"I ask everyone to take action to protect themselves, including evacuating to a safe location."
Eyewitness Chiharu Hara, a recruitment agent in Kumamoto, described panic as the quake hit. "The office swayed violently side to side.
I was afraid it would collapse. Everyone panicked."
Local hospitals faced operational challenges.
A hospital employee said, "People are coming in with burns and fractures from being trapped under objects due to the earthquake, and ambulances are constantly bringing in injured people.
Inside the hospital there are water leaks and electrical system failures."
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Separately, an unconfirmed magnitude 4.5 earthquake caused minor shaking in the Cayman Islands, with no casualties or damage reported.
