Khuzdar - Pakistan's military on Wednesday rushed to reach the scene of a huge earthquake that killed at least 208 people and toppled many mud-built homes when it hit the country's south 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.
"The number of dead from the earthquake has reached 208 now. The injured are over 382," Asad Gilani, one of the province's most senior administration officials, told AFP.
"The rescue teams are working to recover dead bodies and injured, but our priority is to shift injured to hospitals as soon as possible," he said.
Provincial government spokesperson Jan Muhammad Buledi confirmed the new death toll and said: "We are seriously lacking medical facilities and there is no space to treat injured people in the local hospitals.
"We are trying to shift seriously injured people to Karachi through helicopters and others to the neighbouring districts."
Deaths to rise
The scale of the territory involved is daunting. Awaran district has an estimated population of around 300 000, scattered over an area of more than 21 000km2.
More than 60 000 people live within 50km of the epicentre, according to the UN disaster agency, mostly in easily collapsed mud homes.
"We have been busy in rescue efforts for the whole night and fear we will recover more dead bodies from under the rubble during the daylight," said a senior official in Awaran, Abdul Rasheed Baluch.
"Around 90% of houses in the district have been destroyed. Almost all the mud houses have collapsed."
Some of the dead have already been laid to rest in their villages, he added.
The army sent medical teams and helicopters to help with the relief effort, along with 300 soldiers - a number the military said would rise to more than 1 000 later on Wednesday.
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, aged 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 of Gwadar, officials said.
"The island, which is up to 30m high 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.
"There are not many doctors in the area but we are trying to provide maximum facilities in the affected areas," Jan Muhammad Baledi, a spokesperson for the Baluchistan government, said on the ARY news channel.
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 violent and unstable.
It is a flashpoint for growing violence against minority Shi’ite 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.