DUBAI (Reuters) - Overcrowded hospitals in north-west Iran struggled to cope with thousands of earthquake victims on Sunday and rescuers raced to reach remote villages after two powerful quakes killed at least 250 people.
Thousands of people huddled in makeshift camps or slept in streets after Saturday's quakes in fear of more aftershocks, 40 of which had already struck. A lack of tents and other supplies left them exposed to the night chill, one witness told Reuters.
Casualty figures are expected to rise, officials said, as some of the injured were in critical condition while hundreds were trapped under rubble, inaccessible to rescue workers hampered by darkness in the first hours after the quakes.
"I saw some people whose entire home was destroyed, and all their livestock killed," Tahir Sadati, a local photographer, said by telephone. "People need help, they need warm clothes, more tents, blankets and bread."
The worst damage and most casualties appeared to have been in rural villages surrounding the towns of Ahar, Varzaghan and Harees, near the major city of Tabriz, Iranian media reported.
Many villages are hard to reach by road, hindering rescue efforts. Hospitals in Tabriz, Ardabil and other cities nearby took in many of the injured, residents and Iranian media said, and there were long queues of survivors waiting to be treated.
Aidin, a Tabriz resident, said he went to give blood at a local hospital on Saturday and saw staff struggling to cope with the influx of patients. Most patients had been taken there by their families, he said, indicating a shortage of ambulances.
Ahar's 120-bed hospital was full, said Arash, a college student and resident of the town. There were traffic jams on the narrow road between Ahar and Tabriz as victims tried to reach hospitals, he said by telephone.
"People are scared and won't go back into their houses because they fear the buildings aren't safe."
The U.S. Geological Survey measured Saturday's first quake at 6.4 magnitude and said it struck 60 km (37 miles) north-east of the city of Tabriz, a trading hub far from Iran's oil-producing areas and known nuclear facilities.
The second, measuring 6.3, struck 11 minutes later near Varzaghan, 49 km (30 miles) northeast of Tabriz.
Twelve villages were destroyed and about 60 had more than 50 percent damage in the quakes, Iranian media reported. About 110 villages were damaged, Deputy Interior Minister Hassan Ghadami told Fars news agency.
Ghadami said 250 people had been killed and Red Crescent spokesman Hossein Derakhshan told Fars more than 2,000 people were believed to have been injured.
"We saw some villages that were truly destroyed," said Sadati, who visited the affected area to document the aftermath. "One good thing was that the earthquake happened during the day, so many people were not in their homes. If it had happened at night the casualties would have been far worse."
Seventy-one ambulances and 40 units trained to find survivors had been deployed to the affected areas along with more than 5,000 tents, Derakhshan said.
About 16,000 people in the quake-hit area have been given emergency shelter, Red Crescent official Mahmoud Mozafar told Mehr news agency.
Iranian lawmaker Mohammad Hassan-Nejad warned that if relief efforts did not speed up, the death toll would swiftly rise.
"Relief groups have still not reached many villages, because in normal conditions some of these villages are several hours away," he told the Iranian Students' News Agency (ISNA). "Currently the roads are closed and the only way to reach these villages is by air."
Another lawmaker, Abbas Falahi, told Fars rescue workers had not yet been able to reach between 10 and 20 villages.
Photographs posted on Iranian news websites showed numerous bodies, including children, lying on the floor of a white-tiled morgue in Ahar and medical staff treating the injured in the open air as dusk fell. Other images showed rescue workers digging people out of rubble - some alive, many dead.
Iran is situated on major fault lines and has suffered several devastating earthquakes in recent years, including a 6.6 magnitude quake in 2003 that reduced the historic south-eastern city of Bam to dust and killed about 31,000 people.
Saturday's quakes struck in East Azerbaijan province, a mountainous region that neighbours Azerbaijan and Armenia to the north. Buildings in Tabriz, the provincial capital, are substantially built and ISNA reported nobody in the city had been killed or hurt.
Homes and business premises in Iranian villages, however, are often made of concrete blocks or mud brick that can crumble and collapse in a strong quake.
Interior Minister Mostafa Mohammad-Najjar has arrived in the area and was holding meetings with local officials to coordinate the emergency response, ISNA reported. Thirty groups of experts have been sent to villages to estimate damage and help residents, a housing official told state news agency IRNA.
Water, electricity, and phone lines in the area of Varzaghan are all down, further hindering rescue efforts, Iran's English-language Press TV reported.
Tabriz residents left their homes and crowded the streets following the two quakes, those in the city said. "Everyone was scared last night," a resident said by telephone. "They set up tents and were sleeping in the streets and in parks."
(Additional reporting by Marcus George and Zahra Hossenian; Writing by Andrew Torchia and Marcus George Editing by Pravin Char)