Crush syndrome results from prolonged pressure on limbs causing disintegration of muscle tissue (rhabdomyolysis) and release of myoglobin, potassium, and phosphate into the circulation (34). Systemic effects include hypovolemic shock, hyperkalemia, renal failure, and fatal cardiac arrhythmias. Patients with crush syndrome may develop kidney failure and require dialysis (35). Following the 1988 earthquake in Armenia, more than 1,000 victims trapped in collapsed buildings developed crush syndrome as a result of limb compression; 323 developed secondary acute renal failure requiring renal dialysis (36). Amputations and chronic sequelae of orthopedic and neurologic injuries, especially spinal cord injuries, can be expected (37). For example, a rate of 1.5 cases of paraplegia/1,000 injured was observed after the Guatemalan earthquake (38), and more than 2,200 people became paraplegics as a result of injuries sustained in the 1976 Tangshan quake (6). Following the Tangshan earthquake, all these chronically disabled people required extensive treatment and rehabilitation in long-term-care facilities. This care significantly taxed the health care system in the region for years to come.