Rescuers in Ecuador raced to dig out victims trapped under the rubble of homes and hotels on Sunday after a powerful 7.8-magnitude earthquake killed at least 235.
The quake wrecked buildings, toppled power lines and sent terrified residents running from their homes when it struck the Pacific coast Saturday in a zone popular with tourists.
Vice President Jorge Glas called it the "worst seismic movement we have faced in decades." In a news conference on Sunday he raised the toll to 235 killed and 1,557 injured.
The quake, felt across Ecuador, northern Peru and southern Colombia, struck at 6:58 local time Saturday evening (2358 GMT) and lasted about a minute.
It was centered around 170 kilometers (106 miles) northwest of the capital Quito, the US Geological Survey (USGS) said, measuring the magnitude at 7.8.
Among the worst-hit towns was the Pedernales, where mayor Gabriel Alcivar estimated there were up to 400 more dead yet to be confirmed, many under the rubble of some 40 hotels that collapsed.
"Pedernales is devastated. Buildings have fallen down, especially hotels where there are lots of tourists staying. There are lots of dead bodies," he told local media.
"We need help. We need medicine, water and food to help people."
Two Canadians were among those killed by the quake, their country's government told AFP.
Around the town of Portoviejo, the quake reduced houses to rubble, brought down a market and left streetlights and debris scattered.
Hairdresser Fernando Chavez, 45, was in his home at the back of his salon with his wife and three children, when the ceiling was crushed by rubble from a neighboring building.
The family was trapped in the dark among the debris for 10 minutes before they managed to get out. He said it was a "miracle" they survived.
"The cloak of God protected us," he said.
Glas said 14,000 security forces, 241 medical staff and two mobile hospitals were being rushed to the most devastated areas, with reinforcements arriving from Colombia and Mexico.
In the town of Abdon Calderon near Portoviejo, 73-year-old resident Nelly, who would not give her last name, told AFP in tears that she rushed into the street after the quake and saw that the covered market had collapsed.
"There was a person trapped who screamed for help, but then the screaming stopped. Oh, it was terrible," she said.
Ecuador's Geophysical Office reported "considerable" structural damage as far away as Guayaquil, Ecuador's biggest city with more than two million people.
Ecuador lies near a shifting boundary between plates of the earth's crust. It has suffered seven earthquakes of magnitude 7.0 or higher in the region of Saturday's quake since 1900, the USGS said. One in March 1987 killed about 1,000 people, it said.
David Rothery, a professor of geosciences at Britain's Open University, said the quake's 7.8 magnitude meant that "the total energy involved was probably about 20 times greater" than the magnitude 7.0 earthquake that killed at least 41 people in southern Japan on Saturday.
He said there was no causal link between the two quakes.
Miriam Santana, a 40-year-old resident of the western Ecuadoran city of Manta, said locals were in a state of "total desperation."
"It was as if the world was about to end," she told AFP by phone.
Authorities closed the city's airport, saying the control tower suffered "severe damage."
In the north of the capital Quito, people ran out of their homes in terror as power lines swayed back and forth, knocking out power to some areas.
President Rafael Correa, who was on a visit to the Vatican when the quake struck, called for "calm and unity" in a phone interview with Radio Publica.
Pope Francis urged prayers for the victims.
US Secretary of State John Kerry and EU chief diplomat Federica Mogherini expressed condolences and said they were ready to help.
The Red Cross said hundreds of its volunteers were joining in the search for survivors.
"In the coming days, we can expect acute health needs around trauma care and psychosocial support," said Walter Cotte, the Americas Regional Director for the International Federation of Red Cross and Red Crescent Societies, in a statement.
"There may also be urgent needs around maternal and obstetric care. We should also have to expect urgent needs around food, water, sanitation and shelter."