Officials said on Tuesday that at least 20 people had been killed and nearly 300 wounded in an explosion at a fuel depot in the breakaway Nagorno-Karabakh region of Azerbaijan on Monday.

Emergency workers took 290 patients “with various degrees of burns” to four different medical facilities after the blast near the city of Stepanakert, the health ministry of Nagorno-Karabakh said in a statement.

Seven of those people died, and 13 bodies were recovered at the site and taken to a forensics office, the ministry said. Dozens of patients were still in critical condition, it added.

“The doctors and medical staff in Stepanakert are doing their best to save the lives of the wounded in these difficult and cramped conditions,” the ministry said.

A stream of cars, buses, heavy-duty trucks, and even tractors, loaded with duffel bags containing basic possessions and sometimes animals, has been pouring out of Nagorno-Karabakh steadily since Sunday afternoon. The central square of Goris, a town across the border in Armenia, has turned into a makeshift refugee camp with people looking for shelter and other help.

The Armenian government said that 13,350 forcibly displaced people had entered Armenia from Nagorno-Karabakh as of Tuesday morning. The breakaway region’s government urged people fleeing the enclave not to rush because all roads inside Nagorno-Karabakh had been blocked with traffic.

Recent refugees in Goris said that it had taken them up to one full day to get out, and a long stream of cars on a serpentine road was visible from the Armenian side of the border.

Military doctors who are part of the Russian peacekeeping contingent in the area reported on their Telegram messaging account that they were providing emergency assistance to those injured in the explosion. They said that 23 people with burns of varying severity had been delivered to the Russian peacekeeping contingent’s medical unit.

Armenians and Azerbaijanis had lived relatively peacefully around Nagorno-Karabakh, a region the size of Rhode Island in the South Caucasus, for decades until the fall of the Soviet Union. Ethnic Armenians took control of the region in 1994 with the backing of the Armenian military.

Azerbaijan led a 44-day war in 2020 against the ethnic Armenian leadership, gaining control of most of the region. Last December, Azerbaijan installed a blockade to the only road connecting Nagorno-Karabakh to Armenia, cutting off the region from food and fuel supplies and worsening a humanitarian crisis.

Nagorno-Karabakh’s human rights ombudsman, Gegham Stepanyan, who was elected to the role by the breakaway republic’s lawmakers, said on Monday after the explosion that most of the victims were in severe condition, without providing details, and warned that the region did not have adequate medical facilities.