Rescuers in Haiti used heavy equipment and their bare hands on August 16 to hunt for survivors under buildings flattened two days ago by a massive earthquake that killed more than 1,400 people, while an approaching storm threatened more suffering.

Flash floods and mudslides were possible as the front bore down on the Caribbean nation’s southwestern peninsula, which was hard-hit by a 7.2-magnitude quake that toppled thousands of buildings early on August 14.

Hospitals have been overwhelmed with the influx of injured patients, and workers were at a loss with how they might cope with Tropical Depression Grace.

Haiti’s civil protection agency gave a preliminary toll on August 16 of 1,419 dead and 6,900 injured in the powerful quake that struck about 160km to the west of the capital Port-au-Prince.

The earthquake also destroyed more than 37,000 homes, officials said.

“We’re really not doing well psychologically. We have absolutely no idea how we’re going to get through this,” said 26-year-old midwife Aline Cadet, who was helping at the hospital in the hard-hit town of Port-Salut.

“There are women here who were pregnant but lost their baby because they fell or were injured,” she added.

According to the US National Hurricane Center (NHC), Haiti and the Dominican Republic – which share the Caribbean island of Hispaniola – could expect 12-26cm of rain from Grace, “with isolated maximum totals” of 38cm across southern areas through August 17.

“This heavy rainfall may lead to flash and urban flooding, and possible mudslides,” the NHC warned.

Residents faced a dilemma of staying outside to protect themselves from aftershocks, or returning to damaged buildings to shelter from Grace’s heavy rain, which was soaking Haiti by the afternoon of August 16.

The hospital in Port-Salut made its call – the patients being treated in a courtyard were brought into the building for protection from the storm, despite the risks.

“The doctors have asked us to go inside this evening. It’s not safe. There are still tremors, that’s why we’re outside,” said Wilfried Labaye, 41.

His wife Esperance Rose Nadine, 36, was laying on the ground next to him, both of her legs broken when their home collapsed during the quake.

Haiti, still recovering from a massive 2010 tremor that devastated the capital Port-au-Prince, was already in shock from President Jovenel Moise’s assassination last month when the disaster hit. The head of state was assassinated in his home by a team of gunmen, shaking a country already battling poverty, spiralling gang violence and Covid-19.

Some aid has come in from abroad, including 15.4 tonnes of food, medicine and water from Mexico, as well as specialised search crews from the US.

The 7.0-magnitude quake in January 2010 left much of Port-au-Prince and nearby cities in ruins, killing more than 200,000.

More than 1.5 million Haitians were made homeless in that disaster, which also destroyed 60 per cent of Haiti’s healthcare system, leaving authorities and the international humanitarian community with a colossal challenge.