Rescue workers pulled survivors and bodies from buildings tilting precariously in the Taiwanese city of Hualien on Wednesday, after an overnight earthquake killed at least five, injured more than 200 and left dozens missing.
Emergency responders were focusing on a 12-storey apartment block and a nearby hotel, both of which were leaning dangerously after their lower floors pancaked when the 6.4-magnitude quake hit the popular tourist city late on Tuesday.
Local broadcaster TVBS showed rescuers carrying a victim covered in a white sheet from the Marshal Hotel some 14 hours after the quake struck. A walking survivor was rescued a short while later.
There were grave concerns for the badly leaning Yun Tsui residential building, which also housed a restaurant, shops and a hostel.
The national fire agency said 88 people were unaccounted for as of 2 pm (6 am GMT) but it was not immediately clear how many of those were trapped inside buildings.
Dozens of residents — and a pug dog — were rescued with ropes and ladders from the Yun Tsui apartment block overnight. But fire department staff at the site told AFP at least four bodies had been pulled out of the building.
One local resident who lives nearby told AFP how he watched the tower block partially collapse.
"I saw the first floor sink into the ground. Then it sank and tilted further and the fourth floor became the first floor," said Lu Chih-son, 35, who saw 20 people rescued from the building.
"My family were unhurt but a neighbour was injured in their head and is bleeding. We dare not go back home now. There are many aftershocks and we are worried the house is damaged," he told AFP.
Chen Chih-wei, 80, said he was sleeping in his apartment on the top floor of the building when the quake struck.
"My bed turned completely vertical. I was sleeping and suddenly I was standing," he told AFP.
He said he managed to crawl his way to a balcony to wait for rescue, adding that the quake was the strongest he had felt in more than five decades of living in Hualien.
President Tsai Ing-wen visited the apartment block Wednesday morning.
"Now is the prime time for our rescue efforts, our first priority is to save people," she said in a Facebook post.
Four mobile cranes had been brought in on the back of trucks to help prop up the structure, an AFP reporter on the scene said.
Hualien is one of Taiwan's most popular tourist hubs as it lies on the picturesque east coast rail line and near the popular Taroko Gorge.
The foreign ministry said 17 foreigners sought medical treatment for minor injuries.
Local resident Blue Hsu said some of those carried out of the hotel were foreigners.
"The lower floors sunk into the ground and I saw panicked tourists being rescued from the hotel," eyewitness Blue Hsu told AFP.
Officials also said 214 people had been injured in the quake, with 117 people rescued from damaged buildings so far. Some 830 people were in shelters while 1,900 houses were without power.
The quake hit just before midnight (3.50 pm GMT) around 21 kilometres northeast of Hualien, according to the United States Geological Survey.
It followed almost 100 smaller tremors to have hit the area in the last three days and comes exactly two years since a quake of the same magnitude struck the southern Taiwanese city of Tainan, killing more than 100 people.
Most of the deaths from the February 2016 earthquake were from the 16-storey Wei-kuan apartment complex, which toppled on its side and buried many residents in the rubble.
It was the only high-rise in Tainan to crumble completely in that quake.
The safety of the building was called into question immediately after the disaster, when metal cans and foam were found to have been used as fillers in the concrete and residents said there had been cracks in the structure.
Five people were found guilty and sentenced to five years' imprisonment over the disaster, including the developer and two architects, with prosecutors saying they "cut corners" that affected the building's structural integrity.
Taiwan lies near the junction of two tectonic plates and is regularly hit by earthquakes.
The island's worst tremor in recent decades was a 7.6 magnitude quake in September 1999 that killed around 2,400 people.