Hospitals: Soft Target for Terrorism?

Abstract

In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning. De Cauwer H , Somville F , Sabbe M , Mortelmans LJ . Hospitals: soft target for terrorism? Prehosp Disaster Med. 2017;32(1):94-100.

Resilient Health System and Hospital Disaster Planning

“…Hospitals as soft targets of terrorism and in war is an old phenomenon and one that is a guaranteed to continue [15]. This is in part because of the added emotional and psychological importance of healthcare on society as well as the role healthcare facilities play in the broader aspects of social function.…”

Counter-Terrorism Medicine: Creating a Medical Initiative Mandated by Escalating Asymmetric Attacks

“…19 Health care facilities and responders are soft targets that can be primarily or secondarily attacked. [20][21][22][23][24] The history of health care as a target for terror, the increasing impunity globally to the protected status of health care, and the availability of obvious soft targets with significant potential impact makes mitigation of the threat and health care target-hardening a key tenet of CTM. Counter-Terrorism Medicine -A Sub-Specialty of Disaster Medicine Disaster Medicine focuses on a cyclical, revisionist learning model where responses to high-acuity, low-frequency events inform the recovery, preparedness, and mitigation strategies, thus influencing the impact of future "catastrophic" events.…”

An Investigation into Healthcare-Data Patterns

“…For example, London hospitals lost all network connectivity due to several malware infection by the MyTob worm that occurred at the end of 2008 [5]. In 2005, a Chicago hospital lost its entire pharmacy database, and in order to reconstruct medication records for its patients, paper printouts were required to be collected from nurses' stations [6]. And in October 2016 a UK Hospital in Lincolnshire was shut down for four days by a variant of the Globe2 ransomware [7], with all planned operations, outpatient appointments…”