Tuesday morning, ripping apart bridges, tearing down centuries-old churches and triggering landslides that engulfed entire homes.
Residents inspect a car after a concrete block fell on it during an earthquake in Cebu city, central Philippines. (Reuters)
The number of people confirmed killed on Bohol and neighbouring islands climbed from 93 overnight to 142 on Wednesday afternoon, and more bad news was expected as rescue workers reached some of the hardest-hit areas.
"Our efforts today are focused on reaching isolated areas. We suspect individuals are trapped out there and we have to conduct search and rescue," National Disaster Risk Reduction and Management Council spokesman Reynaldo Balido told AFP.
With destroyed bridges, ripped-open roads and power outages fragmenting the island of about one million people, Balido said it was proving difficult for police and government rescue workers to reach isolated communities.
At Loon, a small coastal town of about 40,000 people just 20 kilometres (12 miles) from the epicentre of the earthquake, shocked survivors wandered around the rubble of collapsed buildings looking for relatives.
Farmer Serafin Megallen said he dug with his hands, brick-by-brick, to retrieve his mother-in-law and cousin from the rubble of their home on Tuesday.
"They were alive but they died of their injuries three hours later. There was no rescue that came, we had to rely on neighbours for help," he told AFP.
Megallen said a neighbour with a truck tried to drive the bodies to Loon's funeral parlour, only to find out the bridge across a river on the way was destroyed.
The bodies were then taken across the river aboard a boat.
"But no one will give them last rites because the church was also destroyed," he said.
Ten churches, many of them dating back centuries to Spanish colonial rule of the Philippines, were destroyed or badly damaged on Bohol and the neighbouring island of Cebu.
Loon's limestone Our Lady of Light church was reduced to mounds of crushed rocks.
'Nothing much we can do'
In front of the rubble an improvised altar had been erected with a lone statue of the Virgin Mary, where teary residents stopped by to make the sign of the cross.
"We're trying our best to keep hopes up, but in this desperate situation there is nothing much we can do beyond giving comforting words," local priest Father Tomas Balakayo told AFP.
"I try to be strong but this is terrible, what have these people done to deserve this?"
The only people involved in the search and rescue efforts on Wednesday morning at Loon were residents and local police, who themselves had lost their homes or relatives.
They struggled as aftershocks continued to rattle the area. More than 800 aftershocks were recorded, including two on Wednesday with magnitudes exceeding 5.1, according to national disaster authorities.
President Benigno Aquino visited Bohol on Wednesday to oversee rescue efforts, and sought to reassure survivors.
"The bottom line is we do not have to fear that something stronger than... (Tuesday's quake) is coming," Aquino said in a nationally televised meeting with cabinet members at Tagbilaran, Bohol's capital.
Most of the deaths were on Bohol, which is one of the most popular tourist islands in the Philippines because of its beautiful beaches, rolling "Chocolate Hills" and tiny "tarsier" primates.
The number of confirmed fatalities on Bohol jumped to 132 as authorities in isolated towns restored communications and reported dozens more deaths, the head of the province's information office, Augustus Escobia, told AFP.
But he said reports had still not come in from one town close to the epicentre that was believed to be badly damaged.
Nine people died on neighbouring Cebu island, home to the Philippines' second-biggest city of the same name, while another person was confirmed killed on nearby Siquijor island.
The Philippines lies on the so-called Ring of Fire, a vast Pacific Ocean region where many earthquakes and volcanic eruptions occur.
The deadliest recorded natural disaster in the Philippines occurred in 1976, when a tsunami triggered by a 7.9-magnitude earthquake devastated the Moro Gulf on the southern island of Mindanao.
Between 5,000 and 8,000 people were killed, according to official estimates.