displacement in Syria, the disaster orphaned many children when their families were lost under the rubble.

"She keeps asking for her father, her mother and her sister," said Abdullah Sherif, Hanaa's uncle, at Maarrat Misrine hospital in Syria's northwestern Idlib province.

"We have not dared to tell her the truth yet."

Hanaa was trapped for 33 hours under the rubble of her collapsed building in the border town of Harim, before she was pulled out and rushed to the hospital about 25 kilometers (15 miles) away.

When she got there, she was "in a critical condition," her doctor Bassel Staif said. "She suffered severe dehydration, having been under the rubble without food or water and in the cold weather."

Hanaa's condition has since stabilized, and she sometimes smiles despite the injuries on her face.

But her left arm, which is in a cast, was crushed during the quake, Staif said, noting that his team is doing its best to save it.

"She has now left the intensive care unit, her condition is stable. But she is at risk of having an arm amputated."

'Trauma on top of trauma'

In the hospital room packed with Valentine's Day balloons, Hanaa's uncle remains by her side. But he fears her condition will only worsen when she learns of her family's fate.

The little girl has only her grandparents and uncles to raise her in this opposition-held region, home to some 4 million people, many of them displaced from other parts of war-torn Syria.

Last week's quake has affected more than 7 million children, including 2.5 million in Syria alone, according to James Elder, spokesman for the U.N. children's agency UNICEF.

He says the disaster has piled more misery on Syrian children who have only witnessed tragedy in their lives because of the war that broke out more than a decade ago.

Every child under the age of 12 "has known nothing but conflict, violence or displacement," said Elder. "Some children have been displaced six or seven times.

"For many of these children ... this is trauma on top of trauma."

Samah Hadid of the Norwegian Refugee Council has also warned that children are at "grave psychological risk due to the scale of the shock."

'Only screams'

Three-year-old Arslan was the sole survivor from his family after their building in Harim was one of least 35 destroyed.

His uncle, Ezzat Hamdi, says rescuers kept digging for three days to find the bodies of Arslan's father, mother and siblings.

"We found the father's body hugging the boy," said Hamdi, 30, adding that the mother's body was found 2 meters away.

The little boy has since been kept in intensive care, with Hamdi watching over him.

"The child's lower limbs were crushed" and he suffered internal damage, said doctor Omar al-Ali of the children's hospital in Sarmada.

For Obada Zikra, a member of the White Helmets rescue group that operates in Syria's rebel-held areas, the first hours of the quake disaster were the most agonizing.

"We could only hear the screams and moans of children," he said, noting the brief bursts of joy whenever rescuers found a child alive.

"We have pulled out many children who are still alive, but also dead ones," he said.

"The children of our region have lived through many tragedies. We hope that they will lead different lives... and enjoy the support that any child in the world gets."