The death toll from a strong earthquake that hit northern Indonesia's Aceh province on Wednesday has doubled to at least 93, Indonesia's disaster agency said, as rescuers searched dozens of collapsed buildings for trapped survivors.
Search and rescue teams used earth movers to clear rubble and reach what authorities believed were dozens of victims trapped after the magnitude 6.5 quake.
Sutopo Nugroho of the national disaster management agency said a state of emergency had been declared in Aceh, which sits on the northern tip of Indonesia's Sumatra island.
"We are now focusing on searching for victims and possible survivors," Nugroho said.
President Joko Widodo said he had instructed his chief of staff to visit the disaster area.
Aceh was devastated by a massive earthquake and tsunami centred on its western coast near the provincial capital, Banda Aceh, on Dec. 26, 2004.
Wednesday's quake hit the east coast of the province, about 170 km (105 miles) from Banda Aceh. Nugroho said Aceh's Pidie Jaya regency, with a population of about 140,000, bore the brunt of the damage.
"Many of the victims were killed or injured not because of the quake itself but because of collapsing buildings," he said.
Volunteer teams brought injured residents to local hospitals, filling most to capacity. Many of those treated in hospital corridors and hastily erected disaster tents had suffered broken bones and scratches, a Reuters witness said.
Images on television and social media showed victims being rushed to hospital, flattened buildings and fallen electricity poles, and people gathering outside at street corners.
Dozens of residents remain missing, according to Khairul Nova, an official at the Aceh search and rescue agency.
An Indonesian Red Crescent volunteer described scenes of heavy damage and said many people had been injured. "There isn't enough medical staff around," the Red Crescent's Muklis, who like many Indonesians uses one name, told TVOne.
The United States Geological Survey said the quake struck just after 5 a.m. local time (2200 GMT Tuesday) at a depth of 17 km (11 miles). No tsunami warning was issued.
At least five aftershocks were felt in the hours after the initial quake, the disaster management agency said.
The region suffered massive destruction in 2004 when a 9.2 magnitude quake triggered a tsunami that wiped out entire communities in Indonesia and other countries around the Indian Ocean. Indonesia was the hardest hit, with more than 120,000 people killed in Aceh alone.