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Terrorists Use of Ambulances for Terror Attacks: A Review

Published online by Cambridge University Press:  28 October 2020

Gregory N. Jasani*
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, MarylandUSA
Reem Alfalasi
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, MarylandUSA
Garrett A. Cavaliere
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, MarylandUSA
Gregory R. Ciottone
Affiliation:
Division of Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsUSA
Benjamin J. Lawner
Affiliation:
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MarylandUSA Maryland ExpressCare Critical Care Transport Program, Baltimore, MarylandUSA
*
Correspondence: Gregory Jasani, MD 110 S Paca St 6th floor, Ste 200 Baltimore, Maryland21201USA E-mail: gjasani@som.umaryland.edu

Abstract

Introduction:

Using an ambulance as an attack modality offers many advantages to a terrorist organization. Ambulances can carry more explosives than most vehicles and can often bypass security. Yet, studies examining how terrorist organizations have incorporated ambulances into their attacks are lacking.

Study Objective:

This article seeks to identify and analyze known instances in which an ambulance has been used in a terrorist attack.

Methods:

The Global Terrorism Database (GTD) was searched for terrorist events that involved the use of an ambulance from the years 1970-2018. Variables of event time, location, and loss of life were analyzed.

Results:

Twenty instances where an ambulance had been used in a terrorist attack were identified from the GTD. Fifteen of the attacks occurred in the Middle East, while the remaining five occurred in Southeast Asia. All attacks except one had occurred after 2001, and 13 had occurred within the past decade. Most attacks (12/20) resulted in up to three people killed, while six attacks had 10-20 casualties. The deadliest attack occurred in Kabul, Afghanistan in 2018 and caused over 100 casualties. One event did not have casualty information in the GTD. In all cases, ambulances were used as vehicle-borne improvised explosive devices (VBIED) by terrorist organizations.

Conclusion:

This study shows that terrorists are increasingly acquiring and utilizing ambulances in their attacks, often with deadly consequences. Security and public health experts must be aware of this hazard and work to deny terrorists access to these vehicles.

Type
Original Research
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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