Pakistan's military Wednesday rushed to reach the scene of a huge earthquake that killed more than 230 people and toppled thousands of mud-built homes when it hit the country's southwest with enough force to create a new island off the coast.
The 7.7-magnitude quake struck on Tuesday afternoon in Baluchistan province's Awaran district — a dirt-poor expanse of land that is roughly the size of Wales.
Officials said 238 deaths had been confirmed so far, 208 in Awaran district, and the toll is expected to rise as rescue teams reach more villages in the remote area.
"A total of six districts — Awaran, Kech, Gwadar, Panjgur, Chaghi and Khuzdar — and a population of over 300,000 have been affected by the earthquake," Jan Muhammad Buledi, spokesman for the Baluchistan government, told AFP.
The head of the provincial disaster management agency, Abdul Latif Kakar, told AFP 30 people had died in Kech district, a toll confirmed by a senior local official.
Buledi said teams were working to recover bodies, but the priority was to move the injured to hospitals as soon as possible — a difficult task in a desolate area with minimal infrastructure.
"We are seriously lacking medical facilities and there is no space to treat injured people in the local hospitals," he said.
"We are trying to shift seriously injured people to Karachi through helicopters and others to the neighbouring districts."
The army has sent 100 medical staff and 1,000 troops to the area to help with rescue efforts and has established a medical centre in one of the worst-affected villages, Tarteej.
The scale of the territory involved is daunting. Awaran's population is scattered over an area of more than 21,000 square kilometres (8,000 square miles).
More than 60,000 people live within 50 kilometres of the epicentre, according to the UN disaster agency, mostly in easily collapsible mud homes.
Abdul Rasheed Baluch, a senior official in Awaran, said teams had worked through the night to try to retrieve bodies and survivors from the rubble.
"Around 90 percent of houses in the district have been destroyed. Almost all the mud houses have collapsed," he said.
Some of the dead have already been laid to rest in their villages, he added.
Tremors were felt on Tuesday as far away as New Delhi and even Dubai in the Gulf, while people in the Indian city of Ahmedabad near the border with Pakistan ran into the streets in panic.
Office workers in Pakistan's largest city Karachi rushed out of their buildings.
"Whenever I feel jolts it reminds me of the 2005 earthquake in Kashmir," said Amjad Ali, 45, an IT official standing in the street in Karachi after the quake hit.
The 7.6 magnitude quake in 2005 centred in Kashmir killed at least 73,000 people and left several million homeless in one of the worst natural disasters to hit Pakistan.
New island emerges
A new island appeared after Tuesday's quake close to the Pakistani coastline at Gwadar, officials said.
"The island, which is up to 100 feet high (30 metres) and 200 feet wide, surfaced after the earthquake hit parts of Baluchistan," senior local administration official Tufail Baluch told AFP.
He said a similar island had appeared at the same place in the sea about 60 years ago but disappeared after some time.
The US Geological Survey issued a red alert on Tuesday, warning that heavy casualties were likely based on past data, and the provincial government declared an emergency in Awaran.
Television footage showed collapsed houses, caved-in roofs and people sitting in the open air outside their homes, the rubble of mud and bricks scattered around them.
In April a 7.8-magnitude quake in southeast Iran, close to the border with Baluchistan, killed 41 people and affected more than 12,000 on the Pakistan side of the border.
Iran's Red Crescent reported no damage from the latest quake over the border from Pakistan.
Baluchistan, Pakistan's largest but least populous province, is believed to have substantial gas and oil reserves.
But it is a flashpoint for growing violence against minority Shiite Muslims and has suffered attacks blamed on Taliban militants.
It also suffers from an ongoing separatist insurgency which began in 2004 when Baluch rebels rose up to demand a greater share of profits from the province's mineral resources.