PORT AU PRINCE, Haiti — A massive 7.2-magnitude earthquake struck Haiti on Saturday morning, killing hundreds of people and shaking buildings from the neighboring Dominican Republic to Jamaica and Cuba, as the international community confronted the prospect of a major escalation in the humanitarian crisis already facing one of the hemisphere’s most deeply troubled nations.

Saturday’s quake was stronger, though centered farther from the capital, than the devastating 2010 temblor that killed more than 220,000, prompting foreign governments and aid agencies to prepare for large numbers of dead, injured and homeless. Officials and witnesses reported heavy damage and fatalities dozens of miles from the epicenter, 7.2 miles northeast of Saint-Louis du Sud, where the quake struck at 8:29 a.m. Haiti’s civil protection office reported at least 304 people had died — most of them in the hardest-hit southern and western areas — with hundreds more missing and 1,800 injured. The death toll is expected to rise amid reports that some neighborhoods had been razed.

Government officials, relief agencies and representatives from the United Nations were still assessing the damage, including via reconnaissance flights over the southern and western parts of the country, as a wave of aftershocks continued to hit Haiti. But the sheer force of the temblor and a climbing death toll suggest a devastating new tragedy in the Western Hemisphere’s poorest nation, which has lurched from crisis to crisis for years.

The disaster struck about a month after the assassination of the president, leaving a hobbled interim government in charge of a country so wracked by gang violence and a collapsing rule of law that observers have dubbed it the Somalia of the Caribbean.

Now, 11 years after the devastating 2010 earthquake, Haitians are again dealing with crushed bodies, collapsed buildings and overwhelmed hospitals.

Authorities mobilized teams to clear roads and bridges that are either damaged by the earthquake or blocked by landslides and deploy medical supplies and food to disaster sites. Hundreds of homes, as well as schools, churches and at least one hospital, they said, have been damaged or destroyed.

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Prime Minister Ariel Henry, who is leading the interim government, declared a state of emergency in the hardest-hit portions of the country. He did not issue a call for immediate international assistance. Referring to foreign earthquake aid after 2010 that Haitians said was ill-spent, he called for all assistance to be “channeled through the state.”

“Everyone who wants to help should get in touch with the operation center for national emergency to determine what we need,” he told reporters in Port au Prince.

At least three urban areas in the southern region — Jeremie, Les Cayes and Baradères — suffered major damage, with fears of even broader damage in villages and towns closer to the epicenter. Although high call traffic had jammed lines earlier in the day, cellular phone infrastructure in the area remained operational.

Ralph Simon, a radio station owner in Jeremie, a city of 30,000 in southwest Haiti, said many homes and buildings had been leveled or damaged, including a church. He said he saw two corpses in the rubble of a church. “The impact of this is huge,” he said. “I was still in bed with my children and my wife. My wife had a heart attack, and I had to save her life … There’s damage to houses. People are crying.”

Images on social media and witnesses portrayed scenes of devastation from collapsed structures, with officials saying residents were pouring into ill-equipped hospitals, bringing the injured in cars and beds of pickup trucks. Neighbors aided rescue workers, trying to lift rubble and knock down walls to reach people.

Preliminary disaster modeling from the U.S. Geological Survey (USGS) predicted hundreds of millions of dollars in damage and thousands of fatalities.

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Silvera Guillaume, civil protection coordinator in the coastal city of Les Cayes, said the community’s resources are being overwhelmed.

“It’s a dire situation, people died. There are people right now under the rubble,” Guillaume said. “We deployed first responders to go and remove rubble, but we do not have enough first responders.”

Améthyste Arcélius, administrator of Immaculate Conception Hospital — the largest in Les Cayes — said that its facilities cannot cope with the wounded and that it is in “desperate” need of personnel and medicines.

“There are lots of victims,” Arcélius said. “The hospital needs emergency drugs, health professionals of all categories. Lots of people are coming. The hospital is flooded with victims. We are issuing a call for help.”

At 8:29 a.m., Jabin Phontus, a 23-year-old agronomy student, said he felt his family home in Les Cayes begin to quake.

“I could see the walls breaking, it was scary,” he said by phone. “I took my sister and ran.”

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His mother and brother also escaped their five-room home as it crumbled, leaving them scraped by falling debris.

“The house is partially destroyed, some walls are still up, but we can’t sleep inside,” he said. “We don’t know where to go now. We are seeking shelter. A lot of houses in the neighborhood are destroyed.”

