An explosion at a fuel depot in Nagorno-Karabakh has killed 20 people and injured hundreds more, local ethnic-Armenian authorities say.
Nearly 300 people were admitted to hospitals, with dozens of them reported to be in a critical condition.
It comes as the Armenian government said 19,000 refugees had crossed into the country from the enclave since local forces surrendered to Azerbaijan.
The disputed region is home to some 120,000 ethnic Armenians.
It is not yet clear what caused the explosion on Monday evening near the main city of Khankendi, known as Stepanakert by Armenians.
Petrol stations have been overwhelmed as thousands try to leave the region, which was already suffering from a fuel shortage following a months-long blockade.
The only road connecting Armenia to the enclave remains backed up with hundreds of cars and buses, filled with ethnic Armenians trying to reach the town of Goris across the border.
The winding mountain road from Goris to Armenia’s capital, Yerevan, has also been heavy with traffic from well before dawn.
Witnesses saw families crammed into cars, boots overflowing and roof-racks piled high with belongings. Convinced they are leaving their homes for good, people are squeezing as much of their lives as possible into their vehicles.
Inside Goris, a small town that is the same dusty brown as the jagged mountains that surround it, the narrow streets are filled with more cars and more families. One has arrived in a car held together with little more than sticking tape, its side badly dented and dotted with shrapnel holes, and windows smashed.
Despite Azerbaijan’s public reassurances, there are fears about the residents of Nagorno-Karabakh, with only one aid delivery of 70 tonnes of food having been allowed through since separatists accepted a ceasefire and agreed to disarm.
Azerbaijan announced that another aid convoy, with 40 tonnes of flour and badly-needed hygiene products, was on its way to the enclave.
Ethnic-Armenian leaders say thousands are without food or shelter and sleeping in basements, school buildings or outside.
In a statement on Tuesday, local officials said doctors were working in “difficult and cramped conditions” to save the lives of those injured in the fuel depot explosion, adding that hospitals were treating 290 patients with various degrees of burns.
They said 13 unidentified bodies were found at the scene of the explosion and seven more died in hospital.
Human Rights Ombudsman Gegham Stepanyan wrote on social media: “The health condition of the majority is severe or extremely severe. The medical capacities of Nagorno-Karabakh are not enough.”
The Armenian health ministry said it was sending helicopters to evacuate patients from the region’s strained hospitals. Azerbaijan also said it had sent medical supplies