Rescuers have been digging by hand in the frantic search for survivors in the Indonesian city of Palu, which is reeling from an earthquake and tsunami.
At least 408 people have been killed but there are fears the death toll could rise significantly as workers reach areas closer to the epicentre.
Search efforts are being hampered by blocked roads and a collapsed bridge.
The Red Cross estimates that more than 1.6 million people have been affected by the earthquake and tsunami.
There are particular concerns about the town of Donggala, where the impact is still unclear.
“This is already a tragedy, but it could get much worse,” the Red Cross said in a statement.
Yenni Suryani, the Indonesia country manager for the aid agency Catholic Relief Services, said Donggala appears to be inaccessible by road or air and that help may have to come by sea.
Strong aftershocks have continued to hit the island since Friday’s earthquake.
Rescue teams dug by hand to free 24 people trapped in the rubble of the Roa-Roa hotel in the city of Palu.
The hotel’s owner told local media people could still be heard crying out for help, but said that no heavy lifting equipment was available to rescue them.
Dozens remain missing in the city of 335,000, some thought to be trapped in the debris of collapsed buildings.
Bodies have been lying in city streets and the injured are being treated in tents because of damage to hospitals.
Anxious survivors in Palu bedded down in the open air on Saturday night, heeding advice by officials not to return to their homes as a precaution.
A 7.5 magnitude quake occurred at a shallow depth of 10km (6.2 miles) just off the central island of Sulawesi at 18:03 (10:03 GMT), triggering a tsunami, US monitors say.
Many people were on the beach in Palu, preparing for a festival, and were caught when waves up to 3m (10ft) in height swept in.
Video shows people screaming and fleeing in panic.
“The tsunami… dragged cars, logs, houses,” Sutopo Purwo Nugroho, a spokesman for Indonesia’s disaster agency, told Reuters news agency. “It hit everything on land.”
READ ALSO: Foreign Titbits: Indonesia earthquake: At least 30 dead in Palu
Brett Kavanaugh: FBI contacts second woman
The FBI has approached the second woman to accuse US Supreme Court nominee Brett Kavanaugh of sexual misconduct as it begins a fresh inquiry into him.
Deborah Ramirez accuses Judge Kavanaugh of exposing himself to her during a drinking game when they were students at Yale University in the 1980s.
The judge has denied the allegation, describing it as a smear.
President Donald Trump ordered a new investigation after the judge’s first accuser testified to a Senate panel.
The panel approved Judge Kavanaugh’s nomination but asked for the further inquiry before the full Senate votes on his appointment to America’s top court.
Despite ordering the FBI investigation, President Trump has continued to defend his nominee Mr. Kavanaugh, who denies all the allegations against him.
The Supreme Court has the final say on some of the most contentious matters in the US and appointments are for life. Judge Kavanaugh is expected to tilt the court in favour of conservatives.
Her lawyer, John Clune, announced that the FBI had “reached out” to interview his client and she had agreed to co-operate with their investigation. He made no further comment.
Ms. Ramirez alleges the incident occurred during the 1983-4 academic year when they were both taking part in a drinking game at a dormitory party.