In June 1989, a methane/propane pipeline explosion destroyed two passenger trains in the Bashkirian Republic of the Soviet Union. Over 400 passengers died immediately and 806 were injured. Most of those injured suffered thermal injuries. One hundred and fifty patients were treated at Hospital 21 in Ufa, Bashkiria, by a combined Soviet-US team. Twenty-six patients underwent excision and grafting of their burn wounds. Microbiological studies indicated significant resistance to locally available antibiotics. Antibiotics provided by the US team proved useful in treating the resistant organisms. This disaster and the international response to it exemplify the need for a coordinated response to major burn disasters and the positive results of international cooperation.