At least 72 people have died after a 6.9 magnitude earthquake struck the island of Cebu in the central Philippines last Tuesday. Nearly 600 people were injured while 25,000 families have been displaced, many of them forced to sleep outdoors.

The quake hit Cebu, one of the country’s most populous islands, around 10:00 p.m. local time, jolting many residents out of their sleep. Roads cracked and buildings collapsed under the intense shaking, which led to widespread power blackouts. The epicentre was 19 kilometres north-east of Bogo, a coastal city of about 90,000 people.

Many of the 72 victims were killed when their houses collapsed, either due to the quake itself or landslides that followed after heavy rain.

Outside Bogo, in the town of Medellin, at least 12 residents were crushed to death by the falling ceilings and walls of their homes, some while sleeping. In another nearby town, San Remigio, five people including a child were killed by crumbling walls as they tried to escape a basketball game.

In Bogo, hundreds of residents gathered in a grassy field in total darkness after fleeing their homes. Forced to spend the night outdoors, many used plastic bags for shelter when it started to rain. Victims of the earthquake helped each other to set up shelters and mobile kitchens and tried to find temporary power sources as the night went on.

The Bogo city hospital was “overwhelmed” with patients, including dozens of injured children and adults, according to civil defence officials. Cebu Governor Pamela Baricuatro posted on social media, “Because of the high volume of patients with serious injuries, the medical staff tended to some of them outside the hospital.”

Patients were wheeled out of the overflowing hospital into tents outside, amid fears of further damage to buildings caused by aftershocks. Earthquake monitoring agencies recorded multiple aftershocks, the strongest being a magnitude of 6.

The extent of the quake’s damage was felt as far as Cebu City, 100 kilometres south of the epicentre, where the metal ceiling of a shopping mall fell down and buildings were left in disrepair.

Regional officials estimate the earthquake damaged or destroyed thousands of homes and has affected around 210,000 families, equivalent to 370,000 individuals. Over 110,000 across 42 communities will need assistance rebuilding homes and restoring livelihoods.

The morning after the quake, survivors lined up to refill containers of water, due to water systems across northern Cebu being damaged. Local authorities issued appeals for food and water to be delivered, as roads were cleared of debris and petrol stations were swamped with long queues.

In a village church now serving as shelter, Lucille Ipil, 43, while waiting for water, told Al Jazeera reporters, “The earthquake really ruined our lives. We cannot eat, drink or bathe properly.”

The provincial government also called on medical volunteers to come to Bogo and assist struggling hospital workers. Makeshift maternity wards were assembled outside hospital for mothers and their newborns.

Relief operations are being obstructed by the widespread damage to infrastructure and electricity cuts. President Ferdinand Marcos Jr, who visited Bogo on Thursday, told reporters, “We are having some difficulty because we have nowhere to put the displaced families because we’re unsure of the integrity of the evacuation centres.”

As a result, hundreds are now living in open fields under tarpaulins or borrowed tents. In San Remigio, nearly a thousand people are staying in two tent cities.

Aid has been particularly delayed in reaching rural areas and mountainous villages, with many bridges still impassable and roads covered from landslides. The Philippine Star spoke to villagers in Tinubdan, including Macasero, 35, a mother of a two-month-old baby who had slept in fields and begged for food on the streets, like many of her neighbours.

Food, potable water, shelter materials and medical supplies remain the top priorities, along with the need for water tankers, generators, and heavy equipment to clear debris and restore access roads, which are clogged with traffic between Cebu City and Bogo.

Aftershocks of 4.5 magnitude were recorded on Sunday, alarming residents still reeling from the devastation. The Cebu Provincial Government is maintaining a “red alert” status.

The Cebu earthquake has come in the middle of one of the worst flooding and typhoon seasons on record in the Philippines. One week before, Cebu and other provinces were battered by Super Typhoon Ragasa, which left at least 27 people dead, knocked out power in entire cities and towns and forced the evacuation of tens of thousands. In July, typhoon flooding killed 31 people.

It was under those conditions that mass protests on September 21 erupted across the Philippines. Tens of thousands joined rallies, including in Cebu, to protest government corruption surrounding flood control infrastructure projects. Recent revelations uncovered kickbacks to government officials and the theft of billions by private contractors.

Catastrophic natural disasters plague the Philippines, a country sitting atop the volcanic Ring of Fire, lashed by two dozen typhoons a year and whose cities are submerged during the monsoon months.

The devastating impact of these natural calamities, however, is a product of the lack of disaster facilities, the unplanned and underfunded system of public infrastructure, and densely crowded urban communities, which are the responsibility of successive governments.

In 2013, the UN Office for Disaster Risk Reduction published a paper outlining the lessons learned from the catastrophic Typhoon Haiyan of that year. It concluded that tests such as soil analysis had to be conducted to ensure the safety of buildings throughout the Philippine archipelago. Furthermore, the number of hazard-adaptive evacuation centres had to be dramatically increased, while disaster programs had to be established to help the overall capacity of municipalities to respond to natural disasters.

In the 12 years since, vast swathes of the archipelago remain just as unprepared for earthquakes, and little has been done to ensure new buildings are constructed to resist further calamities. The Philippine political establishment, committed to protecting the corporate elite’s profit interests, will not spend the resources required to address social necessity.

During his visit to the earthquake site, President Marcos promised to provide a miserable 10,000 pesos ($US171) to each family that lost its home. Meanwhile, his administration’s drastic increases to military spending, as part of a US-led war drive against China, express the real priority of the Philippine ruling elite.

The Marcos government is no doubt fearful that such a pro-corporate agenda will provoke further mass opposition, as it has in recent weeks. According to local media outlets, the Philippine military reportedly deployed soldiers to “help maintain order” during the government’s relief efforts.