In pictures: El Salvador's continuing agony

Tuesday's earthquake struck an impoverished and already traumatised country struggling to recover from the effects of last month's earthquake, which left more than a thousand dead.

With their hospital no longer safe, the open air provides the only refuge for these young patients

The earth rocks and Salvadorans again face picking up shattered lives

From the air, the destruction is only too apparent

On the ground, familiar landmarks have disappeared

Buildings left standing have been weakened further and pose yet more danger

The real cost though is in human lives

Hours after the quake, people try to come to terms with their grief