People called out from beneath the remains of a flattened three-storey shop in the capital Port Vila, where scores of rescuers worked through the night to find them, resident Michael Thompson told AFP by satellite phone.
"We got three people out that were trapped. Unfortunately, one of them did not make it," he said.
About 80 people including police, medics, trained rescuers and volunteers used excavators, jackhammers, grinders and concrete saws, "just everything we can get our hands on".
When rescuers on the site went quiet, they could hear three people within signalling they were alive on Wednesday morning, Thompson said.
"There's tonnes and tonnes of rubble on top of them. And two rather significant concrete beams that have pancaked down," he said. "Obviously they are lucky to be in a bit of a void."
The 7.3-magnitude quake struck off Vanuatu's main island at 12:47 pm local time (0147 GMT) on Tuesday.
- 'Major landslide' -
It flattened large buildings, cracked walls and shattered windows, and set off landslides in the low-lying archipelago of 320,000 people, which lies in the quake-prone Pacific Rim of Fire.
Australia and New Zealand said they planned to fly in medical and search-and-rescue teams on Wednesday to provide urgent assistance.
The dead included four in Port Vila's hospital, six in a landslide, and four in the collapsed shop, said an update by Vanuatu's disaster management office obtained by AFP.
Two of the dead were Chinese citizens, the country's ambassador to Vanuatu told Chinese television.
The quake caused "major structural damage" in at least 10 buildings, including the main hospital, while also hitting three bridges and two power lines, the disaster office's report said.
Two major water reserves supplying Port Vila had been "totally destroyed". Mobile and internet network connectivity was "intermittent" and Port Vila's main wharf was closed "due to a major landslide".
The airport was "not operational" but could handle incoming humanitarian aid, the report said.
- 'We could hear screams' -
A string of aftershocks has since shaken the Pacific island nation.
The ground floor of a four-storey concrete block in Port Vila -- used by the US, French, British, Australian and New Zealand diplomatic missions -- collapsed, AFP photos showed.
US, French and Australian staff members who were inside are safe, the three countries have said.
Thompson, who runs a zipline adventure business in Vanuatu, said he had seen at least three bodies in the city.
He drove near the airport past a toppled four-storey block shortly after the quake. Its ground floor had collapsed under the upper stories.
"When we slowed down with the windows down, we could hear screams coming from inside," he said.
The quake crushed four large buildings in Port Vila and triggered landslides including one that had covered a bus, Thompson said.
- Broken glass, debris -
The UN Office for the Coordination of Humanitarian Affairs estimated 116,000 people could be affected by the worst impacts of the quake.
"Immediate response efforts are ongoing as humanitarian partners and authorities work to overcome access and communication challenges," it said in a situation update.
Some people injured in the quake were driven in flat-bed trucks to the Port Vila hospital where others lay in stretchers outside or sat on plastic chairs, their arms and heads wrapped in bandages, public television VBTC images showed.
Video posted by Thompson and verified by AFP showed buildings that folded to the ground and streets strewn with broken glass and other debris from the wreckage.
Vanuatu is ranked as one of the countries most susceptible to natural disasters such as earthquakes, storm damage, flooding and tsunamis, according to the annual World Risk Report.
bur-djw/pbt
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