The death toll from a powerful earthquake in the central Philippines has risen to at least 69, officials said Wednesday, as hospitals on Cebu Island were overwhelmed with injured survivors.

The shallow 6.9-magnitude quake struck late Tuesday off the island’s northern coast near Bogo, a city of 90,000 people. Waves of aftershocks overnight forced hospitals to move patients outdoors for safety. Outside Cebu Provincial Hospital, children cried and adults screamed as they were treated on beds hastily arranged under blue tents.

“Many of them were pinned down by debris, which caused their death,” Office of Civil Defence deputy administrator Rafaelito Alejandro said on government television.

Journalists saw hospital workers loading black body bags into vans bound for local mortuaries. Officials reported that 30 people were killed in Bogo, 22 in San Remigio, 10 in Medellin, five in Tabogon, and one each in Sogod and Tabuelan. The Bogo hospital said at least 186 people were injured.

Rescue efforts continued through the night. In Bogo, firemen drilled through the rubble of a collapsed two-storey motel where two receptionists and a child were feared trapped. “We cannot give up,” fireman Erwin Castaneda told reporters. “We are talking about lives here. We will do everything that we can.”

Some survivors shared stories of narrow escapes. Richard Guion, his arm heavily bandaged, said his 17-year-old son dug him and his wife out from beneath a collapsed concrete wall. “When the cement collapsed, I called out to him,” Guion said, grateful that his son had ignored instructions to go to bed early that night.

President Ferdinand Marcos offered condolences and pledged swift aid to victims.

Footage from Bantayan Island showed light bulbs swinging wildly before the belfry of an old Catholic church toppled into the courtyard. In Cebu City, 100 kilometres to the south, diners fled as a shopping mall’s metal ceiling gave way. “It was as if the Earth stopped spinning,” said Jayford Maranga, 21, who took shelter under a restaurant table.

The provincial government has appealed for medical volunteers to help treat the surge of injured, while roads in several towns have been damaged by cracks.

The Philippines sits on the Pacific “Ring of Fire,” where earthquakes occur almost daily. While most are minor, destructive quakes strike without warning, and scientists have no reliable way to predict them.