Already shaken, the Indonesian island of Lombok was hit by another large earthquake causing weakened buildings to collapse and renewed terror, as the death toll for Sunday's earthquake rose to 319.
The magnitude 5.9 earthquake on Thursday morning sparked fresh panic, hampering aid efforts and caused weakened structures to collapse.
Evacuees in a shelter in northern Lombok's Tanjung district streamed into the road crying, while authorities at evacuation sites urged people to remain calm and stay inside tents.
"We were stuck in the traffic while delivering aid, suddenly it felt like our car was hit from behind, it was so strong," witness Sri Laksmi said.
"People in the street began to panic and got out of their cars, they ran in different directions in the middle of the traffic."
It was the strongest of 355 aftershocks rattling the island since Sunday's magnitude 6.9 earthquake.
Centred in the northeast of the island and was shallow at 12 kilometres, Indonesia's geological agency said the tremor did not have the potential to cause a tsunami. Some 24 people were injured by falling debris in the tremor.
The earthquake added to the trauma of a community shaken from its roots. Thursday's earthquake is the latest in a series of three, starting with a 6.4 magnitude tremor on July 29 in which 16 people died.
At least 319 people were killed in a larger earthquake on Sunday, Indonesia's chief security minister Wiranto said on Thursday. A further 1,400 people were seriously hurt, and 150,000 people have been displaced. The Indonesian Red Cross estimated that 20,000 people in remote areas are still without aid.
Other Indonesian islands have been severely affected, displacing locals, and sending concerned tourists home.
Emergency services and relief agencies have begun organising aid, but efforts to reach those in the mountainous north of the Island, which has born the brunt of the devastation has been hampered by shattered infrastructure.
Entire villages in Lombok have been flattened, and most of the island's rural north has been without electricity since Sunday.
Relief agencies are asking for water and tarpaulin supplies for the tens of thousands of people who were left homeless after the tremors on Sunday. Aid is starting to trickle through to the most remote areas of the country, most of which still do not have basic services.
Makeshift medical facilities have been set up to treat those injured by falling debris. Emergency efforts have been hampered by shattered roads and toppled bridges, placing the island's most marginalised communities out of touch.
Indonesia sits on the Pacific Ring of Fire and is regularly hit by earthquakes. In 2004, the Indian Ocean tsunami killed 226,000 people in 13 countries, including more than 120,000 in Indonesia.
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