DALBADI, PAKISTAN – Survivors built makeshift shelters with sticks and bedsheets Wednesday, a day after their mud houses were flattened in an earthquake that killed 348 people in southwestern Pakistan and pushed a new island up out of the Arabian Sea.

While waiting for help to reach remote villages, hungry people dug through the rubble to find food. The country’s poorest province was struggling with a dearth of medical supplies, hospitals and other aid.

The quake flattened wide swaths of Awaran district, where it was centered, leaving much of the population homeless.

Almost all of the 300 mud-brick homes in the village of Dalbadi were destroyed. Noor Ahmad said he was working when the quake struck and rushed home to find his house leveled and his wife and son dead.

“I’m broken,” he said. “I have lost my family.”

At least 373 people were also injured, according to a statement from the National Disaster Management Authority, which issued the latest death toll.

Doctors in the village treated some of the injured, but due to a scarcity of medicine and staff, they were mostly seen comforting residents.

The remoteness of the area and the lack of infrastructure meanwhile hampered relief efforts. Awaran district is one of the poorest in Baluchistan province. Just getting to victims was challenging in a region with almost no roads and where many people use four-wheel-drive vehicles and camels to traverse the rough terrain.

“We need more tents, more medicine and more food,” said a spokesman for the provincial government, Jan Mohammad Bulaidi.

Associated Press images from the village of Kaich showed the devastation. Houses made mostly of mud and handmade bricks had collapsed. Walls and roofs had caved in, and people’s possessions were scattered on the ground. A few goats roamed the ruins.

The Pakistani military said in a statement it had rushed almost 1,000 troops to the area overnight and was sending helicopters as well. A convoy of 60 army trucks left the port city of Karachi early Wednesday with supplies.

Pakistani forces have evacuated more than 170 people from various villages around Awaran to the district hospital, the military said. Others were transported to Karachi.

One survivor interviewed in his Karachi hospital bed said he was sleeping when the quake struck. “I don’t know who brought me from Awaran to Karachi, but I feel back pain and severe pain in my whole body,” he said.

Bulaidi, the provincial spokesman, said he didn’t know what had happened to the man’s family and that he was trying to contact relatives.

Local officials said they were sending doctors, food and 1,000 tents for people who had nowhere to sleep. The efforts were complicated by strong aftershocks.

Baluchistan is Pakistan’s largest province but also the least populated. Awaran district has about 300,000 residents spread out over 29,000 sq. km.

Medical facilities in the province are few and often poorly stocked with supplies and qualified personnel. The local economy relies mostly on smuggling fuel from Iran or harvesting dates.

The area where the quake struck is at the center of an insurgency that Baluch separatists have been waging against the Pakistani government for years. The separatists regularly attack Pakistani troops and symbols of the state, such as infrastructure projects.

It’s also prone to powerful earthquakes. A magnitude 7.8 quake centered just across the border in Iran killed at least 35 people in Pakistan last April.

Tuesday’s shaking was so violent it drove up mud and earth from the seafloor to create an island off the Pakistani coast. Residents were seen visiting it Wednesday and taking stones as souvenirs.