KUMAMOTO, Japan — Rural communities in southwestern Japan were struggling to get their lives back to normal Thursday, two days after a powerful earthquake set off an explosion at a mall, toppled a factory chimney and flattened homes, killing at least 23 people.

Time was running out to find survivors, as rescuers continued to work in the Kumamoto area on Japan 's southern main island of Kyushu, where the magnitude 7.1 earthquake hit Tuesday.

The number of those missing was unclear. The quake left at least 63 people injured, five of them seriously, the Kumamoto prefectural government said.

Chief Cabinet Secretary Minoru Kihara, speaking to reporters Thursday, gave a higher number for the death toll at 28. That came from a police tally, he said, which includes cases still under investigation. Some of those cases may later turn out to be unrelated to the earthquake.

Survivors spoke about coming home and desperately pulling family members out of the wreckage. Some had suffered injuries and were rushed to the hospital.

Thousands of people spent another night at evacuation centers set up throughout the area in gymnasiums and other big spaces. Some homes were still without water or electricity, while others were simply afraid to go back.

Nearly 23,000 homes were still without electricity and more than 10,000 people were staying in the roughly 400 shelters, where power sources were being added to provide air conditioning.

Concerns were growing about illness, including from the sweltering heat. The Ministry of Environment sent out a heatstroke alert for the Kumamoto area, with temperatures expected to reach as high as 33 C (91 F) Thursday.

Some evacuees sleep in cars

In the town of Hikawa, one of the hardest-hit areas in Kumamoto, many residents are without water or electricity, or both, and some are staying inside their vehicles in parks or at the town hall parking lot.

At the front entrance of the town hall, officials delivered bottled water and packaged instant rice, while the Ground Self-Defense Force service members came with a trolley to provide fresh water.

Yoshiaki Nakashima, a 66-year-old resident who came with two bottles and his beloved pet dog to get water, said he is staying in a car because of his reluctance to stay at one of the three evacuation centers in the area. He also said he doesn’t want to sleep at home because aftershocks made him feel uneasy.

“It’s difficult to turn over while sleeping in a car,” he said, but that living at a shelter is even more difficult.

Akiko Inazaki, another resident in her 30s, is living in a tent set up in the yard of her home, which has been without water and electricity since the quake. Inazaki, who also came to get water, said she will use it little by little.

“Fresh water is so valuable,” she said. Inazaki said she drank so little that she almost had a heatstroke.

Risks of heatstroke are a major concern among officials.

Yutaka Kobayashi, a doctor dispatched from central Japan's Aichi prefecture, said he was touring evacuation centers Thursday to assess the condition of evacuees, especially elderly people and those with injuries as they cope with a harsh environment.

“We have to make sure elderly people are not developing heatstrokes or dehydration,” he said in Hikawa.

While the town parking lot was nearly packed the first night, some residents have moved to three public schools where air-conditioning is running, Hikawa officials said.

A town official, Yuzuru Tamura, said they are starting to run out of emergency food supply, such as canned bread and instant rice.

Families wait for word of those missing

The most serious damage was at the Aeon Mall shopping center in the town of Kashima, which was bustling with thousands of people when the quake struck in the late afternoon.

The company said some 3,000 customers were evacuated to a parking lot before the explosion happened in another part of the mall, where some people were still working. The mall’s second floor collapsed, trapping people.

As of early Thursday, six people were confirmed to have died at the mall site among the 11 people pulled out of the wreckage, according to Kumamoto authorities.

Family members of those still missing could be seen wandering helplessly near the wrecked mall, waiting for word, despite the sweltering weather.

In the Yatsushiro area, where a chimney collapsed at a Nippon Paper Industries factory, 10 people were rescued, but eight others died, and one remained missing, according to the Kumamoto prefectural government disaster team.

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Associated Press writer Yuri Kageyama in Tokyo contributed to this report.

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