At least 20 people were killed and more than 200 were injured on Tuesday when people queuing for fuel at a depot in Nagorno-Karabakh were engulfed in an explosion at the facility. Photo by Narek Aleksanyan/EPA-EFE

“The condition of the majority of the injured is severe or extremely severe. The medical capacities of Nagorno-Karabakh are not enough,” Gegham Stepanyan wrote in a Twitter post.

“We need medical teams and evacuation flights on the ground here very urgently to save people’s lives.”

The Armenian Ministry of Health said Tuesday that it was flying a medical team into Stepanakert to evacuate the injured while the Azerbaijani government said an ambulance was en route carrying burn dressings, sterile gloves, medicines and other critical medical supplies.

The depot blast came as the region’s health services were already under severe strain from treating hundreds of people injured in the past week since Azerbaijan launched a blitzkrieg anti-terror operation against Armenian positions that threatened to restart the 2020 war between the countries.

Nagorno-Karabakh’s separatist authorities said people had lined up outside the depot because they had been promised fuel which is increasingly hard to come by due to a 10-month-long blockade imposed by Azerbaijan that has also resulted in severe food and water shortages.

It is believed the depot was full of Armenians fleeing the fighting with long lines of people waiting on the heels of almost 3,000 who have already left, most of them since Sunday night.

A Russian-brokered cease-fire deal reached Wednesday under which Armenian forces are slated to be evacuated from Nogorno-Karabahk has sparked fears of ethnic cleansing sparking an exodus of civilians with at least 3,000 fleeing across the Armenian border.

Armenian Prime Minister Nikol Pashinyan warned in a speech Sunday of the dangers facing the 120,000 Armenians in Nagorno-Karabakh under Azerbaijani control and called on the international community to take action to protect them.