The full extent of the devastation caused by Monday's earthquake off the Indonesian coast is slowly becoming clear, but aid agencies are battling smashed infrastructure and continuing bad weather to get urgently needed assistance to the victims.
The earthquake hit between the islands of Nias and Simeulue just before midnight Monday, trapping thousands of people in their beds as their concrete houses collapsed around them.
Residents, assisted by an increasing number of professional relief workers were struggling Wednesday to dig survivors out of the rubble, but more help is desperately needed.
Paul Dillon is the spokesman for the International Organization of Migration in northern Indonesia. He says that as well as a huge need for drinking water, the medical emergency continues.
"There are a tremendous number of people who have been injured by falling debris," he explained. "The earthquake itself obviously caused a tremendous amount of damage on Nias. Now the estimates about the amount of damage vary, but the reality is very much - I understand from last estimates - in excess of 2,000 people in need of medical attention."
Much of the most-needed aid is nearby, brought into the region as part of the recovery and reconstruction effort following last December's massive earthquake and tsunami, which hit much the same area.
But there are major obstacles to delivering the assistance to where it is needed most. The infrastructure on Nias and Simeulue has been severely damaged, with roads cracked and bridges collapsed. In some places the only transport is motorcycles, which are even being used to carry the dead to cemeteries.
The residents of Nias are becoming increasingly desperate. There are reports of looting of food stocks and arguments over where heavy lifting equipment should be deployed next - every family wants the bulldozers to search for survivors in its own collapsed home.