Authorities expect the death toll to rise even further after a powerful earthquake collapsed at least one coal mine and many flimsy mud houses in southwest Pakistan.
A powerful earthquake killed at least 20 people and injured more than 200 early on Thursday, an official said.
The death toll was expected to rise even further as crews searched in the remote mountainous area, said Suhail Anwar Shaheen, the local deputy commissioner.
At least four of the dead were killed when the coal mine in which they were working collapsed, said Shaheen, citing coal miners in the area. As many as 100 homes also collapsed, burying sleeping residents inside.
The epicentre of the 5.9 magnitude quake was about 14 kilometres north-northeast of Harnai in Baluchistan province, according to the US Geological Survey. The initial measurement of the quake's strength was 5.7 magnitude. It struck about 20 kilometres below the Earth's surface; shallower quakes tend to cause more damage.
The area, about 100 kilometres from Quetta, the provincial capital, is dotted with coal mines, which has Shaheen worried the death toll could rise. It struck in the early morning while scores of miners were already at work, he said.
Most of the population in the area live in sunbaked mud houses, many of which collapsed. Rescue efforts were underway, but Shaheen said it would take hours just to reach many of the hardest-hit areas.
Local TV channels showed residents wrapped in blankets sitting on the side of the road waiting for the aftershocks to subside and help to arrive.