A huge emergency effort is under way after an 8.0 earthquake hurled towering waves at the Samoas, flattening or submerging villages and killing dozens.

Four tsunami waves 15 to 20 feet high roared ashore on American Samoa, reaching up to a mile inland.

"I thought it was the end of the world," said Salamo Laumoli, director of health services at the LBJ Tropical Medical Center in the capital, Pago Pago. "I have never felt an earthquake like that before."

Relief efforts are being stymied by extensive damage to the infrastructure of the islands.

"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.

People in outlying villages on one end of the main American Samoa island have been cut off because the connecting bridge was washed away.

The Samoa Red Cross estimated that about 15,000 people were affected by the tsunami.

The U.S. disaster agency said it was also preparing supplies stored in Hawaii for transport to the island chain.

While yesterday's scenes were dramatic – villages flattened, cars sucked out to sea, a boat washed up by the side of the road – the disaster was nowhere near the scale of the 2004 Indian Ocean tsunami, which killed more than 230,000 people.

Interestingly, Samoa is considered one of the best-prepared countries in the quake-prone region, with a newly installed tsunami alert system that was successfully tested earlier this year. Earth tremors are supposed to set off sirens, while tsunami warnings are broadcast on local radio and sent as text messages.

The alert system functioned as it should have but the waves came only six minutes behind the quake. "If things happen so quickly, there's not a lot you can do," says Peter Muller, the regional disaster response adviser to the United Nations' Office for the Coordination of Humanitarian Affairs.

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