Ascoli Piceno, Italy(CNN) Italy began the painful task of burying its dead Saturday following a massive earthquake, as aftershocks rattled the heart of the country and the death toll climbed to 291.
Some of the mourners at a state funeral for Italy's earthquake victims were clearly in shock as they said goodbye to victims.
In the town of Ascoli Piceno, a local gym was transformed into a funeral hall, a basketball net the backdrop of the altar.
Survivors: 'The future is finished'
Thirty-five coffins adorned with flowers and framed photographs sat in three rows for victims from the town of Arquata del Tronto in the state funeral. Taped at the foot of each coffin was a white paper with the name of the deceased.
Wreaths delivered for the state funeral.
READ: Historical treasures lost, damaged in Italian quake
Hundreds attended the state funeral and Catholic service to lay their loved ones to rest.
A woman at the funeral named Maria said she lost friends and family in the quake, and described how she and her husband used their bare hands to dig neighbors out of the rubble.
"Community is very important. In small villages like this. The relationship with the land and those you love, with our family, is very, very strong. It will be even stronger. We won't give up," she said.
Italy quake highlights our vulnerability to disasterFamily members clustered around each coffin before the service, a teenager sitting on the floor beside one, weeping inconsolably. One family encircled a coffin with peach-colored flowers and held each other in a long embrace.
Mourners grieve at Italy's state funeral for earthquake victims.
Hundreds of people attended the Catholic ceremony of prayers, Bible readings and hymns, many themselves survivors in casts and bandages. A wall hanging of Jesus on a crucifix overlooked the grieving community, as mourners fanned themselves in the stifling heat.
'A new spring'
Among the coffins was one belonging to a young girl named Giulia Rinaldi. Bishop Giovanni d'Ercole, who led the ceremony, told the painful story of how Giulia was found dead on top of her younger sister, Giorgia, apparently shielding her sibling from the downfall.
Earthquake strikes central Italy
Firefighters help residents recover personal belongings from damaged houses in the village of Rio, Italy, on Sunday, August 28. A 6.2-magnitude earthquake struck central Italy on Wednesday, killing more than 290 people. The death toll is expected to rise as rescue teams reach remote areas.
Firefighters stand by an excavator in Amatrice, Italy,on August 28, as dangerously damaged buildings and overhanging ledges are pulled down.
A rescued dog receives treatment in a veterinary care unit in Amatrice, Italy on August 28.
Volunteers on motorbikes drive through the town of Villa San Lorenzo a Flaviano, Italy, on August 28 as they bring supplies to smaller villages.
A destroyed house is seen on Saturday, August 27, in Pescara del Tronto, Italy.
Police inspect rubble and debris in Amatrice, Italy, on August 27.
A drone controlled by Italian firefighters flies over damaged houses in San Lorenzo, Italy, on August 27.
Damaged coffins and rubble are seen at the cemetery of Sant'Angelo, Italy, on August 27.
Rescuers of the Italian Red Cross carry the body of a victim in Amatrice, Italy, on Friday, August 26.
Firefighters and rescue workers stand near the damaged Sant'Agostino church and a destroyed ice cream shop in the Italian village of Amatrice on Friday, August 26.
A woman rests in the courtyard of a convent in Amatrice on August 26.
Firefighters inspect a damaged building from the elevated platform of a firetruck in Amatrice on August 26. Amatrice has been the hardest-hit town, with more than 200 killed there.
An aerial view shows the damage in the village of Saletta on August 26. Strong aftershocks in the region have rattled residents and emergency crews.
A man and woman comfort each other in front of a collapsed house in Amatrice on August 26.
Firefighters cordon off an area around the rubble from a destroyed building in Amatrice on August 26.
Emergency team members set up a tent camp for earthquake victims at a sports field in Arquata del Tronto on August 26.
Rescuers make their way through destroyed houses in Pescara del Tronto on Thursday, August 25. It's unclear how many people remain trapped under debris.
A field kitchen in Amatrice provides meals for emergency workers and earthquake survivors on August 25.
Rescue and emergency service personnel use an excavator to search for victims under the remains of a building in Amatrice on August 25.
An old building in Amatrice is partly damaged after the quake.
An emergency services helicopter takes off in Amatrice as rescuers continue the search for survivors.
A man rests on a bench after spending the night in a makeshift camp set up inside a gym in Amatrice on August 25.
A bird's eye view of Amatrice shows the devastation after the deadly quake struck on Wednesday, August 24.
Rescuers help a woman from the rubble in Amatrice on August 24.
Search-and-rescue teams survey collapsed houses in Pescara del Tronto on August 24.
A man cries as another injured man is helped in Amatrice.
This woman in Amatrice was wounded during the earthquake.
Rescuers carry a man through earthquake debris in Amatrice.
Rocco Girardi receives treatment after being rescued from the rubble in Arquata del Tronto on August 24.
The body of a unidentified child lies on a bench in Arquata del Tronto on August 24.
The quake left this house in ruins in Arquata del Tronto.
Two people hug each other next to damaged houses in Pescara del Tronto.
Two women pass along a stuffed toy in Amatrice on August 24.
Residents take in the damage in Amatrice.
This aerial photo shows damaged buildings in Amatrice. The quake struck at 3:36 a.m and was felt across a broad swath of central Italy.
