The death toll in Indonesia's quake-tsunami disaster nearly doubled to more than 800 Sunday, as ill-equipped rescuers struggled to reach scores of trapped victims, health officials resorted to mass burials and desperate residents looted shops for food and water.
"The casualties will keep increasing," said national disaster agency spokesman Sutopo Purwo Nugroho, whose agency announced 832 deaths.
"Today we will start the mass burial of victims, to avoid the spread of disease."
Indonesian Vice-President Jusuf Kalla said the final death toll in the north of Sulawesi island could be in the "thousands" since many regions have still not been reached.
"It feels very tense," said 35-year-old mother Risa Kusuma, comforting her feverish baby boy at an evacuation centre in the gutted coastal city of Palu. "Every minute an ambulance brings in bodies. Clean water is scarce. The mini-markets are looted everywhere."
Indonesia's Metro TV on Sunday broadcast footage from a coastal community in Donggala, close to the epicentre of the quake. Some waterfront homes appeared crushed but a resident said most people fled to higher ground after the quake struck.
"When it shook really hard, we all ran up into the hills," a man identified as Iswan told the TV.
Indonesian President Joko Widodo arrived in the region Sunday afternoon.
In Palu on Sunday aid was trickling in, the Indonesian military had been deployed and search-and-rescue workers were doggedly combing the rubble for survivors -- looking for dozens feared trapped under one hotel alone.
"Communication is limited, heavy machinery is limited... it's not enough for the numbers of buildings that collapsed," Nugroho said.
The 7.5-magnitude quake struck Friday, sparking a tsunami that ripped apart the city's coastline.
Save The Children program director Tom Howells said access was a "huge issue" hampering relief efforts.
"Aid agencies and local authorities are struggling to reach several communities around Donggala, where we are expecting there to be major damage and potential large-scale loss of life," Howells said.
Dozens of corpses lay in an open courtyard at the back of a Palu hospital, baking under a fierce tropical sun, with only one building separating it from an open triage site on the opposite side.
"I have one child -- he's missing," Baharuddin, a 52-year-old Palu resident, told AFP as he stood on floor tiles smeared with blood.
"I last spoke to him before he went to school in the morning."
The disaster agency said it believed about 71 foreigners were in Palu when the quake struck, with most safe.
Three French nationals and a South Korean, who may have been staying at a flattened hotel, had not yet been accounted for, it added.
Amid the levelled trees, overturned cars, concertinaed homes and flotsam tossed up to 50 metres inland, survivors and rescuers struggled to come to grips with the scale of the disaster.
On Saturday evening residents fashioned makeshift bamboo shelters or slept out on dusty playing fields, fearing powerful aftershocks would topple damaged homes and bring yet more carnage.
C-130 military transport aircraft with relief supplies managed to land at the main airport in Palu, which reopened to humanitarian flights and limited commercial flights, but only to pilots able to land by sight alone.
Satellite imagery provided by regional relief teams showed severe damage at some of the area's major ports, with large ships tossed on land, quays and bridges trashed and shipping containers thrown around.
Hospitals were overwhelmed by the influx of injured, with many people being treated in the open air. There were widespread power blackouts.
"People here need aid -- food, drink, clean water," said Anser Bachmid, a 39-year-old Palu resident.
'I just ran'
Dramatic video footage captured from the top floor of a parking ramp as the tsunami rolled in showed waves toppling several buildings and inundating a large mosque.
"I just ran when I saw the waves hitting homes on the coastline," said Palu resident Rusidanto, who like many Indonesians goes by one name.
"This was a terrifying double disaster," said Jan Gelfand, a Jakarta-based official at the International Federation of Red Cross and Red Crescent Societies.
"The Indonesian Red Cross is racing to help survivors."
Images showed a double-arched yellow bridge had collapsed with its two metal arches twisted as cars bobbed in the water below.
A key access road had been badly damaged and was partially blocked by landslides, the disaster agency said.
Disaster-prone
Friday's tremor was also felt in the far south of the island in its largest city Makassar and on neighbouring Kalimantan, Indonesia's portion of Borneo island.
As many as 2.4 million people could have felt the quake, the disaster agency said.
The initial quake struck as evening prayers were about to begin in the world's biggest Muslim majority country on the holiest day of the week.
Indonesia is one of the world's most disaster-prone nations.
It lies on the Pacific "Ring of Fire", where tectonic plates collide and many of the world's volcanic eruptions and earthquakes occur.
Earlier this year a series of powerful quakes hit Lombok, killing more than 550 people on the holiday island and neighbouring Sumbawa.
Indonesia has been hit by a string of other deadly quakes including a devastating 9.1-magnitude earthquake that struck off the coast of Sumatra in December 2004.
That Boxing Day quake triggered a tsunami that killed 220,000 throughout the region, including 168,000 in Indonesia.
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