In a statement posted online on Sunday, President Savkat Mirziyoyev said rioters had carried out “catastrophic actions” in the city of Nukus, throwing stones, setting fires and attacking police. “Unfortunately, there are deaths between civilians and law enforcement officers,” Mirziyoyev said during a speech in Karakalpakstan broadcast by his Telegram press service. He did not specify the number and nature of the victims. Sultanbek Ziyayev, head of the Ministry of Health of the Republic of Karakalpakstan, told the Daryo.uz news website that hospitals in Nukus were full of patients who were injured when protesters clashed with security forces. “Thousands of injured have been and are being treated,” he said, according to the website. An exiled opposition politician, Pulat Akhunov, told Reuters news agency that based on contacts with local sources and video footage, at least five people were killed. He said there were unconfirmed reports of dozens more dead. Akhunov said that people could not move and get more information because of the state of emergency imposed by the authorities. Karakalpakstan has experienced significant internet outages since the publication of draft amendments last week, stripping the region of its nominal “sovereign” status and its right to secede from Uzbekistan in a referendum. Mirziyoyev has since withdrawn plans to revoke the province’s autonomy following the protests. “According to the constitution, it is an autonomous region, it has its own parliament, it has a number of privileges that it is supposed to enjoy, including the opportunity to hold elections and choose to secede from Uzbekistan,” said Bruce Pannier, Prague. journalist specializing in Central Asia, told Al Jazeera. The region takes its name from the Karakalpak people, who are well represented in cities such as Nukus, where the protests took place, but are now a minority in the western region of two million people. “In Uzbekistan in general, protests are very rare because the security forces have very strong control over the country,” Pannier said. “In Karakalpakstan in particular, they’ve had some much smaller protests over the years simply because it’s a depressed area. It doesn’t see a lot of investment, there are a lot of health problems there, so it’s not unusual to have protests, but something of this magnitude is unusual by Uzbek standards.” Uzbekistan on Saturday declared a month-long state of emergency in the impoverished region where a major protest over the proposed changes has erupted. On Sunday, Mirziyoyev made a second visit to the region in two days. “A group of people, hiding behind false slogans, won the trust of the citizens, misled them, disobeyed the legitimate demands of the authorities, caused chaos and tried to occupy local government buildings,” he told local lawmakers. “Several groups tried to occupy the buildings of the Department of Internal Affairs of the city of Nukus and the Department of the National Guard in order to obtain weapons,” he claimed. “Taking advantage of their numerical superiority, these men attacked law enforcement officers, severely beating them and causing serious injuries,” he added. Uzbekistan is a tightly controlled Central Asian state and former Soviet republic where the government harshly suppresses all forms of dissent. Hugh Williamson, Europe and Central Asia director at Human Rights Watch, said on Twitter: “There are unconfirmed reports of excessive use of force by security personnel during protests in Nukus on July 1.” He called for an investigation. 3/ There are unconfirmed reports of excessive use of force by security personnel during protests in Nukus on 1 July. The facts should then be investigated by the authorities. Police should use minimal force to manage protests @hrw — Hugh Williamson (@HughAWilliamson) July 3, 2022 The foreign ministry of neighboring Kazakhstan, whose government crushed violent protests in early January, said it was concerned about events in Uzbekistan. “We welcome and support the decisions of the top leadership of Uzbekistan to stabilize the situation in the Republic of Karakalpakstan,” the ministry said in a statement.