At least five people have died and dozens more are missing after a 6.4 magnitude earthquake shook a city on the east coast of Taiwan.
At least five buildings in Hualien City caved in and were shown tilting on their sides in the tourist port city.
Rescuers are working to reach five people they know are trapped in buildings, while more than 140 are unaccounted for.
The worst hit was a military hospital which rescuers have propped up with cranes as it leans at about 45 degrees.
A hotel employee died after the bottom three floors of the Marshal Hotel caved in while another person died in a residential building.
Rescuers are trying to free two people trapped in the hotel as family members wait nearby.
The quake hit just before midnight on Tuesday night, injuring 243 people, with two dozen in a critical condition, Taiwan’s Central News Agency reported.
Video footage and photos showed several large buildings leaning at sharp angles.
Their lower floors were crushed into heaps of concrete, smashed glass, bent iron beams and other debris.
Residents were seen lowering their children from balconies in slanted buildings before climbing down themselves or being helped down by firefighters.
The tremor was felt shortly before midnight on Tuesday, forcing the closure of a busy road nearby.
The epicentre was very shallow at just 10.6km deep and was the 94th tremor since a 6.1 magnitude quake struck nearby on Sunday.
Roads were seen with large cracks in them while the tremor disrupted electricity and water supplies to thousands of households, the National Fire Agency said.
The government said a bridge in the city on Taiwan’s eastern coast could not be used, and the structure of an inn had tilted during the earthquake.
Chen Chih-wei, 80, said he was sleeping on the top floor of his apartment building when the quake struck.
My bed turned completely vertical, I was sleeping and suddenly I was standing, he said.
He said it was the strongest tremor he had felt in more than five decades of living in Hualien.
In a post on her Facebook page, President Tsai Ing-wen said she had arrived in Hualien on Wednesday morning to review rescue efforts.
She said she ordered search and rescue workers not to give up on any opportunity to save people, while keeping their own safety in mind.
This is when the Taiwanese people show their calm, resilience and love, she wrote. The government will work with everyone to guard their homeland.
Chen Tzai-Tung, a worker with the government disaster centre, said it was not safe for rescuers to enter the 12-storey Yunmen Cuiti apartment building where most of the missing are thought to be trapped.
As aftershocks came through the night 830 people went to shelters, including a newly built baseball stadium where beds and hot food were provided.
Taiwan lies along the Ring of Fire, the seismic faults surrounding the Pacific Ocean where the majority of the world’s earthquakes occur.
The island’s worst tremor in recent decades was a 7.6 magnitude quake in September 1999, which killed about 2,400 people.
Two years ago, a magnitude 6.4 quake collapsed an apartment building in southern Taiwan, killing 115 people.
Five people involved in the construction of the building were found guilty of negligence and sent to prison.