(CNN) The unprecedented attacks on two mosques in the New Zealand city of Christchurch, in which at least 49 people died and 20 were seriously injured, have left a peaceful nation reeling.
But this is not the first time the coastal city of around 400,000 people on New Zealand's South Island has been swept by tragedy.
Between 2010 and 2011, the country's third most populous city was plagued by a series of earthquakes.
The worst happened in February 2011, when a 6.3-magnitude earthquake ripped through Christchurch in the middle of the day -- toppling buildings onto buses, buckling streets and damaging cathedrals.
While New Zealand is accustomed to earthquakes, few have been as devastating as that tremor, which killed 185 people, injured 6,000 and damaged 170,000 buildings.
The bulk of the deaths occurred when a six-story office block, the CTV Building, collapsed during the quake.
According to official figures, 115 people were killed in the CTV Building, 18 people died in the PGC office building, eight people died on buses and 28 people died elsewhere in central Christchurch, while 12 victims were in suburban locations. Another four deaths were found to be directly associated with the incident.
The victims came from numerous countries across globe and included a group of students learning English in the CTV Building.
Witness Gavin Blowman told CNN at the time that he ran to the street when the earthquake struck.
"It felt like I was running on jelly," he said. "We saw a giant rock tumble to the ground from a cliff -- a rock that had been there for millennia. It fell on the RSA (veterans' association) building -- it was terrifying."
Laura Campbell told CNN she was at work when the earthquake struck. She described seeing "windows blowing out, bricks falling down, people screaming, the whole nine yards."
The earthquake caused soft sand and silt to liquefy, which led to ruptured water and sewer pipes, shattered roads and wrecked buildings. It caused cliffs to collapse and dislodged boulders.
The widespread damage cost the country an estimated NZ$20 billion ($13.7 billion) according to New Zealand's government, and the city's retail, hospitality and accommodation sectors were hit the hardest.
As of January 2019, the country's earthquake commission is still dealing with 2,233 claims from the quake.
According to the city council, the tremors "had an immediate effect on Christchurch City's population, with an estimated 20,000 leaving the city in the first two years."
The psychological toll of the earthquake quickly became apparent. In 2012, a study by the Canterbury District Health Board and the Mental Health Foundation found that more that 80% involved in the study said their lives had changed "significantly" since the event. More than two-thirds of people asked said they were "grieving for lost Christchurch."
Another study found that heart attacks spiked a year after the earthquakes.
According to Reuters, the residents of the most-damaged areas were 22% more likely to be admitted to hospitals for heart attacks than their neighbors in the least-damaged areas.
"Our study suggests it's not just the shaking people experience, but the long-term impacts on their lives, if they lose their homes," one of the study's authors, Vicky Cameron, told Reuters.