A truck packed with Eritrean and Somali migrants crashed near the Libyan town of Bani Walid early on Wednesday, leaving at least 19 dead and nearly 80 injured, officials said.
Bani Walid hospital manager Mohamed al-Mabrouk said the truck flipped over about 80 kilometres south of Bani Walid. At least 78 people had been injured, eight of them seriously, he said.
"We did not receive the driver (at the hospital), and we don't know what has happened to him," said Mabrouk. "Most likely he's survived otherwise he would be brought here."
A total of 124 Somali and Eritrean migrants were brought to the hospital after the crash, officials and aid workers said. Women and children were among the casualties.
One aid worker who was at the scene said around 250 people were believed to have been on the truck when it swerved off the road at about 3 a.m. He said about 50 migrants are thought to have fled.
The hospital in Bani Walid said it lacked the capacity to deal with the casualties, and appealed for help from local charities.
Most of the injured who were brought there did not have beds, and medical staff used a water container to support one man's broken leg. Some of those critically injured were transferred to the capital, Tripoli.
Bani Walid, located 145 kilometres south of Tripoli, is a hub for smugglers who bring sub-Saharan migrants by road from neighboring countries up towards Libya's Mediterranean coast.
They are often held and transported in brutal conditions, passed between smugglers who take payments for different stages of the journey and extort money from migrants.
From northern Libya, many of the migrants are put out to sea by smugglers in flimsy inflatable dinghies, hoping to be picked up by international ships and brought to Italy. More than 600,000 have made the crossing since 2014.
Irregular migration is considered a crime in Libya, though authorities often collude with smugglers.