Whole towns in Vanuatu have been "literally blown away" by the destructive force of Cyclone Pam, witnesses say.
The tropical cyclone - considered one of the biggest ever to hit the country - smashed into the South Pacific island nation on Friday.
The United Nations is investigating unconfirmed reports 44 people died in the northeast Penama Province after the category five storm made landfall.
It brought winds of more than 250 kilometres an hour as it slammed into the island.
World Vision worker Chloe Morrison says the deadly storm has wrought catastrophic damage.
She spent a terrifying night bunkered down in a house in Port Vila, the nation's capital, with her co-workers.
"There are reports from our other colleagues of entire villages being literally blown away overnight," she told AAP.
"Local houses and leaf huts would have been picked up like confetti last night."
Tin roofs had been stripped off houses and trees uprooted, she said.
She said shelter, clean water and access to food were the main concerns.
But it was hard to get a sense of the true extent of the damage, given many of the islands had poor infrastructure before the storm hit, she said.
The Bureau of Meteorology, which has been monitoring the storm, said most parts of Vanuatu had been affected.
The storm reportedly changed course at the last minute, hitting the capital Port Vila harder than expected.
The Red Cross says people are being assisted at dozens of safe buildings and evacuation centres across six provinces.
The organisation has established 12 evacuation centres in and around Port Vila.
People were evacuated on Friday to safe shelters in Torba, Sanma and Penama provinces in the north of the country.
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