title: 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.
authors.affiliation: 1Department of Neurology,Dimpna Regional Hospital,Geel,Belgium.
authors.forename: Harald
authors.initials: H
authors.lastname: De Cauwer
authors.affiliation: 2Department of Emergency Medicine and Traumatology,Dimpna Regional Hospital,Geel,Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Somville
authors.affiliation: 4Department of Emergency Medicine,University Hospitals,Leuven,Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Sabbe
authors.affiliation: 5Center for Research and Education in Emergency Care,University of Leuven,Leuven,Belgium.
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Mortelmans
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D014943:Global Health; D006761:Hospitals; D006801:Humans; D023481:Terrorism
keywords:  BPHA Belgian Public Health Administration;  DHS US Department of Homeland Security;  ED emergency department;  FBI US Federal Bureau of Investigation;  FDA US Federal Drug Administration;  FDNY New York City Fire Department;  PTSD posttraumatic stress disorder;  SAMU Service d’Aide Médicale Urgente; disaster planning; emergency department; hospital preparedness; terrorism