A head-on collision between a bus and a cash-in-transit van left 20 people dead on Monday on a major road in South Africa’s northern Limpopo province, with dozens taken to hospital, transport officials and emergency medical company said.

After the crash, the bus rolled from a bridge on the N1 freeway into a river below, said ER24, whose paramedics were on the scene.

“Three people were found deceased by the roadside and 16 down by the river – all were declared dead on arrival,” ER24 said in a statement. “One patient, of the 69 passengers confirmed transported to hospital for various injuries, has since died,” it said.

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The Limpopo transport department said the crash happened around 5 p.m. (1500 GMT) on Monday and that the bus was carrying passengers from the town of Makhado to areas in the province’s Vhembe district.

Police divers have been dispatched to verify that no one was swept away by the river, the department said in a statement.

ER24 said police were investigating the circumstances surrounding the crash and that heavy rains had fallen in the area where it happened.

A provincial police spokesman did not immediately respond to a request for comment.