(CNN) -- A huge emergency effort is under way in the Samoan islands after tsunami waves triggered by a huge earthquake left scores dead and flattened or submerged entire villages.
At least 111 people are confirmed killed in Samoa, neighboring American Samoa and Tonga. Officials in the Polynesia region have expressed fears the toll will rise as rescue workers struggle to reach outlying villages.
The 8.0-magnitude quake hit the small cluster of Samoan islands in the South Pacific early Tuesday.
In Samoa, the death toll currently stands at 82, according to government minister Maulolo Tavita. But he said he feared the number of casualities would continue to rise.
Around 220,000 people live on the two main islands which make up the nation of Samoa. The population of the U.S. island territory of American Samoa is about 66,000. See a map of the affected region »
At least 22 people were confirmed dead late Tuesday in American Samoa. Photos of the devastation taken by CNN iReporters showed boats washed up in trees and crumbled cars smashed up in the streets. See iReporter images of the aftermath »
Salamo Laumoli, director of health services at the LBJ Tropical Medical Center in the capital, Pago Pago, said he feared more fatalities would turn up as rescue workers strived to access parts of the island severed by damaged infrastructure.
"I thought it was the end of the world," said Laumoli. "I have never felt an earthquake like that before."
Patients at the hospital were briefly moved to higher ground, but they were soon brought back and the hospital is operating, the U.S. Federal Emergency Management Agency said. The airport in the capital of Pago Pago was also operational and being used for emergency flights, FEMA said.
The British Foreign Office said one of the dead was a British national, but no other details were provided.
In Tonga, Lord Tuita, the acting prime minister, said at least seven people had been confirmed dead on the northern island of Niuatoputapu. Three others were missing and four people were being treated for serious injuries, he said.
"The hospital on the island is reported to have suffered major damage; telephone communications has been cut as a result of damage to equipment and facilities on the island; homes and government buildings have been destroyed; the airport runway has been severely damaged making it impossible for any fixed wing aircraft to land," a statement from the Tongan prime minister's office said. Were you there? Send us your photos and video
A series of aftershocks reverberated through the region Tuesday as reports emerged of entire villages flattened or submerged by the tsunami. The walls of water were so strong that they twisted concrete beams and mangled cars. See an explainer on tsunamis »
Laumoli said people in outlying villages on one end of the main American Samoa island had been cut off because the connecting bridge was washed away. Listen to Laumoli speak about the impact of the quake and tsunami »
The Pacific Tsunami Warning Center in Ewa Beach, Hawaii, has canceled tsunami watches and warnings for American Samoa. However, a tsunami advisory is still in effect for for the coastal areas of California and Oregon. Watch report on end of tsunami warning »
The Japan Meteorological Agency canceled a tsunami advisory along its eastern coast Wednesday. The precautionary alert meant forecasters feared a tsunami wave of less than a foot and a half was possible.
American Samoa Gov. Togiola Tulafono, speaking from Hawaii, said Tuesday's quake ranked "right up there with some of the worst" disasters on the island. He said he had spoken to the military about mobilizing reserve forces for assistance.
Tulafono was on his way back home from Hawaii on Tuesday night on one of two U.S. Coast Guard transport planes delivering aid. He told reporters Tuesday it had been hard being away from home as the disaster unfolded. It was a time, he said, for families to be together.
President Barack Obama declared American Samoa a major disaster area, ordering federal aid to supplement local efforts.
The Coast Guard is transporting more than 20 officials from the Federal Emergency Management Agency to American Samoa, said John Hamill, external affairs officer for FEMA in Oakland, California.
The FEMA team will include a variety of debris experts, housing experts, members of the Corps of Engineers, and other disaster relief specialists, Hamill said.
The quake generated three separate tsunami waves, the largest measuring 5.1 feet from sea level height, said Vindell Hsu, a geophysicist with the Pacific Tsunami Warning Center. Preliminary data had originally reported a larger tsunami.
