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Mass-Casualty Terrorist Bombings In Istanbul, Turkey, November 2003: Report of the Events and the Prehospital Emergency Response

  • Ülkümen Rodoplu (a1), Jeffrey L. Arnold (a2), Rifat Tokyay (a3), Gurkan Ersoy (a4), Serkan Cetiner (a5) and Tayfun Yücel (a6)...

Abstract

Background:

This paper describes the two mass-casualty, terrorist attacks that occurred in Istanbul, Turkey in November 2003, and the resulting prehospital emergency response.

Methods:

A complex, retrospective, descriptive study was performed, using open source reports, interviews, direct measurements of street distances, and hospital records from the American Hospital (AH) and Taksim Education and Research State Hospital (TERSH) in Istanbul.

Results:

On 15 November, improvised explosive devices (IEDs) in trucks were detonated outside the Neve Shalom and Beth Israel Synagogues, killing 30 persons and injuring an estimated additional 300. Victims were maldistributed to 16 medical facilities. For example, AH, a private hospital located six km from both synagogues, received 69 injured survivors, of which 86% had secondary blast injuries and 13% were admitted to the hospital. The TERSH, a government hospital located 1 km from both synagogues, received 48 injured survivors. On 20 November, IEDs in trucks were detonated outside the Hong Kong Shanghai Banking Corporation (HSBC) headquarters and the British Consulate (BC), killing 33 and injuring an estimated additional 450. Victims were maldistributed to 16 medical facilities. For example, TERSH, located 18 km from the HSBC site and 2 km from the the BC received 184 injured survivors, of which 93% had secondary blast injuries and 15% were hospitalized. The AH, located 9 km from the HSBC site and 6 km from the BC, received 16 victims.

Conclusion:

The twin suicide truck bombings on 15 and 20 November 2003 were the two largest terrorist attacks in modern Turkish history, collectively killing 63 persons and injuring an estimated 750 others. The vast majority of victims had secondary blast injuries, which did not require hospitalization. Factors associated with the maldistribution of casualties to medical facilities appeared to include the distance from each bombing site, the type of medical facility, and the personal preference of injured survivors.

Copyright

Corresponding author

Ali Cetinkaya Blvd, No. 35/7-8, Alsancak, Izmir Turkey E-mail: ulkumenrodoplu@ttnet.net.tr

