A 7.7-magnitude earthquake has hit central Burma, with powerful tremors felt across Thailand and China. At least 20 people have been reported dead after the quake struck near Mandalay, Burma’s second-largest city, followed by a strong 6.4 aftershock 11 minutes later. Hospital patients were forced to evacuate to a parking lot, many still hooked up to intravenous drips and oxygen tanks, as the earthquake rattled the city. Buildings were left in ruins, while power lines and several bridges collapsed. Dozens of injured people have been rushed to the hospital. Burma’s military regime has declared a state of emergency across six regions, including in the capital, Naypyitaw.

Burma is one of Asia’s poorest nations, still reeling from a devastating war sparked by a military coup in 2021. Humanitarian aid groups have warned of challenges in assessing the true toll of the damage and accessing impacted communities due to the ongoing conflict between the Burmese military and other militia groups. Electricity and communication lines are also down.

In Thailand, at least three people were reported dead in Bangkok when a 30-story skyscraper that was under construction collapsed. Dozens remain buried.