CIANJUR, Indonesia -- Indonesian rescuers used jackhammers, circular saws and sometimes their bare hands Tuesday to shift the rubble of flattened buildings as they searched for the dead and missing from an earthquake that killed at least 268 people.
With many missing, some remote areas still unreachable and more than 1,000 people injured in the 5.6 magnitude quake, the death toll was likely to rise. Hospitals near the epicenter on the densely populated island of Java were already overwhelmed, and patients hooked up to IV drips lay on stretchers and cots in tents set up outside, awaiting further treatment.
Experts said the shallowness of the quake and inadequate infrastructure contributed to the severe damage, including caved-in roofs and large piles of bricks, concrete and corrugated metal.
The quake was centered on the rural, mountainous Cianjur district.
More than 2.5 million people live in Cianjur district, including about 175,000 in the main town of the same name.
The quake struck at a depth of 6.2 miles and also caused panic in the capital of Jakarta, where high-rises swayed and some people evacuated.
National Disaster Mitigation Agency head Suharyanto, who uses one name, told reporters that 1,083 people were injured and at least 151 missing. But not all of the dead have been identified, so it's possible some the bodies pulled from the rubble are of people on the missing list.
Rescue operations were focused on about a dozen locations in Cianjur, where people are still believed trapped, said Endra Atmawidjaja, the public works and housing spokesperson.
"We are racing against time to rescue people," Atmawidjaja said.
Initial rescue attempts were hampered by damaged roads and bridges and power outages. By Tuesday, power supplies and phone communications had begun to improve.
Atmawidjaja said seven excavators and 10 large trucks had been deployed from neighboring areas to clear roads.
In the village of Cijedil, the quake triggered a landslide that blocked streets and buried several houses, said Henri Alfiandi, chief of the National Search and Rescue Agency.
"We are maximizing operations at several points where it is suspected that there are still casualties. Our team is also trying to reach remote areas," he said.
Many of the dead were public school students who had finished their classes for the day and were taking extra lessons at Islamic schools when the buildings collapsed, West Java Gov. Ridwan Kamil said.
More than 13,000 people whose homes were heavily damaged were taken to evacuation centers, Kamil said, though thousands spent the night in the open fearing aftershocks.
Cargo trucks carrying food, tents, blankets and other supplies from the capital arrived early Tuesday in temporary shelters.
Outside the Cianjur Regional Hospital, hundreds waited for treatment.
"I was working inside my office building. The building was not damaged, but as the quake shook very strongly, many things fell. My leg was hit by heavy stuff," said Dwi Sarmadi, who works for an Islamic educational foundation in a neighboring district.
He was waiting near a tent outside the hospital after some overwhelmed clinics were unable to see him.
"I really hope they can handle me soon," he said.
President Joko Widodo visited Cianjur and pledged Tuesday to rebuild infrastructure, including the main bridge connecting Cianjur to other cities, and provide government assistance up to $3,180 to each resident whose house was damaged.
"I would like to express my deep condolences to the victims and their families in this Cianjur earthquake," he said.
Information for this article was contributed by Niniek Karmini of The Associated Press.