Terrorist bomb explosion in Nairobi Kenya 7th August 1998. an analysis of soft tissue and other injuries sustained and their management

Abstract

Terrorist bombings are ugly acts of the modern world that are usually politically motivated. The explosives used range from home made devices to conventional explosives such as grenades and bombs, with materials such as nails, radioactive and toxic substances added to the explosive devices sometimes. On 7th August 1998, Nairobi was the victim of a terrorist attack targeted at the American embassy. The dual explosion injured non-suspecting civilians as well as rescuers. This retrospective study has analyzed the effects and injuries due to this bombing. All patients treated at Kenyatta Hospital for blast related injuries that met the inclusion and exclusion criteria were included in the study. Data was collected in a questionnaire and entered into Microsoft excel and SPSS data sheets for analysis. An estimated 5000 people were injured in the bombing, while 213 died at the site. 1471 were treated at Kenyatta National hospital for bomb blast related injuries. 54.5% were male, 71.6% were between 20 and 40 years old. Flying debris and shrapnel caused most of the injuries. The injured sustained mainly soft tissue injuries that were treated on an out patient basis. The regional distribution of soft tissue injury suggests the protective role of clothing and headgear. Scars; keloids and hypertrophic scars, were the commonest complication following these injuries. Scar management formed the bulk of work during the reconstruction period. Patients were admitted mainly for injuries that required surgery in main theatre, head injury was the main cause of in-patient hospital deaths. Though skeletal injuries were uncommon, most of the fractures seen involved long bones. Effective management of a disaster of this magnitude requires inter-departmental cooperation. Triage should start at the site of accident, and the casualties rapidly transported to medical care institutions. In hospitals, a disaster management team, whose responsibility is to rapidly mobilize human and material resources, is essential