Police and soldiers patrolled the terror-stricken streets of two Ecuadorian cities on Wednesday after a series of attacks were blamed on organized crime groups waging a deadly drug war.

A state of emergency and a night curfew have come into force in the western provinces of Guayas and Esmeraldas, after a wave of strikes on Tuesday that left five police officers dead and a civilian injured at a clinic.

The civilian died Wednesday from gunshot wounds to the head, health officials said, bringing the death toll from the attacks to six.

Two police officers were also injured.

Groups armed with weapons and explosives, including car bombs, hit more than 18 targets in the cities of Guayaquil and Duran in Guayas province and in Esmeraldas further north on Tuesday.

Targets included police and gas facilities, a clinic and a bus station.

In response, President Guillermo Lasso declared a 45-day state of emergency with a night-time curfew from 9 p.m. to 5 a.m. for the two provinces and special powers to restrict freedom of movement and assembly.

Classes have been suspended in some areas.

On Wednesday, the streets of Guayaquil — the scene of much of the street and prison violence that has plagued Ecuador since last year — were unusually quiet. And nervous.

Jorge Arguello, the 36-year-old publishing director, told AFP there was “fear on the streets” and that he himself was afraid to leave home after seeing motorcycles – which have been linked to gangs and hit men – making the rounds have made.

Crime-fighting operations in the city of 2.8 million, capital of Guayas province, led to 28 arrests on Wednesday morning, according to Interior Minister Juan Zapata.

Weapons, ammunition and explosives were confiscated.

“It’s scary going out,” said Elizabeth, 37, from Guayaquil, who declined to give her full name for fear of reprisals.

In the morning, she and other neighbors had to call 911 to report what they believed to be a car bomb on the street in front of their homes.

“They came immediately, they deactivated it and nothing bad happened. But the street smelled like gunpowder,” Elizabeth recalled.

Ecuador — once a relatively peaceful neighbor of major cocaine producers Colombia and Peru — has seen a spate of violent crime that authorities blame on turf wars between drug gangs believed to have ties to Mexican cartels.

Civilians are increasingly involved in the bloodshed that has claimed the lives of more than 60 police officers since last year.

Authorities said Tuesday’s attacks came in response to a mass transfer of inmates from the gang-controlled Guayas 1 prison in Guayaquil.

Angered by the move, inmates at a prison in Esmeraldas took eight guards hostage. They were all later freed.

A day earlier, two headless bodies were found hanging from a pedestrian bridge in Esmeraldas.

In recent years, Ecuador has developed from a transit route for drugs into an important distribution center.

The United States and Europe are the main destinations for drugs from Latin America.

The homicide rate in Ecuador nearly doubled to 14 per 100,000 people in 2021, reaching 18 per 100,000 between January and October this year, according to official figures.

Hundreds of inmates have died since February last year – many beheaded or burned – as gang warfare is also being fought behind bars – particularly in Guayas 1.

“These acts of sabotage and terror are … an open declaration of war,” Lasso said of Tuesday’s attacks.

In 2021, law enforcement seized a record 210 tons of drugs, mostly cocaine. So far this year’s seizures total 160 tons.