Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-10-31T17:46:32.271Z Has data issue: false hasContentIssue false

Suicide Bombing Terrorism

Published online by Cambridge University Press:  22 October 2021

Derrick Tin*
Affiliation:
Senior Fellow, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Cambridge, MassachusettsUSA
Jordan Galehan
Affiliation:
Assistant Professor of Criminology, Department of Behavioral Sciences, Flagler College, Saint Augustine, FloridaUSA
Vesna Markovic
Affiliation:
Professor and Chair, Justice, Law and Public Safety Studies, Lewis University, Romeoville, IllinoisUSA
Gregory R. Ciottone
Affiliation:
Director, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, MassachusettsUSA
*
Correspondence: Derrick Tin, MBBS Senior Fellow, BIDMC Disaster Medicine Fellowship Department of Emergency Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Cambridge, MassachusettsUSA E-mail: dtin@bidmc.harvard.edu

Abstract

Introduction:

While suicide bombings in the context of warfare have existed throughout history, there was an exponential rise in such attacks in the decade following the initiation of the War on Terror. The health care implications of such attacks are a growing concern across the emergency response sector, and this study is an epidemiological examination of all terrorism-related bombings sustained from 1970-2019, comparing the rates of fatal injuries (FI) and non-fatal injuries (NFI) between suicide bombing attacks (SBA) versus non-suicide bombing attacks (NSBA).

Method:

Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD database was downloaded and searched using the internal database search functions for all events that occurred from January 1, 1970 - December 31, 2019. Bombing/explosion as a primary “attack type” and explosives as a primary “weapon type” were selected for the purpose of this study, and events were further sub-classified as either “suicide attack” or “non-suicide attack.” Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis.

Findings:

There were 82,217 bombing/explosion terrorist attacks using explosives documented during the study period with 135,807 fatalities and 352,500 NFI.

A total of 5,416 events (6.59% of all events) were sub-classified as SBA causing 52,317 FI (38.52% of all FI) and 107,062 NFI (30.37% of all NFI).

Mean SBA FI was 9.66 per event and mean SBA NFI was 19.77 per event compared to a mean NSBA FI of 1.09 per event and mean NSBA NFI of 3.20 per event.

Conclusion:

