A magnitude 7.4 earthquake struck Colombia Monday morning, killing at least 169 people and devastating the western portion of the country.

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The quake struck at 7:34 a.m. and was centered in the Chocó province near the municipality of San José del Palmar, according to the U.S. Geological Survey. It toppled multistory buildings, damaged hospitals and airports, and was felt in the capital Bogotá and neighboring Ecuador and Panama.

Emergency crews, soldiers, police, and volunteers worked through the night, sometimes digging with their bare hands, to rescue victims trapped below rubble or inside collapsed buildings. In Cali, hundreds of patients were treated outside after part of a hospital crumbled. Officials expect the death toll to rise in the coming days as more deaths are confirmed by rescue workers.

Colombia’s President Abelardo de la Espriella, who assumed office just three days before the earthquake struck, declared a state of emergency and said that he would personally lead the disaster response