MENA, Saudi Arabia (AP) – Thousands of Muslim pilgrims rushing to complete a symbolic stoning ritual during the hajj tripped over luggage Thursday, causing a crush in which at least 345 people were killed, the Interior Ministry said.

The stampede occurred as tens of thousands of pilgrims headed toward al-Jamarat, a series of three pillars representing the devil that the faithful pelt with stones to purge themselves of sin. Dr. Abbasi, a Red Crecent doctor at the scene, said up to 1,000 were injured.

Footage from the scene showed lines of bodies laid out on stretchers on the pavement and covered with sheets. Ahmed Mustafa, an Egyptian pilgrim, said he saw bodies taken away in refrigerator trucks.

“There must be dozens of people dead,” he said. An Egyptian pilgrim, Suad Abu Hamada, heard screaming and “saw people jumping over each other.”

“The bodies were piled up. I couldn’t count them, they were too many,” she said.

The site is a notorious bottleneck for the massive crowds that attend the annual hajj pilgrimage and has seen deadly stampedes in the past, including one in 1990 that killed 1,426 people and another in February 2004 that killed 244.

The latest crush came despite Saudi attempts to ease the flow of traffic around al-Jamarat. This year’s hajj was marred by the Jan. 5 collapse of a building being used as a pilgrims’ hotel that killed 76 people in Mecca.

The stampede happened as pilgrims were rushing to complete the last of three days of the stoning ritual before sunset, Interior Ministry spokesman Maj. Gen. Mansour al-Turki, said. Some of the pilgrims began to trip over dropped luggage, causing a large pileup, he said. Many pilgrims carry their personal effects with them as they move between the various stages of the hajj.

Al-Turki said 345 people were killed. State-run Saudi television Al-Ekhbariyah reported that most of the victims were from South Asia.

The pillars are located on a large pedestrian bridge, the width of an eight-lane highway over the desert plain of Mena outside the holy city of Mecca. Four ramps lead up the bridge to give pilgrims access to the site, and the stampede occurred at the base of one ramp.

Mena General Hospital, a small facility several hundred yards from the site, was filled with injured, and some victims were sent to hospitals in Mecca and Riyadh, said Ismail Abdul-Zaher, a doctor at the hospital.

Ambulances and police cars streamed into the area, and security forces tried to move pilgrims away from part of the site, though thousands continued with the ritual. The stampede took place despite Saudi efforts to improve traffic at the site, where all 2.5 million pilgrims participating in the annual hajj move from pillar to pillar to throw their stones, then exit.

Saudi authorities replaced the small round pillars with short walls to allow more people to throw their stones without jostling for position. They also recently widened the bridge, built extra ramps and increased the time pilgrims can carry out the rite, which on the second and final days traditionally takes place from midday until sunset.

The stoning ritual is one of the last events of the hajj pilgrimage to Islam’s holiest sites, which able-bodied Muslims with the financial means are required by their faith to do at least once.

Many pilgrims had already finished the stoning ritual Thursday and had gone back to Mecca to carry out a farewell circuit around the Kaaba, the black stone cube that Muslims face when they do their daily prayers.