At least 20 people including Italian tourists were killed Friday when two buses collided head-on in the Dominican Republic, an official said.

A car was also involved in the crash on a highway between the eastern cities of La Romana and Higuey, said Latif Mafout Rodriguez, director of the capital’s Metropolitan Transportation Authority.

Ambulances and helicopters transferred some of the wounded to local hospitals. Mafout said at least 20 people died. Preliminary reports indicated four Italians were killed, he said.

There were about 26 Italians on board one of the buses and it was not immediately clear how many were injured and to what extent.

A survivor said the accident occurred when one of the buses tried to pass a parked car along a curve and crashed into the oncoming bus.

“It’s a horrific scene,” August Dario Audes Correa, a Dominican lawyer on one of the buses, told Z-101 radio. “There were very few injured, most of the passengers died.”

The Dominican Republic is popular with Italians as a retirement and vacation destination and many have homes in the Caribbean country.