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A mas­sive earth­quake that rocked Myan­mar could ex­ac­er­bate hunger and dis­ease out­breaks in a coun­try al­ready wracked by food short­ages, mass dis­place­ment and civ­il war, aid groups and the Unit­ed Na­tions warned Mon­day. The of­fi­cial death toll climbed past 1,700, but the true fig­ure is feared to be much high­er.

The 7.7 mag­ni­tude quake hit Fri­day, with an epi­cen­ter near Myan­mar’s sec­ond-largest city of Man­dalay, dam­ag­ing the city’s air­port, buck­ling roads and down­ing hun­dreds of build­ings along a wide swath of ter­ri­to­ry down the mid­dle of the coun­try.

Some 270 monks were tak­ing an ex­am in Man­dalay’s U Hla Thein monastery, which crum­pled to the ground when the quake struck.