Forensic findings from the Nairobi U.S. embassy terrorist bombing

Background: The 1998 terrorist bombing of the US-Embassy in Nairobi resulted in the highest number of civilian deaths ever recorded from a single urban terrorist bombing in global history. Objective: To present forensic findings from the Nairobi terrorist bombing and discuss some contributory factors to the high-fatality witnessed. Design: Desriptive retrospective study. Setting: Office of the Chief Government Pathologist of Kenya. Results: A total of 211 persons were confirmed to have died as a direct result of the bomb blast. Out of the 201 cases examined in this paper, 198 (99%) died on the day of the blast. Sixty percent of the deceased were males and 85% were aged between 21 and 50 years. Most of the deceased were visually identified (95%). The rest required fingerprinting (3%), DNA testing (2%), and forensic odontology (1%). Ninety six percent of the victims (194 cases) had primary blast injuries. The typical triad of blast fragmentation injuries was found in only 47% of the cases. Eighty nine percent (179 cases) had injuries in multiple anatomical regions. The most common cause of death was head injury (30%). Conclusion: The anatomical pattern of injuries and other pathological findings among fatalities from this terrorist bombing are similar to those recorded from other bombing incidents worldwide. Contributory factors to the high fatality include the collapse of a densely populated building, the TNT-equivalent force of the bomb, the confined site of detonation, and probably the lack of a proper disaster response system. East African Medical Journal Vol. 83(7) 2006: 380-38