As he spoke, he said a group of people near him were “trying to break down a wall to get to someone inside” a house.

In Baradères, closer to the epicenter, former Mayor Pascal Calixte said that some neighborhoods were “90 percent” destroyed.

“Everybody is panicked,” Calixte said. “There is a lot of damage. The church is destroyed. Today is market day. But we had landslides and rocks killed some people who were coming to sell their things. In some areas, 90% of the houses were destroyed.”

Among the fatalities was Jean Gabriel Fortuné, an influential politician and former mayor of Les Cayes. He and least one other person died when the hotel he owned and lived in, Le Manguier, caved in, according to Duples Plymouth, a communications aide for Fortuné.

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Foreign governments have begun to respond to the crisis. The White House said President Joe Biden had been briefed on the situation and had authorized an immediate response, naming U.S. Agency for International Development Administrator Samantha Power as the senior U.S. official to coordinate the effort.

Haiti became an center for charities and nongovernmental organizations in the aftermath of the 2010 earthquake. But many organizations have left, particularly in recent years as the country has descended into violence. Those remaining are scrambling to respond.

Christy Delafield, spokesperson for the charity Mercy Corps, said the group is moving to mobilize a team to the area, but relief workers face logistical challenges. The main road to the area runs through gang-filled territories just south of Port-au-Prince, leaving aid groups to focus on access by air.

But the regional airport in Les Cayes is a rural airstrip with limited capacity and is already overwhelmed.

“We saw a similar situation with Hurricane Dorian” that struck the Bahamas in 2019, Delafield said. “There isn’t a lot of capacity in that area to handle assistance.”

Muhamed Bizimana, assistant country director for Care Haiti, said his organization was also facing logistical challenges, and was having to rely on “local staff” for assessments in the hardest-hit areas, given the risks of traveling over land through gang-controlled regions south of Port-au-Prince.

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“We’re exploring maritime transport,” he said.

Shelters for untold numbers of those experiencing homelessness — especially in denser urban areas in the south and west — remain an immediate priority, he said.

But longer term, the quake has the potential to worsen a hunger crisis in the country. He said he had received reports of crops in the south destroyed by landslides in the aftermath of the earthquake.

“This has not been a good year for Haiti,” Bizimana said. “It’s one crisis after another.”

In a statement, Leila Bourahla, Haiti’s country director of Save the Children, said its staff on the ground saw “horrific devastation.”

“Dozens of collapsed houses, numerous injured people and fatalities,” Bourahla said. “While it will take days to assess the full scale of the damage, it is clear that this is a massive humanitarian emergency.”

The reported magnitude from the USGS was greater than the catastrophic 7.0-magnitude earthquake that hit seven miles west of Port-au-Prince in 2010, which resulted in more than 220,000 casualties. The quake on Saturday struck farther away from the densely populated capital. But USGS noted that people in the most heavily-hit areas largely reside in poorly constructed dwellings that are vulnerable to earthquake shaking.

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The earthquake is set to deepen a humanitarian crisis in a country battling hunger, poverty and violence that never fully recovered from the 2010 quake. After the devastation of Hurricane Matthew in 2016, 1.4 million Haitians required humanitarian assistance.

U.N. agencies report 46% of the population is already experiencing acute or severe food insecurity — among the highest in the world. Aid agencies face massive hurdles to transport aid south of the capital, given the open gang warfare on National Road 2 — the nation’s major western and southern artery.

Until last month, Haiti was one of a small number of countries in the world that had yet to roll out a coronavirus vaccination campaign — and the only country in the Americas. Meanwhile, coronavirus cases have surged as thousands fleeing violence have packed into overcrowded shelters around the capital.

Haiti also entered a new period of political instability in the aftermath of the assassination of President Jovenel Moïse in July.

Jose Luis Fernandez, the United Nations Food and Agriculture Organization representative in Haiti, said southern portions of the country were already facing “severe and acute” food shortages.

The earthquake “will worsen the food insecurity situation in the country, especially in areas of the south. There are pictures of many roads and bridges that have been destroyed. This is going to disrupt the flow of food.”

Haiti reeled from the quake even as the nation looked to the east with trepidation, with Tropical Storm Grace bearing down on the island nation. The storm, with maximum sustained winds of 45 mph, was poised to arrive sometime Monday, running a risk of heavy rainfall.

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Faiola reported from Miami.