Deaths among homeless people in Istanbul.

The number of the homeless people in Istanbul, one of the largest cities in the world, is at present unknown. There has been no previous study in Turkey on cases and causes of death occurring among these individuals. In this paper, documents and autopsy reports of the Mortuary Section of the Council of Forensic Medicine, Istanbul, covering the period January 1st, 1991-December 31st, 1995, were reviewed. We established that there were 126 cases of death among homeless individuals in Istanbul during this period, 120 of them being males (95%), four (3%) females, and two (2%) transsexuals. Ninety-four corpses were found outdoors, 32 indoors. No personal documents, such as identity cards, were found in 110 individuals (87%), whereas only 16 individuals could be identified. Most deaths occurred in the age group of 41-50 years. One hundred and three of the cases (82%) died in the cold season between October and April. The deaths of 98 cases were attributable to natural causes, whereas the remaining 28 cases died from unnatural causes. Respiratory tract diseases occupied the first rank among cases of death from natural causes (44%). Alcohol abuse and other infections were further striking factors contributing to the fatal outcome. This is the first retrospective study on this topic in Turkey. However, more detailed and anterospectively programmed studies on this subject, a growing social problem, should be carried out.

Firearm fatalities in Edirne, 1984-1997.

During the 14-year period from 1984 to 1997 there were 85 firearm fatalities investigated by the Department of Forensic Medicine and the Department of Pathology in Edirne, Turkey. We determined the characteristics of these 85 firearm deaths which comprised 17.03% of all medicolegal autopsies. The overall incidence was 1.58 per 100,000 population. The median age was 35.5 years. Fifty-four percent of the victims were aged between 20 and 40 years. Males constituted 82% of the victims. The most frequent manner of death was homicide (68.3%). Handguns accounted for 62.4% of the weapons used. The most common sites for the firearm entrance wounds were both head-neck-nape (32.8%) and chest (32%). In conclusion, our study shows that, in spite of legal restrictions, illegal access to firearms is easy and deaths by firearms are still increasing.

Intra- and perioral shooting fatalities.

Determination of the manner of death in the case of intra- and perioral firearm wounds can be difficult especially if death scene investigation is unclear and inadequate. In this study, we investigated some characteristics of these firearm wounds which were autopsied in Istanbul. During the 5-year period from 1991 through 1995, there were 15 intra- and perioral firearm fatalities investigated. In all the cases, only one shot was fired into the mouth. They constituted 1% of all the firearm fatalities. The mean age of the victims was 27 years and males constituted 73.3% of the victims. Most of the wounds were caused by handguns. Homicides accounted for 53.3% of these deaths. Three of 15 cases could not be identified as intraoral firearm wounds by general practitioners during the scene investigations.