Suicide bombing attacks are a unique terrorist methodology that can inflict wide-spread psychological damage as well as significantly higher death and injury tolls when compared to more traditional NSBA. They have been increasing in popularity amongst terrorist organizations and groups, and Counter-Terrorism Medicine (CTM) specialists need to be aware of the unique injury patterns and potential risk mitigation strategies associated with SBA depending on the target type, location, and gender of the perpetrator.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Horowitz, MC. The rise and spread of suicide bombing. Annual Review of Political Science. 2015;18:6984.CrossRefGoogle Scholar
Pedahzur, A, Martin, S.Suicide Attacks.” In: LaFree, G, Freilich, JD, (eds). Handbook of the Criminology of Terrorism. Hoboken, New Jersey USA: John Wiley & Sons; 2015.Google Scholar
Markovic, V. Suicide squad: Boko Haram’s use of the female suicide bomber. Women Crim Justice. 2019;29(4-5):283302.CrossRefGoogle Scholar
Hoffman, B. The Logic of Suicide Terrorism. The Atlantic. 2003. https://www.theatlantic.com/magazine/archive/2003/06/the-logic-of-suicide-terrorism/302739/. Accessed April 12, 2021.Google Scholar
Temple-Raston, D. How Much Does a Terrorist Attack Cost? A Lot Less Than You’d Think. NPR. 2014. https://www.npr.org/sections/parallels/2014/06/25/325240653/how-much-does-a-terrorist-attack-cost-a-lot-less-than-you-think. Accessed April 12, 2021.Google Scholar
Kiras, J. Suicide Bombing. Britannica. 2011. https://www.britannica.com/topic/suicide-bombing. Accessed April 12, 2021.Google Scholar
Vallance, K. Iraqi Embassy in Beirut racked in “kamikaze” hit. The Christian Science Monitor. 1981. https://www.csmonitor.com/1981/1216/121619.html. Accessed June 3, 2021.Google Scholar
Kapusta, P. Suicide Bombers in CONUS. Sch Adv Mil Stud United States Army Command. 2007.Google Scholar
Helmer, D. Employment of Suicide Bombing During the 1980s. Fort Leavenworth, Kansas USA: Army Univ Press; 2006.Google Scholar
Ahmadzai, A. Perspectives on Terrorism: Dying to Live: The “Love to Death” Narrative Driving the Taliban’s Suicide Bombings. Perspect Terror. 2021;XV(1):1738. https://www.universiteitleiden.nl/binaries/content/assets/customsites/perspectives-on-terrorism/2021/issue-1/vol-15-issue-1.pdf. Accessed April 12, 2021.Google Scholar
Court, M, Edwards, B, Issa, F, Voskanyan, A, Ciottone, G. Counter-Terrorism Medicine: creating a medical initiative mandated by escalating asymmetric attacks. Prehosp Disaster Med. 2020;35(6):595598.CrossRefGoogle ScholarPubMed
Global Terrorism Database (GTD). START.umd.edu. https://www.start.umd.edu/data-tools/global-terrorism-database-gtd. Accessed March 14, 2021.Google Scholar
Codebook: Inclusion Criteria and Variables. College Park, Maryland USA: National Consortium for the Study of Terrorism and Responses to Terrorism; 2019.Google Scholar
Markovic, V. Suicide bombings and lethality: a statistical analysis of tactics, techniques and procedures. Dissertation Abstracts International Section A: Humanities and Social Sciences. 2009. https://www.worldcat.org/title/suicide-bombings-and-lethality-a-statistical-analysis-of-tactics-techniques-and-procedures/oclc/436171062. Accessed June 3, 2021.Google Scholar
Ganor, B. The rationality of the Islamic radical suicide attack phenomenon. Int Inst Counter-Terrorism. 2007. https://www.ict.org.il/Article/973/TheRationalityoftheIslamicRadicalSuicideattackphenomenon#gsc.tab=0. Accessed June 3, 2021.Google Scholar
Kimhi, S, Even, S. Who are the Palestinian suicide bombers? Terrorism and Political Violence. 2004;16:815840.CrossRefGoogle Scholar
Almogy, G, Belzberg, H, Mintz, Y, Pikarsky, AK, Zamir, G, Rivkind, AI. Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239(3):295303.CrossRefGoogle ScholarPubMed
Grimland, M, Apter, A, Kerkhof, A. The phenomenon of suicide bombing: a review of psychological and non-psychological factors. Crisis. 2006;27(3):107118.CrossRefGoogle Scholar
Davis, J. Evolution of the Global Jihad: female suicide bombers in Iraq. Stud Confl Terror. 2013;36(4):279291.CrossRefGoogle Scholar
Cragin, R, Daly, S. Women as Terrorists: Mothers, Recruiters, and Martyrs. Westport, Connecticut USA: Praeger Security International. 2009.Google Scholar
Holmes, S. Women in modern terrorism, from liberation wars to global jihad and the Islamic State. J Policing, Intell Count Terror. 2018;13(3):375.CrossRefGoogle Scholar
Pape, R. The Strategic Logic of Suicide Terrorism. American Political Science Review. 2003;97:343361.CrossRefGoogle Scholar
Warner, J, Matfess, H. Exploding Stereotypes: The Unexpected Operational and Demographic Characteristics of Boko Haram’s Suicide Bombers. Combatting Terrorism Center at West Point, United States Military Academy; 2017.Google Scholar
Galehan, J. Instruments of violence: female suicide bombers of Boko Haram. Int J Law Crime Justice. 2019;58:113123.CrossRefGoogle Scholar
Bala, M, Kaufman, T, Keidar, A, et al. Defining the need for blood and blood products transfusion following suicide bombing attacks on a civilian population: a Level I single-center experience. Injury. 2014;45(1):5055.CrossRefGoogle Scholar
Arnold, JL, Halpern, P, Tsai, MC, Smithline, H. Mass casualty terrorist bombings: a comparison of outcomes by bombing type. Ann Emerg Med. 2004;43(2):263273.CrossRefGoogle ScholarPubMed
Arnold, JL, Tsai, MC, Halpern, P, Smithline, H, Stok, E, Ersoy, G. Mass-casualty, terrorist bombings: epidemiological outcomes, resource utilization, and time course of emergency needs (Part I). Prehosp Disaster Med. 2003;18(3):220234.CrossRefGoogle Scholar
Bala, M, Willner, D, Keidar, A, Rivkind, AI, Bdolah-Abram, T, Almogy, G. Indicators of the need for ICU admission following suicide bombing attacks. Scand J Trauma Resusc Emerg Med. 2012;20(1):16.CrossRefGoogle ScholarPubMed
Turégano-Fuentes, F, Caba-Doussoux, P, Jover-Navalón, JM, et al. Injury patterns from major urban terrorist bombings in trains: the Madrid experience. World J Surg. 2008;32(6):11681175.CrossRefGoogle ScholarPubMed
Kao, RL, McAlister, VC. Care of victims of suicide bombing. Can J Surg. 2018;61(6):s184187.CrossRefGoogle ScholarPubMed
Chim, H, Yew, WS, Song, C. Managing burn victims of suicide bombing attacks: Outcomes, lessons learnt, and changes made from three attacks in Indonesia. Crit Care. 2007;11(1):19.CrossRefGoogle ScholarPubMed
Bala, M, Rivkind, AI, Zamir, G, et al. Abdominal trauma after terrorist bombing attacks exhibits a unique pattern of injury. Ann Surg. 2008;248(2):303309.CrossRefGoogle ScholarPubMed
Bala, M, Shussman, N, Rivkind, AI, Izhar, U, Almogy, G. The pattern of thoracic trauma after suicide terrorist bombing attacks. J Trauma. 2010;69(5):10221028.Google ScholarPubMed
Tin, D, Hart, A, Ciottone, GR. Terrorism in China and the emerging needs for Counter- Terrorism Medicine following a decade of deaths and injuries. Prehosp Disaster Med. 2021;36(3):270275.CrossRefGoogle ScholarPubMed
Tin, D, Hart, A, Hertelendy, A, Ciottone, G. Terrorism in Australia: a decade of escalating deaths and injuries. Prehosp Disaster Med. 2021;36(3):265269.CrossRefGoogle ScholarPubMed
Tin, D, Hart, A, Ciottone, GR. Hardening hospital defenses as a counter-terrorism medicine measure. Am J Emerg Med. 2020;45:667668.CrossRefGoogle Scholar
Tin, D. Enhancing medical preparedness to meet the changing threat of terrorism. The Strategist. 2021. https://www.aspistrategist.org.au/enhancing-medical-preparedness-to-meet-the-changing-threat-of-terrorism/. Accessed April 24, 2021.Google Scholar