References

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1Central Intelligence Agency.Turkey. CIA World Fact Book Website. Available at www.cia.gov/cia/publications/factbook/. Accessed 30 September 2003.
2Ministry of Foreign Affairs. Turkey and the world – 2010-2020. Republic of Turkey Ministry of Foreign Affairs Website. Available at www.mfa.gov.tr/grupe/eh/eh13/09.htm. Accessed 30 September 2003.
3Rodoplu, U, Arnold, J, Ersoy, G: Terrorism in Turkey: Implications for emergency management. Prehosp Disast Med 2003;18(2):152160.
4Anadolu Agency. People injured in explosions in Istanbul identified. 15 November 2003. LexisNexis Academic Website. Available at http://web.lexisnexis.com. Accessed 19 March 2004.
5Anadolu Agency. Thirty-four people discharged from VKV American Hospital. 15 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
6Anatolian Agency. We condemn terrorism. Cumhuriyet Bulletin. 16 November 2003.
7Anatolian Agency. List of the wounded. Cumhuriyet Bulletin. 21 November 2003.
8Anonymous. The list of dead and wounded. Milliyet Website. Available at http://www.milliyet.com.tr/2003/11/15/son/sontur12.html. Accessed 29 March 2004.
9Anonymous. The list of dead and wounded. Milliyet Website. Available at http://www.milliyet.com.tr/2003/11/21/son/sontur03.html. Accessed 29 March 2004.
10Bortnick, RA: Names of wounded in hospitals.World Separdic News Service Website. Available at www.sephtardinews.com/names.html. Accessed 16 March 2004.
11Cumhuriyet Istanbul Bureau: The hospitals were in alarm. Cumhuriyet Bulletin. 21 November 2003.
12Agence France Presse: Istanbul blast claim 20 lives, injure 257 people. 15 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
13Anadolu Agency. Bombs with high destructive capacity produced by ammonium sulfate, nitrate and pressed fuel oil used in attacks in Istanbul. 16 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
14Anadolu Agency. Car bomb kills 20 at Istanbul synagogues. 15 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2003.
15Anadolu Agency. Explosions occurred in two synagogues in Istanbul. 15 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2003.
16Bastion, J: Scenes of mayhem in Istanbul after two car bombs target synagogues. 15 November 2003. Agence-France-Presse. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
17Bastion, J: Synagogue bombings leave Istanbul in mayhem. Agence-France-Presse. ClariNews Website. Available at http:quickstart.clari.net. Accessed 19 March 2004.
18Deutsche Presse-Agentur: Four more charged in connection to Istanbul bomb attacks. 27 November 2003. LexisNexis Academic Website. Available at http//:web.lexis-nexis.com. Accessed 19 March 2004.
19Helicke, JC: Simultaneous car bombs hit near synagogues in Istanbul; at least 17 people killed. Associated Press. 15 November 2003. LexisNexis Academic Website. Available at http//:web.lexis-nexis.com. Accessed 19 March 2004.
20Jenkins, G: Synagogue bombs kill Turkish Muslims. Sunday Times (London). 16 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
21Jenkins, G: Terror strikes Turkey. Al-Ahram Weekly Website. Available at http://weekly.ahram.org.eg/pring/2003/665/re4.htm. Accessed 21 March 2004.
22Keinon, H: Twin Istanbul bombings kill 23. The Jerusalem Post. 16 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
23Lazaroff, T and Keinon, H: Al-Qaida behind Istanbul bombings. The Jerusalem Post. 17 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
24O'Byrne, D: Suicide bomb blasts kill 20 at synagogues. Main on Sunday (London). 16 November 2003. LexisNexis Academic Website. Available at http//:web.lexis-nexis.com. Accessed 19 March 2004.
25Zaman, A and Wilkinson, T: Blasts rock synagogues in Turkey, killing 20; The two car bombings in Istanbul also injured hundreds, most outside the targeted structures. Los Angeles Times. 16 November 2003. LexisNexis Academic Website. Available at http//:web.lexis-nexis.com. Accessed 19 March 2004.
26Global News Wire – Asia Africa Intelligence Wire: Turkish experts: Highly destructive 300-400 kg explosive used in synagogue bomb. BBC Monitoring International Reports. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
27Anadolu Agency: Seventy buildings damaged in Saturday's explosion in Beyoglu. 17 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
28Agence France Presse: Turkey charges three more people over Istanbul bombings. 07 December 2003. LexisNexis Academic Website. Available at http//:web.lexis-nexis.com. Accessed 19 March 2004.
29Anadolu Agency. Health Minister Akdag: There are currently 77 people in hosptials having treatment. 16 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
30Anadolu Agency: People who die and injured are identified. 16 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
31Associated Press: Man dies of injuries in Turkish synagogue bombing, raising death toll to 63. 9 February 2004. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
32Anonymous: It happened in 2003. The Jerusalem Post. 26 December 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
33Erdem, S: Al-Qaeda admits Istanbul bombings and warns of more. The Times (London). 17 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
34Aygin, E and Helicke, JC: Deadly truck bombs hit British consulate, London-based bank in worst terrorist blasts in Turkish history. Associated Press. 20 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
35Dovkants, K, Dougherty, H: Terrorist's key aim was to kill the British consul. The Evening Standard (London). 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
36Akinci, B: Fear grips Istanbul after second deadly set of blasts. Agence France Presse. 20 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
