Rescue teams in the Philippines searched for survivors in mud and rubble on Wednesday and authorities urged help for hospitals inundated with the injured after the deadliest earthquake in more than a decade killed at least 69 people.

Authorities said they feared the eventual toll would be even higher from the shallow 6.9-magnitude earthquake, which struck in waters off the central holiday island of Cebu late on Tuesday.

Buildings came crashing down, including a church that was more than 100 years old. Shops, homes and bridges were damaged across the island’s northern coast and power was cut.

Aftershocks continued throughout Wednesday, as authorities set up mobile kitchens for hundreds of evacuees and raced to provide temporary power as night approached.

Search for survivors beneath landslide

Bodies covered in black sheets were carried on stretchers and placed side-by-side on the ground outside a hospital in Bogo, the worst-affected city, along the coast about 18 km (11 miles) from the epicentre. A man wept as he pulled back a plastic sheet and clutched the face of a dead relative.

Civil defence teams were searching for signs of life beneath a landslide that had killed at least 14 people in the city.

“As much as I would want to say there’s no more fatalities, the toll could still go up,” Cebu provincial information officer Ainjeliz Orong said of the landslide.

Mark Ochea, a security guard, said he was working at a big fast food restaurant when one side of the building collapsed.

“It’s a good thing that all of the people were all out front,” he said. “We’re still anxious ... we have even lost count of the number of aftershocks we’ve experienced and it’s been like that since last night.”

Tricycle driver Sonny Cuse said the quake shook his home and he was relieved his family managed to flee in time.

“We thought we could have died today, but we’re thankful that we are all safe. I’m thankful to the Lord,” he said.

The quake was the country’s deadliest since at least 2013, when a 7.2-magnitude quake struck the neighboring island of Bohol, killing 222 people. The Philippines sits on the Pacific “Ring of Fire” and experiences more than 800 quakes each year.

No figure yet on total number missing

There was no immediate figure on Wednesday for the number of people still missing. Authorities said 186 people were injured and issued calls for medical volunteers to help hospitals. Heavy rain and the absence of power made the rescue more difficult.

Earthquake monitoring agencies put the quake’s depth at around 10 km (6.2 miles) and recorded multiple aftershocks, the strongest with a magnitude of 6. There was no tsunami threat.

Videos posted by local media showed people rushing out of their homes on Cebu, a 200 km-long island of 3.4 million people, as the ground shook and buildings collapsed. Huge cracks opened in roads and motorcyclists scrambled to safety on the rails of a bridge that shook rapidly from side to side.

The coast guard deployed a vessel carrying doctors, nurses and other medical personnel bound for Bogo. The crew loaded boxes of medical supplies and sacks of equipment on board.

The government advised visitors to Cebu, among the Philippines’ most popular tourist destinations, to remain on alert. Cebu’s international airport, the country’s second busiest, remained operational.

President promises swift help

President Ferdinand Marcos Jr assured survivors of swift assistance.

“We are assessing the damage, we are assessing the needs,” he told reporters.

Mariano Martinez, mayor of San Remigio close to Bogo, said there were at least 11 casualties in the area, with victims as young as 12 and the death toll expected to climb.

Vice Mayor Alfie Reynes said among the victims were people playing basketball in a sports complex that partially collapsed. She appealed for food, water and heavy equipment.