26/11 Mumbai Terrorist Attack Revisited: Lessons Learnt and Novel Disaster Model for Future

Terrorism is the unlawful exercise of random and ruthless violence against property or individuals, usually innocent civilians, in order to intimidate governments or societies for political or ideological purposes. Mumbai, the financial capital of India and its busiest metropolitan city, has been a prime target for terrorist attacks. In the last two decades, the number of terrorist attacks in Mumbai have caused over 700 fatalities (Table 1). On 26 November 2008, ten transnational terrorists attacked Mumbai, which included the busiest railway station in peak hour, five-star hotels, a café shop and hospitals. The multiple attacks and control measures lasted for three days, leading to the deaths of over 149 people which included civilians, foreign nationals, security personnel and hospital staff. The attack was a meticulously planned and executed act of terrorism where explosive devices and gunfire were used to cause the maximum number of casualties and lasted for 60 h. This attack was therefore different from previous attacks which were serial blasts in Mumbai in 2006 (Hirshberg, Holcomb & Mattox 2001), and in London in 2005 (Aylwin et al. 2006; Bhandarwar et al. 2012). In the 2011 attack, 66.8% of injured people required surgical interventions, compared to less than 35% in both the Mumbai and London blasts (Deshpande, Mehta & Kshirsagar 2007). The Sir J.J. Group of Hospitals (SJJGH) in Mumbai received the maximum number of casualties (271 patients) in a short duration of time. The modes of transport of patients were mainly taxis, handcarts, fire brigade vans, ambulances and private vehicles, assisted by local people. The in-hospital disaster plan was activated immediately, as large numbers of patients were expected.