Officials say dozens injured after magnitude 5.9 quake struck remote Harnai while many people were sleeping.

At least 20 people have been killed and more than 200 wounded after an earthquake strikes Pakistan’s southwestern province of Balochistan, local officials say, with rescue teams attempting to clear debris and gain access to the area.

The 5.9 magnitude earthquake struck as most residents of the Harnai district, about 100km (60 miles) east of the provincial capital Quetta, were asleep at just past 3am local time (22:00 GMT) on Thursday, according to United States Geological Survey data.

The tremor took place at a depth of about 20 kilometres (12 miles).

The United States Geological Survey said the quake had a depth of about 5.6 miles, which is considered very shallow and potentially more dangerous because it is closer to the surface. The center of the earthquake was about 60 miles from Quetta, the provincial capital that is near the Afghan border. It is where, in 1935, a 7.7-magnitude earthquake struck, killing up to 60,000 people.

Disaster officials said the death toll from the quake on Thursday was expected to rise. The Pakistani military said its troops had reached the area to help with rescue operations. “Army doctors and paramedics, along with necessary medicines, are assisting civil administration for necessary medical care,” the military’s news media wing said in a statement.

A state of emergency was imposed at Civil Hospital in Quetta, where officials issued a call to all medical personnel for help.

The USGS initially measured the quake at 5.7 magnitude, but revised it to 5.9 a few hours later. It also revised the depth from 20.8 kilometers (12.9 miles) to 9 kilometers (5.6 miles).

The quake caused power outages and damage across Harnai, according to resident Zafar Khan Tareen. The district consists of numerous scattered villages of basic mud houses that are home to coal mining communities.

“We went out and took our children out at the same time. Thank God everyone in our house is safe. However, the roof and walls of the house were badly damaged,” he said.

“Almost all the shops have also collapsed and in every street of villages … one or two people have died and many children are among the injured.”

Harnai resident Muhammad Ali said his daughter was killed when a room in his house collapsed. The other rooms were also badly damaged, with cracks in the walls, he said.

“When the earthquake occurred last night, many people ran out of their houses. We also ran out but one of my daughters died, two other girls were left behind and are injured,” he said.

In a Twitter post Thursday, Pakistani Prime Minister Imran Khan expressed his sorrow at the loss of lives in the earthquake.

“I have ordered immediate assistance on an emergency basis for the Harnai, Balochistan, earthquake victims & for an immediate assessment of the damage for timely relief & compensation. My condolences & prayers go to the families who lost their loved ones,” he wrote.

Sohail Afridi, the district commissioner of Harnai, said rescue efforts were ongoing.

“Since 3 a.m. the rescue operation has been underway. The injured have been taken to the hospital via helicopter,” Afridi said, adding the situation is “currently under control.”

Harnai’s rural location makes it difficult to access, welfare organization Edhi Foundation told CNN.

A road leading to the district has been blocked by a landslide, according to the Balochistan Levies Force, the paramilitary law enforcement group in the province. A video posted by the group on Twitter showed officers working to clear the road, removing debris by hand in the headlights of two vehicles.

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