37Anadolu Agency. 27 dead, 450 wounded in Istanbul bombings. 20 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
38Dovkants, K, Atik, N, Dougherty, H: The moment we were all blown up. The Evening Standard (London). 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
39Moore, M: Bombers hit British targets in Istanbul. At least 27 dead, hundreds hurt at Consulate, bank. The Washington Post. 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
40Nelson, SS: 26 dead as blast hit British targets in Turkey. Knight Ridder/Tribune News Service. 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
41Pope, I: I thought it was an earthquake…then I saw the blood and bodies; 27 killed and 450 injured as British targets are bombed. Daily Record (Scotland). 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
42Smith, CS, Arsu, S: A region inflamed: Istanbul; Blasts hit 2 British sites in Turkey as Bush visits Blair. The New York Times. 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
43Turgat, P, Huggler, J: Terror at the Consulate. The Independent (UK). 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
44Anadolu Agency: Aksu: Vehicles and bombs used in today's and last Saturday's attacks are almost the same. 20 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
45Free Press News Services: Istanbul bombs, kill 27; about 450 were hurt in blasts at a bank and the British Consulate. London Free Press (Ontario, Canada). 21 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
46Gorvett, J: British consul among dead in Istanbul blasts. Aljazeera Website. Available at http://english.aljazeera.net. Accessed 19 March 2004.
47Bloomberg, : Hong Kong Shanghai Banking Corporation shares decline after Istanbul offices are bombed. Bloomberg Website. Available at http:quote.bloomberg.com. Accessed 21 March 2004.
48Anadolu Agency: Garden wall of British Consulate General in Istanbul destroyed in blast. 20 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
49Harding, L, Smithy, H, Burke, J: Istanbul bombings. The Observer. 23 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
50Anadolu Agency: 38 buildings damaged in the blast in British consulate general in Istanbul. 21 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
51Anadolu Agency: Terrorist attacks in Istanbul – treatment of 57 persons continues in hospitals. 21 November 2003. TurkishPress Website. Available at www.turkishpress.com. Accessed 19 March 2004.
52Cook, L: Dateline: Istanbul, November 26. Agence France Presse. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
53Global News Wire-Asia Africa Intelligence Wire: Turkish market dives, global stocks fall after Istanbul bombings.Turkish Daily News. 21 November 2003. LexisNexis Academic Website. Available at http://web.lexisnexis.com. Accessed 19 March 2004.
54Agence France Presse: Turkish authorities ban pictures of dead and injured in Istanbul. 20 November 2003. LexisNexis Academic Website. Available at http://web.lexis-nexis.com. Accessed 19 March 2004.
55Arnold, JL, Tsai, MC, Halpern, P et al. : Mass-casualty, terrorist bombings: Epidemiological outcomes, resource utilization, and time course of emergency needs (Part I). Prehosp Disast Med 2003; 18(3):220234.
56Batho, S, Russell, L, Williams, G: Crisis management to controlled recovery: The emergency planning response to the bombing of Manchester City Centre. Disasters 1999;23(3):217233.
57Carley, SD, Mackway-Jones, K: The casualty profile from the Manchester bombing 1996: A proposal for the construction and dissemination of casualty profiles from major incidents. J Accid Emerg Med 1997;14:7680.
58Caro, D, Irving, M: The Old Bailey bomb explosion. Lancet 1973;1: 14331435.
59Cooper, GJ, Maynard, RL, Cross, NL, et al. : Casualties from terrorist bombings. J Trauma 1983;23:955967.
60Feliciano, DV, Anderson, GV, Rozycki, GS, et al. : Management of casualties from the bombing at the Centennial Olympics. Am J Surg 1998; 176:538543.
61Hill, JF: Blast injury with particular reference to recent terrorist bombings incidents. Ann Roy Coll Surg Engl 1979;61:411.
62Johnstone, DJ, Evans, SC, Field, RE, et al. : The Victoria bomb: A report from the Westminster Hospital. Injury 1993;24:59.
63Leibovici, D, Gofrit, ON, Stein, M, et al. : Blast injuries – bus versus open-air bombings: A comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma 1996;41:10301035.
64Paran, H, Neufeld, D, Shwartz, I, et al. : Perforation of the terminal ileum induced by blast injury: Delayed diagnosis or delayed perforation? J Trauma 1996;40:472475.
65Rutherford, WH: Experience in the Accident and Emergency Department of the Royal Victoria Hospital with patients from civil disturbances in Belfast 1969-1972, with a review of disasters in the United Kingdom 1951–1971. Injury 1973;4(3):189199.
66Walsh, RM, Pracy, JP, Huggon, AM, et al. : Bomb blast injuries to the ear: The London Bridge incident series. J Accid Emerg Med 1995;12:194198.
67Withers, JN: Personal protection during the bombing of the Victoria BOQ. Mil Med 1996;131:12851289.
68Hogan, DE, Waeckerle, JF, Dire, DJ, et al. : Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med 1999;34:160167.
69Centers for Disease Control: Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center – New York City, September 2001. MMWR 2002;51:15.
70Jacobson, S: Recollections of 11 September 2001. Acad Emerg Med 2002; 9:216.
71Menlove, S: Reflections. 11 September 2001 – What we learned. Acad Emerg Med 2002;9:217.
72Nierenberg, R: Reflections. 11 September 2001 – What we learned. Acad Emerg Med 2002;9:217.
73Pesola, GR, Dujar, A, Wilson, S: Emergency preparedness: The World Trade Center and Singapore Airline Disasters. Acad Emerg Med 2002;9:220222.

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