Injured children cried and adults screamed while being treated on beds beneath blue tents outside the Cebu Provincial Hospital, having been wheeled outside as a precaution against waves of aftershocks overnight.

They are survivors of the shallow magnitude 6.9 quake that struck late on Tuesday off Cebu island's north near Bogo, a city of 90,000 people, according to the US Geological Survey.

Others were not so fortunate, and AFP journalists saw hospital workers loading black body bags into vans that took the dead to local mortuaries.

"Many of them were pinned down by debris, which caused their death," Office of Civil Defence deputy administrator Rafaelito Alejandro said on government television, putting the updated death toll at 69.

Richard Guion, his left elbow heavily bandaged, told how he and his wife, who broke her foot, were dug from under the collapsed concrete wall of their home by their 17-year-old son, who was playing outside when the quake struck.

"When the cement collapsed, I called out to him," said the 39-year-old Guion, thankful his son ignored his order to go to bed early.

Thirty people were killed in Bogo, the civil defence office's Alejandro said.

In other municipalities near the quake's epicentre, 22 were killed in San Remigio, 10 in Medellin, five in Tabogon and one each in Sogod and Tabuelan, he said.

The Bogo hospital put the number of injured at 186 so far.

- 'I am struggling' -

Teddy Fontillas, 56, told AFP he had not slept while he helped transfer the injured to other hospitals.

"I'm already struggling, but what we are doing is necessary to help our patients," he said.

Elsewhere in Bogo, firemen used excavators to drill holes into the collapsed heap of a two-storey motel, where two receptionists and a child were feared trapped beneath debris.

A distraught Isagani Jilig, whose wife and child are among the missing, joined about a hundred people watching the rescue.

"I will never leave this site until I find them again. As a father, I have to be strong now more than ever," Jilig, 41, told AFP.

Fireman Erwin Castaneda said they had been searching for five hours but "we cannot give up".

"We are talking about lives here. We will do everything that we can," he told AFP.

President Ferdinand Marcos pledged swift aid for victims.

"I offer my heartfelt condolences to the bereaved families," he said in a statement.

Dramatic footage filmed by residents on Bantayan island near Cebu showed a string of light bulbs on an old Catholic church swaying wildly before the church's belfry tumbled into the courtyard.

Local television showed riders dismounting from their motorcycles and holding onto railings as a Cebu bridge rocked violently.

In Cebu city, 100 kilometres (60 miles) to the south, online shoe merchant Jayford Maranga said he hid under a restaurant table to avoid the collapsing metal ceiling of a shopping mall.

"My friend and I ate at the food court near closing time, and then, bang! It was as if the Earth stopped spinning. And then the mall started shaking," 21-year-old Maranga told AFP.

The Cebu provincial government has put out a call on its official Facebook page for medical volunteers to assist in the quake's aftermath.

A number of village roads also sustained damage. The road in Tabogon town was riddled with five-centimetre (two-inch) cracks, AFP journalists saw.

Earthquakes are a near-daily occurrence in the Philippines, which is situated on the Pacific "Ring of Fire", an arc of intense seismic activity stretching from Japan through Southeast Asia and across the Pacific basin.

Most are too weak to be felt by humans but strong and destructive quakes come at random, with no technology available to predict when and where they might strike.