Survivors of a 7.7-magnitude earthquake that hit a remote region in Pakistan's province of Balochistan Tuesday wait in searing heat for government aid to arrive as more than 100,000 people have been left homeless by the disaster, which has killed at least 515 people.
Babar Yaqoob, chief secretary of Balochistan, gave the updated death toll Friday as he was touring the destroyed district of Awaran, where the earthquake struck.
Survivors spent another night in the open or under makeshift shelters Thursday night as response teams struggled to reach the remote region in the southwestern province.
The population of Awaran is scattered over more than 13,000 square miles of rugged terrain, where infrastructure is limited and there are few medical facilities or even roads.
Photos: Deadly earthquake strikes Pakistan
Al Jazeera's Kamal Hyder, reporting from Awaran Thursday, said conditions were desperate among the survivors and many were going without food, water and shelter, having lost everything in the quake.
Doctors in a village treated some of the injured, but because of a scarcity of medicine and staff, they were mostly just comforting residents.
"We need more tents, more medicine and more food," said Jan Mohammad Bulaidi, a spokesman for the provincial government.
He told Al Jazeera that more than 2,000 tents and food packages have reached the affected areas.
"We have reached the Awaran headquarters, and many of the affected areas are very far away. As you can imagine, we have many issues in getting aid to those areas," he said. "There is also the danger of militancy in these areas."
The area where the quake struck is home to Baloch separatists waging a decades-long armed movement against the state.
Highlighting the danger from militants, a helicopter carrying National Disaster Management Authority Chief Maj. Gen. Alam Saeed came under rocket fire in Awaran; no damage was done, and no one was hurt.
Hours later, paramilitary troops helping the relief effort were fired at with small arms by suspected rebels about 12 miles north of Awaran, but there were no casualties, a senior security official told Agence France-Presse.
The Pakistani military said it rushed almost 1,000 troops to the area overnight and was sending helicopters as well. A convoy of 60 Pakistani army trucks left the southern port city of Karachi early Wednesday with supplies.
The government was preparing to send more than 14,000 tents, Interior Minister Chaudhry Nisar said, and was using a plane to get to hard-to-reach areas.
The earthquake is Pakistan's deadliest since the Kashmir tremor of 2005, which killed 73,000. The toll is expected to rise as rescue teams dig through the rubble of countless flattened mud-brick homes.
Nisar told parliament "huge activity" was under way to help those affected, but he said teams were struggling to reach some areas, even 40 hours after the quake.
In Awaran town, about 200 survivors demonstrated outside government offices, complaining that they had not been given food or shelter.
Survivors in Gajjar, about 74 miles east of Awaran, where the quake killed at least 108 people, said they had scavenged for food and criticized the lack of government aid.
"The government is completely missing, and we have not received a single relief item like tents or food," survivor Abdul Razzaq said.
"We don't even have tents to cover my kids," said Haji Wajd Ali, who lives in the village of Labach, where every other house was destroyed. "There are no shops. There is no food. There is no water," he said as temperatures reached 100 degrees Fahrenheit during the day.
Balochistan, Pakistan's largest province, is its least densely populated and poorest region. Separatists, who have increasing popular support, say the central government in Islamabad exploits Balochistan's natural resources but does not invest in the province's infrastructure.
Al Jazeera and wire services