The death toll from a 7.2-magnitude earthquake in Haiti climbed to 1,297 on Sunday, a day after the powerful temblor turned thousands of structures into rubble and set off frantic rescue efforts ahead of a potential deluge from an approaching storm.

Saturday’s earthquake also left at least 5,700 people injured in the Caribbean nation, with thousands more displaced from their destroyed or damaged homes. Survivors in some areas were forced to wait out in the open amid oppressive heat for help from overloaded hospitals.

The devastation could soon worsen with the coming of tropical depression Grace, which is predicted to reach Haiti on Monday (today) night. The US National Hurricane Centre warned that although Grace had weakened from tropical storm strength on Sunday, it still posed a threat to bring heavy rain, flooding and landslides.

The earthquake struck the southwestern part of the hemisphere’s poorest nation, almost razing some towns and triggering landslides that hampered rescue efforts in a country already struggling with the coronavirus pandemic, a presidential assassination and a wave of gang violence.

The epicenter was about 125 kilometres west of the capital of Port-au-Prince, the US Geological Survey said, and aftershocks continued to jolt the area on Sunday.

In the badly damaged coastal town of Les Cayes, Jennie Auguste lay on a flimsy foam mattress on the tarmac of the community’s tiny airport waiting for anything — space at a hospital or a small plane like the ones ferrying the wounded to the capital. She suffered injuries in the chest, abdomen and arm when the roof collapsed at the store where she worked.

“There has been nothing. No help, nothing from the government,” Auguste’s sister, Bertrande, said.

In scenes widespread across the region hit by the quake, families salvaged their few belongings and spent the night at an open-air football pitch. On Sunday, people lined up to buy what little was available: bananas, avocados and water at a local street market.

Some in the town praised God for surviving the earthquake, and many went to the cathedral, which appeared outwardly undamaged even if the priests’ residence was destroyed.

“We only have Jesus now,” said Johanne Dorcely, whose house was destroyed. “If it wasn’t for Jesus, I wouldn’t be able to be here today.”

Workers tore through the rubble of collapsed buildings with heavy machinery, shovels and picks. After sundown, Les Cayes was darkened by intermittent blackouts and many people slept outside again, clutching small transistor radios tuned to news, terrified of a possible repetition of Saturday’s strong aftershocks.

Prime Minister Ariel Henry has declared a one-month state of emergency for the whole country and said he was rushing aid to areas where towns were destroyed and hospitals were overwhelmed.

“The first convoys started following the coordination efforts of several ministers mobilised at the level of the National Emergency Centre,” Henry told reporters on Sunday. “We salute the dignity, the resilience effort of the victims and their ability to start over. From my observations, I deduce that Haitians want to live and progress. Let us unite to offer these people a living environment conducive to development.”

United Nations Children’s Fund (Unicef) Executive Director Henrietta Fore said on Sunday that humanitarian needs are acute, with many Haitians urgently needing healthcare, clean water and shelter. Children who have been separated from parents need protection, she said.

“Little more than a decade on, Haiti is reeling once again,” Fore said in a statement. “And this disaster coincides with political instability, rising gang violence, alarmingly high rates of malnutrition among children, and the Covid-19 pandemic — for which Haiti has received just 500,000 vaccine doses, despite requiring far more.”

The country of 11 million people received its first batch of US-donated coronavirus vaccines only last month via a UN program for low-income countries.

Haiti’s Office of Civil Protection said more than 7,000 homes were destroyed and nearly 5,000 damaged. Hospitals, schools, offices and churches were also affected.

Medical workers from across the region were scrambling to help as hospitals in Les Cayes started running out of space to perform surgeries.

“Basically, they need everything,” said Dr Inobert Pierre, a pediatrician with the nonprofit Health Equity International, which oversees St Boniface Hospital, about two hours from Les Cayes.

“Many of the patients have open wounds and they have been exposed to not-so-clean elements,” added Pierre, who visited two hospitals in Les Cayes — one with some 200 patients, the other with around 90. “We anticipate a lot of infections.”

Pierre’s medical team was taking some patients to St Boniface to undergo surgery, but with just two ambulances, they could transport only four at a time.

Small planes from a private firm and the Florida-based missionary service Agape Flights landed at the Port-Au-Prince airport on Sunday, carrying about a half dozen injured from the Les Cayes area. Young men with bandages and a woman were hoisted on stretchers to waiting Haitian Red Cross ambulances.

Silvestre Plaza Rico, who was supervising one of the volunteer flights, said rescue planes had made several airlifts of about half dozen injured victims each on Saturday. “There were many, many, many, from different towns,” Plaza Rico said.

The earthquake struck just over a month after President Jovenel Moïse was shot to death in his home, sending the country into political chaos. His widow, Martine Moïse, who was seriously wounded in the attack, posted a message on Twitter calling for unity among Haitians: “Let’s put our shoulders together to bring solidarity.”

Shortly after the earthquake, Henry said he wanted “structured solidarity” to ensure the response was coordinated to avoid the confusion that followed the devastating 2010 earthquake, when aid was slow to reach residents.

US President Joe Biden named US Agency for International Development (USAID) Administrator Samantha Power to oversee the US effort to help Haiti. She announced on Sunday that USAID was sending a search and rescue team from Virginia at the request of Haiti’s government. The 65-person team will bring specialised tools and medical supplies, she said on Twitter.

Working with USAID, the US Coast Guard said a helicopter was transporting medical personnel from the Haitian capital to the quake zone and evacuating the injured back to Port-au-Prince. Lt Commander Jason Nieman, a spokesperson, said another helicopter was being sent from the Bahamas, along with other aircraft and ships.

Already on the scene were several members of Cuba’s 253-member healthcare mission to Haiti, and the socialist nation’s state media showed photos of them giving first aid to victims injured by the quake.

The North Carolina-based aid group Samaritan’s Purse announced it would fly 13 disaster response specialists and 31 tons of emergency supplies to Haiti. These include shelter materials and water filtration units.

Humanitarian workers said gang activity in the seaside district of Martissant, just west of the Haitian capital, was complicating relief efforts.

The UN Office for the Coordination of Humanitarian Affairs said Haiti’s southern peninsula is a “hotspot for gang-related violence,” where humanitarian workers have been repeatedly attacked.

The agency said the area has been “virtually unreachable” over the past two months because of roadblocks and security concerns. But it said late on Sunday that local officials negotiated with gangs in the seaside district of Martissant to allow two humanitarian convoys a day to pass through the area.

Anna Jefferys, spokesperson for the UN agency, said the first convoy passed through Sunday with government and UN personnel. The UN’s World Food Program plans to send food supplies via trucks to southern Haiti on Tuesday, she added.

Haiti, where many live in tenuous circumstances, is vulnerable to earthquakes and hurricanes. A magnitude 5.9 earthquake in 2018 killed more than a dozen people.

The magnitude 7.0 quake of 2010 hit closer to densely populated Port-au-Prince and caused widespread destruction. Haiti’s government put the death toll at more than 300,000, while a report commissioned by the US government placed it between 46,000 and 85,000.