Members of the powerful gang coalition Viv Ansanm stormed a prison in Haiti on Monday, releasing more than 500 inmates after setting fire to a police substation during a day of panic in the central region of the country that sent residents, patients and staff at one of the biggest hospitals fleeing.

Haiti National Police spokesman Lionel Lazarre, who confirmed the attack to the Miami Herald, said gangs began their attack on Sunday night in Mirebalais, a rural town not far from Haiti’s border with the Dominican Republic.

“They burned part of the police station and several disabled cars in the police station yard,” he said. “All of the prisoners left.”

Videos shared on social media showed panicked residents running through the streets, carrying belongings on their heads. Others were wading through a river to get away from the gunfire.

The target of the gangs’ attack appears to have been the prison, which housed 516 inmates, according to the Port-au-Prince based human rights group Fondasyon Je Klere/Eyes Wide Open Foundation.

Of the inmates, only 65 had been before a judge and sentenced. The rest, including 27 women, 410 men and 14 juveniles, were in pretrial detention, meaning they had not yet been before a judge.

Marie Yolene Gilles, head of the foundation, said the armed gang members traveled along the main National Highway and arrived in the city without resistance.

“They attacked the police station, they penetrated the prison, they burned homes, they burned the businesses of people in the city of Mirebalais” she said.

After the assault on the prison, she said, “they freed prisoners and set fire” to it.

Gilles said that, as in other instances, armed gangs had announced that they would attack Mirebalais and “there was no resistance, there was no response.”

The attack on the Mirebalais prison followed the same pattern as the attacks a year ago against the National Penitentiary in the capital and the Croix-des-Bouquet Civil prison on its outskirts. More than 4,000 inmates, including gang members, were freed after criminal groups stormed both facilities, Haiti’s two largest prisons.

“The same phenomenon was repeated and nothing was done to prevent it,” Giles said.

Her foundation “continues to ask where the country’s money for intelligence is going,” Gilles said. “The bandits always announce their attacks against the cities, against the prisons, against the police substations and they never have any resistance. Why didn’t (the police) take steps to counter the attacks against Mirebalais? Because everyone knew.”

Frédérique Occéan, a presidential appointee for the region, said in a press conference that local officials had worked to keep the attack from happening without success.

“We are working to limit the destruction,” he said. “The population needs to remain calm; they need to stay home and they should not flee the city. You have to stay and support the security forces, so we can stand and fight together.”

He said for weeks local leaders had been asking for armored vehicles to be deployed to the city to reinforce the security forces in the area. “Up until now, we have not yet received any armored vehicles,” he said. “ We have a lot of political will to fight, but we need the means to fight.”

He blamed the attack on ongoing efforts in the region to stop the illegal trafficking of arms across the border. Tensions increased after a police operation on Sunday in the border town of Belladère led to several arrests, he said. “After those arrests, after the weapons were seized, after the vehicles that were confiscated ... the threats grew; the guys today went to the prison and broke the prison and freed everyone.”

When gangs stormed the town residents didn’t know where to go. At the University Hospital of Mirebalais, built by the late Dr. Paul Farmer after the devastating 2010 earthquake, some patients and staff fled while others tried to hide.

Reports initially suggested that the hospital was under attack, but as of 11:30 a.m., the administration said it was a false alarm.

The privately built hospital is run by Boston-based Partners In Health and its Haiti affiliate, Zanmi Lasante. It is one of the few facilities in Haiti that provides cutting-edge treatment for cancer, HIV/AIDS and other infectious diseases.

Mirebalais is among several cities in Haiti’s Central Plateau, which has become a refuge for those fleeing the violence in Port-au-Prince, where more than 1 million Haitians have been displaced, 60,000 just in the past month. The city is not far from the Haiti-Dominican border, which has become a focal point of illegal arms trafficking and a conduit for gangs to receive high-caliber guns and ammunition.

Lazarre said several specialized Haitian police units were flown into the city on a helicopter to battle gang members.

As of 1 p.m., he told the Herald, the city was “for the moment under the control” of the police.

“Police are carrying out operations in areas where the gang members are located,” he said.

Lazarre said police had killed, wounded and arrested several gang members but did not provide numbers. Weapons were also seized, he said.

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