The death toll from a truck bombing in Somalia's capital has risen above 300, the director of an ambulance service said Monday, as the fragile Horn of Africa nation reeled from the deadliest single attack it's ever experienced.
More people died of their wounds in the past few hours, said Dr. Abdulkadir Adam of Aamin Ambulance service. Funerals have begun, and the government said the death toll is expected to rise in what has become one of the world's worst attacks in years.
Saturday's truck bombing targeted a crowded street in Mogadishu, and about 300 others were injured, many with horrific burns. Somalia's government is blaming the al-Qaida-linked al-Shabab, Africa's deadliest Islamic extremist group, which has not commented.
More than 70 critically injured people were airlifted to Turkey for treatment on Monday as international aid began to arrive, officials said. Nervous relatives stood on the tarmac at the airport, praying for the recovery of their loved ones.
Overwhelmed hospitals in Mogadishu have struggled to assist other badly wounded victims, many burned beyond recognition. Exhausted doctors struggled to keep their eyes open as the screams from victims or newly bereaved families echoed in the halls.
The attack is one of the deadliest attacks in sub-Saharan Africa, larger than the Garissa University attack in Kenya in 2015, in which 148 died, and the US Embassy bombings in Kenya and Tanzania in 1998, in which about 219 were killed.
In addition to Turkey, Kenya and Ethiopia have offered to send medical aid in response to what Somali's government has called a "national disaster," said Information Minister Abdirahman Osman.
Al-Shabab, which for more than a decade has waged war in Somalia, often targets high-profile areas of Mogadishu. Earlier this year, it vowed to step up attacks after both the Donald Trump administration and Somalia's recently elected president announced new military efforts against the group.
The country's Somali-American leader, President Mohamed Abdullahi Mohamed, has declared three days of mourning and joined thousands of people who responded to a desperate plea by hospitals to donate blood.
Mogadishu, a city long accustomed to deadly bombings by al-Shabab, was stunned by the force of Saturday's blast. The explosion shattered hopes of recovery in an impoverished country left fragile by decades of conflict, and it again raised doubts over the government's ability to secure the seaside city of more than two million people.
The United States has condemned the bombing, saying "such cowardly attacks reinvigorate the commitment of the United States to assist our Somali and African Union partners to combat the scourge of terrorism." It tweeted a photo of its charge d'affaires in Somalia donating blood. But the US Africa Command said US forces had not been asked to provide aid.
The US military has stepped up drone strikes and other efforts this year against al-Shabab, which is also fighting the Somali military and over 20,000 African Union forces in the country.
Saturday's blast occurred two days after the head of the US Africa Command was in Mogadishu to meet with Somalia's president, and two days after the country's defense minister and army chief resigned for undisclosed reasons.
The United Nations special envoy to Somalia called the attack "revolting." Michael Keating said the UN and African Union were supporting the Somali government's response with "logistical support, medical supplies and expertise."
What next? As the toll rises above 300 from one of the world's deadliest attacks in years, the al-Shabab extremist group has sent a powerful signal that the international focus on extremism can't afford to overlook the African continent.
Saturday's truck bombing showed that al-Shabab, targeted for years by US airstrikes and tens of thousands of African Union forces, has once again made a deadly comeback.
Pushed from Somalia's capital in recent years, al-Shabab has retreated mostly to rural areas of the country's south, where the fragile central government can't assert its authority and local fiefdoms are in charge.
From there, Africa's deadliest Islamic extremist group has continued to plan guerrilla-style attacks like Saturday's truck bombing in the capital, Mogadishu.
While demonstrating al-Shabab's resilience in the face of new military offensives by the US and Somalia in recent months, the attack also highlights the shortcomings of US drone strikes in a politically fraught country with a weak military and even weaker police, analysts said.
"Decapitation strikes certainly serve a purpose, but al-Shabab will not be defeated this way. They replenish leadership very quickly," said Matt Bryden, a security consultant on the Horn of Africa who once served as a United Nations expert.
Although al-Shabab has not claimed responsibility for Saturday's attack, the Somali government says there can be no doubt. Bryden agreed, saying that "no other group in Somalia has the capacity to put together a bomb of this size, in this nature."
Mohamed Sheikh Abdi, a political analyst in Somalia, said he believed al-Shabab is reluctant to take credit for the attack because the high civilian death toll would hand "an expensive propaganda prize for the government ... as a rallying call and boost its public image."
Al-Shabab earlier this year vowed to step up attacks in response to new military efforts by both the Trump administration and Somalia's recently elected Somali-American president.
It is not yet clear how the US military will respond to Saturday's bombing.
The extremist group knows how to make a comeback. It suffered perhaps its worst setback in 2014 after a US airstrike killed its spiritual leader Ahmed Abdi Godane, who had helped forge the group's alliance with al-Qaida. Godane was quickly replaced by the more reclusive Ahmad Umar, who remains at large.
In the past year al-Shabab attacks, including against the 22,000-strong multinational African Union force in Somalia, have become more frequent. About half of the 1,228 civilian casualties recorded by the UN this year in Somalia have been caused by the extremist group.
Rise. Somalia saw a 38 percent rise in civilian deaths from improvised explosives in the first half of this year, the London-based Action on Armed Violence said Monday.
"Time and again throughout its history ... al-Shabab has shown itself to be a remarkably resilient group," said J. Peter Pham, director of the Africa Center at the Atlantic Council. "There is no reason to believe that it will not also survive in some fashion the recent setbacks it has suffered in terms of strikes and defections."
Over the years al-Shabab has grown from mounting low-level, symbolic assaults to staging complex attacks at home and abroad. The group is responsible for two major attacks that killed scores in neighbouring Kenya, at Garissa University in 2015 and Westgate Mall in 2013. Al-Shabab called them retaliation for Kenya's military involvement in Somalia.
Al-Shabab's attacks have persisted despite the efforts of the international community, which has invested millions of dollars in training the Somali national army. That is due in part to the fragility of Somalia, known as a failed state for decades as it was torn apart by conflict and clan disputes. The central government now struggles to assert control beyond key areas like Mogadishu.
Somalia — a key bridge between Africa and the Middle East and separated by a narrow strait of water from another chaotic nation, Yemen — is historically a complicated country for the United States. The US pulled out of Somalia after the 1993 incident in which two helicopters were shot down in Mogadishu and bodies of Americans were dragged through the streets.
But in April, after the Trump administration expanded military operations in Somalia, the US announced it was sending dozens of regular troops in the largest such deployment to the country in roughly two decades. The US said it was for logistics training of Somalia's Army. Weeks later, a US service member was killed during an operation against al-Shabab.
Bryden, the Somalia expert, said the training efforts of the US and others have become "too centralizsed in Mogadishu" and too focused on the Army, without any serious efforts to boost the capacity of police and regional forces.
The government has fewer than five officers who have been trained in investigating crime scenes caused by improvised explosives, he said.
Saturday's attack appeared to take advantage of the country's latest security turmoil, coming two days after Somalia's defence minister and army chief resigned for unknown reasons.
As the death toll continued to rise, the African Union, set to withdraw its forces and hand over the country's security to the Somali military by the end of 2020, asked the international community for help.
"It is now clear that without adequate and appropriate support to Somalia, many of the security gains made in recent years could be reversed," the continental body said in a statement.