Rescuers in Ecuador Monday pulled three people out alive after being trapped for more than 32 hours in the rubble of a shopping center that was flattened by Saturday's powerful earthquake.
Televised images of the dramatic rescue in the port city of Manta gave Ecuadorians hope that scores of people still unaccounted for may yet be found, even as the death toll from Saturday's 7.8 magnitude quake, which struck the country's northwest coast, climbed above 410.
The quake, Ecuador's worst natural disaster in more than half a century, injured more than 2,500 people and left thousands homeless.
The cities of Manta, Portoviejo, and the tourist city of Pedernales were among the worst affected, although damage was widespread throughout the country.
"Many people remain buried under the rubble," Ecuadorian Red Cross spokesman Diego Castellanos told VOA by telephone Monday from the capital, Quito.
WATCH: Video footage from Ecuador
In Washington Monday, a State Department spokesman said one American is among those killed in the Ecuador quake. He did not provide further details.
Spokesman John Kirby said Washington has offered assistance and stands ready to work with the Ecuadorian government in the relief.
Thousands of soldiers and police have been deployed, and have begun providing temporary shelters, although many have spent two nights camped outside their flattened homes.
In some of the most remote areas, people clawed through the rubble with their bare hands, desperately searching for survivors, before equipment arrived.
Rescue workers are bringing first aid and emergency supplies to the worst affected areas, but Castellanos says some of the areas are hard to reach.
"By road it is very difficult [to reach] because in some places the roads were very badly damaged by the earthquake," Castellanos said. "It is difficult, but we are doing it."
Hundreds of aftershocks have followed, and authorities warn many could be severe. Most of the aftershocks Monday were ranging from 3.1 to 5.7-magnitude, according to the Twitter page of Ecuador's Geophysics Institute.
President Rafael Correa, who cut short a visit to Italy to oversee relief efforts, visited the disaster area Sunday. He said the death toll "will certainly rise and probably in a considerable way," as rescuers continue to search through the rubble.