Bohol, Philippines - "It was as if God demolished our island," Francis Lajot said, after attempting to drive on a mountainside road buried by boulders as large as SUVs, and sliced with cracks that could swallow a motorcycle.
Along the route, in village after village in this central Philippine province of 1.2 million people, school buildings that had usually served as evacuation centres during natural disasters lay bare - some with entire walls caving in - while hundreds of homeless families camped outside, too scared to seek shelter because of multiple aftershocks.
After a magnitude 7.2 earthquake struck Bohol and its neighbouring islands on Tuesday, rescuers and relief volunteers struggled with obstructed roads to reach victims. According to the government, 23 bridges in Bohol were destroyed. Heavy rain and thunderstorms on Thursday also complicated rescue efforts.
In one remote area of the province, a survivor told Al Jazeera she was still waiting for help to dig out her husband and her 80-year-old parents after a landslide buried their house. The current death toll of 151 is expected to rise as dozens remain missing, authorities said.
The United Nations humanitarian agency said workers have been sent to assist the government with the response.
It is a very unfortunate event for Bohol and the rest of the country. I hope that there will be no further loss of lives.
In the coastal town of Loon, one of the worst-hit areas, residents crowded under tents not too far from a one-storey pile of limestone rubble - which had been a centuries-old Catholic church until Tuesday morning.
On one side, the family of Andres and Leticia Guadalquiver huddled with their 11 children and four grandchildren. When they fled, the family only carried a cooking pot and water jug with them. They said even if they wanted to go back to their village, they have no house to return to.
Joel Ruyeras, the town parish priest, told Al Jazeera at least three people were feared buried under the church debris. Shortly before the quake, Ruyeras was inside the church officiating the daily mass.
An undetermined number of people were also reportedly trapped in the partially damaged local hospital. At a local funeral home, the manager told Al Jazeera it had received 45 bodies. Her brother was one of those killed.
"It is a very unfortunate event for Bohol and the rest of the country," Rene Relampagos, a Congress member and former governor of the province, told Al Jazeera. "I hope that there will be no further loss of lives."
Relampagos and other local officials met with President Benigno Aquino III, who visited the island province on Wednesday to see the damage.
More than 1,270 aftershocks were recorded in Bohol, including a magnitude 5.5 quake on Thursday morning that left many people on edge, some running away from buildings.
The Philippine disaster agency has also reported more than 300 injuries. Emergency vehicles in the province face difficulties in transporting those hurt, many parts of the island, a popular tourist destination, also remain without power.
In Loon - 630km south of the capital Manila - Phylis Eden Reyes, a school volunteer, barely escaped when the Sacred Heart Academy, adjoining the flattened Jesuit-founded church, also collapsed. Reyes said she ran outside and when she turned back, the school was buried by the church ruins and thick dust.
"It would have been much worse," Reyes said, adding there was not enough time to evacuate the hundreds of students that normally attend the school. Tuesday was a national holiday to mark the Muslim Eid al-Adha celebration, and many children were off that day.
Mary Jane Vestudio, 23, was preparing breakfast outside her house when she started to feel the tremor. She ran and tried to rescue her six-month-old baby, April Mae, who was sleeping in a hammock inside. But the force of the quake jammed the door. The front wall of their house collapsed, with the falling debris just missing her baby.
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The parents of Ryan Gara met a different fate. His father, Antero, tried to rescue his paralysed mother, Tita. Both died when the concrete wall of their house gave way to the force of the quake. Gara stared blankly as a village elder recounted the incident to Al Jazeera.
On the ground, wary evacuees have expressed frustration at the pace of the relief effort. In central Bohol province, some villagers had yet to hear from or see local officials, more than 24 hours after the temblor.
Others who received help said the government assistance was inadequate for the number of people who needed it. In Loon, families reported receiving one can of sardines and a kilogram of rice.
During his visit to Cebu and Bohol, President Aquino promised to send immediate help to the disaster-stricken provinces, and improve future disaster-response efforts.
The Philippine archipelago is located in the Pacific "Ring of Fire", where earthquakes and volcanic activity are common. A magnitude-7.7 quake killed nearly 2,000 people on the northern island of Luzon in 1990.