An emergency hospital camp is set up to treat earthquake victims in Arquata del Tronto.
A woman tries to comfort her child in Amatrice on August 24.
Residents survey a collapsed staircase in Amatrice on August 24.
Residents of Pescara del Tronto care for an elderly earthquake victim on August 24.
Search-and-rescue teams look for survivors in Pescara del Tronto.
Survivors sit among the rubble of a house in Amatrice on August 24.
Residents search for victims in Amatrice.
An injured man is rescued from a collapsed building in Amatrice on August 24.
A man leans on a wall in Pescara del Tronto.
A dog searches for people trapped in collapsed buildings in Amatrice.
Rescuers search for victims in Amatrice on August 24.
A man is pulled alive from the rubble.
A man surveys damage near a dust-covered car in Amatrice on August 24.
Two people huddle together in Amatrice after the earthquake.
A rescue worker drives a truck of rubble as cleanup operations begin in Amatrice.
"They were holding each other, between them in embrace, both death and life," he said.
"A lot of the dead were children. So a thought to you young people -- we are now living in a time of war ... The earthquake is like a war because nature does not forgive. We have to defend ourselves because it is wise. We must have a dialogue with nature and never provoke nature," he said.
Relatives and friends attend a night vigil in Ascoli Piceno, Italy, ahead of Saturday's funeral.
But he also said that after the tragedy, the communities affected would be given new life: "A new spring and a new birth come."
"Faith is difficult. But faith shows us how to start again, with your feet on the ground and your face towards heaven."
The bishop led Holy Communion and blessed the dead, waving incense over their coffins as mourners signed the cross.
Scouts hold hands to form a ring around grieving families.
Italian Prime Minister Matteo Renzi and President Sergio Mattarella attended the the funeral, meeting with mourners and consoling them, making sure to reach each and every family on what was declared a national day of mourning.
'They're dead inside'
Outside the gym, 20-year-old Paul Manaut from Rome said he had been on holiday in the region with his family but had returned home to Rome when the quake struck. He grabbed everything he had from his apartment that would be of use -- toilet paper, shampoo -- and rushed back to the area, finding that he had lost some of his friends.
State funeral held for Italy's earthquake victims
Firefighters carry the coffin of 9-year-old Giulia Rinaldo outside the gymnasium for the state funeral service for victims of the earthquake in Ascoli Piceno, Italy, Saturday, August 27.
A woman touches a coffin of one of the victims during the funeral.
From left, Italian President Sergio Mattarella, Italian Senate President Pietro Grasso, Italian Lower Chamber President Laura Boldrini and Italian Prime Minister Matteo Renzi attend the funeral service.
A priest conducts services during the funeral.
Relatives mourn near coffins of victims during the service.
Relatives gather around the coffin of a victim.
Italian Prime Minister Matteo Renzi, left, comforts a woman at the end of the state funeral service.
After the service, he said he hoped to start a Facebook campaign to help raise money to buy items for victims, including televisions so that the kids could play video games and the adults could watch movies to forget the disaster.
"They need help. They're not strong enough yet. They haven't even realized what happened. With our help and everybody's help, we're going to build them up, because it's not the houses that fell -- a house is a house ... It's the people, they're dead inside," he said.
Aftershocks continue
Even as communities mourned, the aftershocks rattled central Italy early Saturday, the US Geological Survey reported.
The rescue efforts continue through the aftershocks, though hopes of finding more people alive are quickly fading. Experts say the chances of survival drop significantly after a 72-hour period, a window that closed early Saturday.
In a hospital in Ascoli Piceno, one man talked about how he lost his mother in the earthquake.
"My first thought is my mother is here but I can't help her," Mattia Rendina said from his hospital bed, his bones fractured, his face bruised.
"She passed away to God. She's gone now," he said, tears welling up in his eyes.
"I'm like this because my mother [taught] me to be a person like this. To be strong."
2,500 displaced in camps
To accommodate the displaced, emergency camps have been set up across affected areas, offering food, shelter and psychological support to those who have lost their homes and loved ones.
The Civil Protection Agency said 2,500 were living in the camps, and that more were being built to meet the enormous need.
Images from an Amatrice camp showed people lining up for pasta and an elderly couple sitting on the edge of mattresses on a gym floor, having a meal as those around them hugged and consoled one another.
The Italian Council of Ministers approved a state of emergency Thursday for the regions affected by the earthquake, allocating 50 million euros (about $56.5 million) in funding.
People prepare to spend the night Thursday in a makeshift camp set up in a gym in Amatrice.
Residents gathered at a square in Amatrice, some of the women crying and hugging, as dust still lingered in the air. Men stood in stoic silence.
'So many dead, so many children'
At a camp in Sant'Angelo, northeast of Amatrice, people gathered and shared their stories of loss.
"There is no hope, too many people dead. And Amatrice doesn't exist anymore," Angelina Leone said, holding back tears. "Amatrice has disappeared, and there are so many dead, so many children."
At yet another camp in Accumoli, Anna Maria Volpetti, 52, said she had been visiting her hometown with her family when the quake hit.
"We are lucky," she said. "The earthquake was brutal."
CNN's Atika Shubert and journalist Livia Borghese reported from Ascoli Piceno. CNN's Bharati Naik contributed and journalist Angela Dewan wrote from London.