Ambulances arrive on the road in Paktika province, Afghanistan on Wednesday following a massive earthquake.

Rescue and relief teams are struggling to reach survivors of a deadly earthquake that hit Afghanistan’s remote southeast, killing at least 1,000 people and injuring hundreds more even as the country battles multiple humanitarian crises.

The eastern Paktika province, home to some of the country’s most impoverished farmers and cattle herders, was the worst hit, several officials from the Taliban government said. Casualties and damage were also reported in nearby Khost and Nangahar provinces, which border Pakistan.

The 5.9 magnitude earthquake that hit predawn Wednesday was the worst natural disaster to hit the nation since a landslide in 2014 killed 2,000 people in the northeastern Badakhshan province. The Taliban, which has sent rescue helicopters and officials to the affected areas, has urged the international community to step in and help with relief and rescue efforts.

“It was a bit difficult for the rescue teams to access some of the locations since they are mountainous or have terrible roads,” Bilal Karimi, a Taliban spokesman, said by phone. “This incident was just a tragedy and Afghanistan cannot alone respond to a natural disaster of such scale. We have less resources and we’ve asked the international aid agencies and countries for help.”

A lack of hospitals in the area is also a challenge, Karimi said “but we are trying to transfer the injured to hospitals in Kabul and nearby provinces.”

The majority of houses, most of them simple mud and brick construction, in Paktika’s worst-hit district, Gayan, have collapsed, said Faiz Faizee, a local freelance journalist.

Aid agencies had already been trying to shore up resources to boost health and emergency services in the country that’s in the grips of an economic collapse and spiraling hunger following the exit of U.S. troops last August. The Taliban takeover of the government has led to the drying up of international aid that made up more than 40 percent of Afghanistan’s gross domestic product. The U.S. has also blocked the central bank’s access to some $9 billion in overseas reserves.

“Local responders and institutions have played a critical role in saving lives of thousands who would otherwise still be trapped in the rubble,” Necephor Mghendi, the head of delegation of Afghanistan for the International Federation of Red Cross and Red Crescent Societies said in a press statement. “Following the deadly earthquake, we will have to scale up further our operations in Khost and Paktika.”

U.S. President Joe Biden is monitoring developments and has directed USAID and other federal government partners to assess America’s response options to help those most affected, according to a statement issued by National Security Advisor Jake Sullivan. South Korea has announced aid and Pakistan, Iran and Qatar have sent food supplies and other essential items to the country.

The country, already in its worst drought in three decades, has also been hit hard by the recent surge in food prices, fueled by the war in Ukraine. The United Nations has warned that more than half of the country’s 40 million people are facing acute hunger and a million children could die of starvation.

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