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Helicopters plucked tourists from destroyed, mountaintop resorts as the death toll from Costa Rica's magnitude-6.1 earthquake rose to at least 9 victims, the Red Cross said Friday.
Dozens more remained missing as survivors reported seeing people buried by landslides.
"I watched as the earth took my aunt and my cousins ... I watched them be buried," Miguel Angel Marin told Channel 7 news.
The quake shook the Central American nation Thursday afternoon, collapsing homes, unleashing massive landslides, and trapping hundreds of people in damaged mountain towns.
Red Cross spokeswoman Fiorella Vilca said the dead include 7- and 11-year-old sisters buried in a landslide, a 12-year-old girl whose home was crushed by falling earth, two men found dead in San Pedro de Poas, and three bodies found in a battered truck near the Angel waterfall popular with tourists. Another victim died of a heart attack in the capital, San Jose.
On Friday, rescue officials reached nearly 500 people trapped in the hardest hit zone — a mountainous area with few access roads, most of which were blocked by landslides.
"We are trying to evacuate these areas as soon as possible," Red Cross spokesman Freddy Roman said.
Many residents of the area are small farmers who raise livestock or grow strawberries and ornamental plants. The region has also seen increased tourism in recent years.
Allan Flores, head of the Costa Rican Tourism Institute, told Channel 7 that about 200 Costa Rican and foreign tourists were trapped at the La Paz Waterfall Gardens hotel, a luxury eco-resort in Vara Blanca.
He said no tourists at the hotel appeared to be injured. Those who could hike out were being led to rescue vehicles, while the rest were being airlifted back to the capital.
Local media reported that the resort suffered severe damage in the quake and visitors had to sleep outside.
When a helicopter from Channel 7 flew over the hotel early Friday, before the rescue effort began, a woman shouted in English: "We want to get out of this place!"
Phone calls to the resort went unanswered.
At least three of the deaths were at the waterfalls near the resort.
A Belgian tourist told Channel 7 that she was on a lookout platform near the falls with her husband and his two young children when the quake suddenly collapsed the structure and they fell 20 yards (20 meters).
They survived with only minor injures.
There were also reports of cars being buried by landslides and widespread destruction in the remote town of Cinchona.
Resident Manuel Cambronero told Channel 7 by phone that Cinchona was destroyed.
"The only thing left is the field where we plant strawberries," he said. "It gives me chills just remembering it, because the mountains moved and all the homes collapsed on the ground."
The U.S. Geological Survey said the temblor was centered 22 miles (35 kilometers) northwest of San Jose, near the Poas Volcano National Park.