Rescue teams struggled in heavy rain on Thursday to find people trapped under debris after a powerful earthquake hit the Indonesian city of Padang, possibly killing thousands.
The 7.6 magnitude quake struck the bustling port city of 900,000 people on Wednesday, toppling hundreds of buildings. Telephone connections were largely severed, making it hard for officials to work out the extent of destruction and loss of life.
"We need aid as soon as possible. We need food and medicine. Our houses have collapsed," said Siti, a resident of Padang, capital of West Sumatra province.
"There are people still trapped inside after their houses collapsed."
Health Minister Siti Fadillah Supari told reporters at an airport in Jakarta before leaving for Padang that the number of victims "could be more (than hundreds or thousands). I think it's more than thousands, if we look at how widespread the damage is. But we don't really know yet".
The national disaster agency put the confirmed death toll at 220. Officials said 500 houses had collapsed.
A second quake, of magnitude 6.8, hit another part of Sumatra island on Thursday, causing fresh panic, according to television reports. The second quake's epicenter -- inland and further to the southeast -- was 154 km (96 miles) northwest of Bengkulu, the U.S. Geological Survey said.
The area could not immediately be contacted.
A Reuters reporter at the partially collapsed Jamil hospital in Padang said there were at least 40 corpses on the ground. Many patients had been evacuated to the hospital's yard.
The reporter, whose own house collapsed, said some medical tents had been set up nearby but that many people who had gathered were still waiting for treatment.
A woman holding her dead baby cried for help: "My son is dead. My son is dead." TV footage showed troops carrying a woman on a stretcher, blood seeping from wounds on her legs and her body covered in dust.
Heavy rain hampered rescue efforts and officials said power had been cut in Padang, which lies on a coastal plain and is surrounded by steep mountains that stretch far inland.
Sumatra is one of the most seismically active parts of Asia.
A 9.15 magnitude quake, its epicenter 600 km (375 miles) northwest of Padang, caused the 2004 tsunami that killed 230,000 people in Indonesia and other Indian Ocean nations.
Australian businesswoman Jane Liddon told Australian radio from Padang that the city center was devastated.
"The big buildings are down. The concrete buildings are all down, the hospitals, the main markets, down and burned. A lot of people died in there. A lot of places are burning."
"Most of the damage is in the town center in the big buildings."
TV footage showed piles of debris, collapsed houses and multi-storey buildings, with scores of crushed cars, after the earthquake.
The main hospital had collapsed, roads were cut by landslides and Metro Television said the roof of the airport had caved in.
Damage to roads had affected transport of rubber in West Sumatra province, the fifth-largest producing province for rubber in Indonesia.
Officials said heavy equipment such as bulldozers, excavators and concrete cutters were badly needed.
The disaster is the latest in a spate of natural and man-made calamities to hit Indonesia, a sprawling archipelago of 226 million people.
Welfare Minister Aburizal Bakrie said on Wednesday the damage could be similar to that caused by a 2006 quake in the central Java city of Yogyakarta that killed 5,000 people and damaged 150,000 homes.
Sumatra is home to some of the country's largest oil fields as well as its oldest liquefied natural gas terminal, although there were no immediate reports of damage. Padang sits on one of the world's most active fault lines along the "Ring of Fire" where the Indo-Australia plate grinds against the Eurasia plate to create regular tremors and sometimes quakes. Geologists have long warned Padang may one day be destroyed by a huge earthquake because of its location.