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A Nepalese woman makes a path for pedestrians Monday at the foot of a Katmandu home damaged in Sunday's quake, which was centered in India's Sikkim state. Rescue crews hampered by landslides scrambled to reach remote villages.
A Nepalese woman makes a path for pedestrians Monday at the foot of a Katmandu home damaged in Sunday’s quake, which was centered in India’s Sikkim state. Rescue crews hampered by landslides scrambled to reach remote villages.
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IMPHAL, India — Rain, landslides and severed communications continued to hamper rescue efforts late Monday after a large earthquake shook northeastern India, Nepal and Tibet, killing at least 54 people.

The epicenter of the magnitude-6.8 earthquake — which struck shortly after 6 p.m. Sunday — was in India’s northeastern Sikkim state near the Nepal border. With most of Sikkim connected to the rest of India by a single, badly damaged national highway, a higher death toll is expected once emergency workers reach isolated communities.

The damage would have been much worse, experts said, were Sikkim not India’s least populated state, with 500,000 residents. Hundreds of people were injured.

By late Monday, food and doctors were being airlifted into the area, although these operations also were hampered by poor weather, said R.K. Singh, India’s home secretary. In one case, officials reported 16 landslides in a single 6-mile stretch of road.

Geologists said the quake was caused by pressure and related instability as the Indian tectonic plate moves northward into the Eurasian plate — the same forces that have created some of the world’s highest mountains in the Himalayas.

Television footage of the area showed buckled roads, buildings upended and rocks the size of tractor-trailers blocking mountain highways as hundreds of people walked to rescue centers. About 2,000 people were in emergency camps set up by the armed forces, Indian authorities reported Monday.

Helicopters and more than 5,000 army troops were called in to help after the earthquake. The mountainous area has become increasingly attractive to trekkers and other visitors, and border police reported rescuing more than 20 tourists.

P.M. Rai, a lawmaker from Sikkim, said early tallies suggested at least 150 people were in area hospitals, including a significant number suffering from trauma.

Authorities said this was the worst quake to hit Sikkim in six decades. There were no immediate reports of damage to hydroelectric dams.

Preliminary reports suggested at least 42 people were killed in India, and a total of 12 died in Nepal and Tibet.

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