The 7th August 1998, Nairobi American Embassy Bomb Blasts Survivors with Orthopaedic Conditions

Objective: To determine the demography, occupation, types of orthopaedic conditions and conributory factors among survivors of the bomb blast. Design: Retrospective descriptive study. Setting: Health facilities and rehabilitation centres at which survivors attended, Africa medical Research Foundation (AMREF) and at the author’s follow up clinic. The study period of 1999 to 2002. Results: Out of study population of 1090, 315 (29%) had orthopaedic conditions. Of the 305 documented cases, 64% were married and 22% were single, while 64% had between 0-3 and 25% had 4-6 children. Two hundred and seventy seven survivors were subsequently followed during the AMREF implemented medical assistance programme (1999-2002). Female victims were 172 (62.1 %) giving a female to male ratio of 1.6:1. Eighty six percent were in age group 21 to 50 years, with a range of 14 to 77 years and a mean of 36 years. Professionals, executives, managers, semi professionals and skilled workers comprised 89.5% of the victims when documented occupation was considered and was 66% when undocumented occupation was included. The survivors who were inside buildings comprised 71.8% and 75.5% were within 100 metres from the bomb blast site. Fifty percent were first treated in public hospitals. The following injuries were noted:- Fractures 11.9%, tendon injuries 5.1% nerve injuries 3.6% and back injuries 28.5%. The victims who were inside buildings were 70.6% and those within 100 metres radius from the blast site were 74.3%. Survivors with joint injuries were 24.2%. Conclusion: The bomb victims were in economically productive group, and a large percentage having 0-3 dependants. Being inside a building and within 100 metres from the blast carried the largest risk of injury. A re-examination of building by- laws and safety is therefore suggested as well as adequate staffing, training, and equipping of public hospitals since 50% of victims received their first treatment in public hospitals. The economic impact, when finally assessed will be considerable due to loss of property, lives, earnings and cost of medical care. The formation of a disaster management body that will draw up protocols for handling disaster is strongly recommended