At least 18 women and girls waiting to get free flour in Pakistan's southern city of Karachi died when the crowd around them swelled and a stampede occurred, officials said.
The deaths came during the Muslim holy month of Ramadan, a traditional time for charitable acts including giving away food. At times, however, the giveaways have turned rowdy and dangerous in this largely impoverished nation.
Monday's stampede occurred in a small building with narrow passages. As more women entered to get the flour, some began to panic and guards began using strong-arm tactics to clear the place, officials and witnesses said.
Karachi police chief Wasim Ahmad said at least 18 women and girls died in the ensuing rush. Mohammad Amin Khan of Karachi Civil Hospital said some of the women had suffocated and that there were at least 20 bodies.
"Hundreds of women were pushing to enter into the small hall, and guards started beating us to get the place cleared," said 30-year-old Kulsoom, who gave only one name and ended up among the many wounded. "I fell down and was being crushed. My heart was missing beats and I thought I was dying."
Panicked relatives streamed into the hospital, while others brought limp bodies in the backs of trucks or in their arms. Some women wailed while laying on stretchers.
The flour giveaway was organized by a private donor who Ahmad said was detained for not giving police prior notice of the event.
"Poverty is on the rise, there is a desperation among people," local government official Javed Hanif said. "Naturally, when people are frustrated, whenever they get such an opportunity, they try to grab the maximum."