The BBC's Kylie Morris has arrived on the Indonesian island of Nias, which was devastated by Monday's quake.
Flying over Gunung Sitoli, the main town on Nias, you could see multi-storey buildings had collapsed, one floor falling down into the other. Clusters of people stood on top of what was left, combing the wreckage.
The wreckage of Gunungsitoli is apparent from the air
At a monastery, nuns attempted to find food for scores of badly injured people who had taken shelter there. They complained that they had no access to medicine and very little food.
The earthquake is believed to have claimed 500 lives already. And that figure will only grow because people are trapped under piles of rubble.
The arrival of an aid helicopter drew hundreds to a soccer field. One woman stopped to ask me if there would be cooking oil. Another man showed me a gash in his head where he said the corner of a building had fallen on him.
There is no electricity and a lack of shelter, with main roads and bridges shattered by the force of the earthquake. Aid agencies have described the situation as critical.
I've seen many wounded people walking in the dishevelled streets, asking for water.
All around there's a deep sense of shock as if people cannot believe what has happened to them. To compound the problems, the destruction has made access much more complex.
The air field has suffered severe damage so fixed wing planes, to deliver critical supplies, are unable to land. Collapsed roads have cut off areas from immediate help. Many have great cracks running through them.
A boy waits at a helicopter landing site on Nias island
The aid agency Oxfam has been ferrying the wounded back to mainland Sumatra and bringing essential medical supplies to the island's hospital.
But that has also been badly damaged and is staffed by a single doctor and nurse. Where possible the seriously injured are being brought in by motorbike but fuel is in short supply.
The high street of Gunung Sitoli is a scene of disaster. Smoke billowed from collapsed houses as survivors of the wreckage staggered away to find help.
The people of Nias are struggling to cope with the aftermath of the earthquake. The extent of the damage is so great it is difficult to understand where to begin.
There may be people trapped in the rubble anxiously hoping that they'll be saved. But combing through the unstable wreckage may be too dangerous without the right equipment.