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Murderous terror attacks against innocent people, in particular by
suicide bombers, increased dramatically toward the end of the 20th century
and early in the 21st. Their targets were in countries with diverse
populations and political systems including in Egypt, India, Indonesia,
Iraq, Israel, Kenya, Pakistan, Russia, Saudi Arabia, Spain, Sri Lanka,
Tanzania, Turkey, the United Kingdom, and the United States.
It is improper to try and estimate terror share in public health by
comparing crude mortality rates. Terror is not just a death toll. It is
the most severe form of trauma(1) associated with severe injuries and
often with permanent disability. There are long term psychological
consequences to terror violence experienced by the affected and non
affected individual and the entire society(2). Terror threat affects the
individual, society and medical systems in many aspects(3). Terror may
endanger the stability of democratic societies. Therfore, funding
dedicated to public health preparedness to terror attacks, should be
weighed in accordance with this wide spectrum of threats.
Professor Shmuel C Shapira M.D. M.P.H
Hadassah University Hospital
1. Shapira SC, Mor-Yosef S. Applying lessons from medical management of
conventional terror to responding to weapons of mass destruction terror:
The experience of a tertiary university hospital.Conflicts and Terrorism
2003;26:379-5.
2. Kroll J. Posttraumatic symptoms and the complexity of responses to
trauma. JAMA 2003; 290:667-70.
3. Shapira SC, Mor-Yosef S. Terror politics and medicine: The role of
leadership.Conflicts and Terrorism 2004; 27:65-71.
Competing interests:
None declared
Competing interests:
No competing interests
11 September 2005
Shmuel C Shapira M.D M.P.H
Deputy Director General
Hadassah University Hospital POB 12,000 Jerusalem Israel
Terror is much more than the net death toll
Murderous terror attacks against innocent people, in particular by
suicide bombers, increased dramatically toward the end of the 20th century
and early in the 21st. Their targets were in countries with diverse
populations and political systems including in Egypt, India, Indonesia,
Iraq, Israel, Kenya, Pakistan, Russia, Saudi Arabia, Spain, Sri Lanka,
Tanzania, Turkey, the United Kingdom, and the United States.
It is improper to try and estimate terror share in public health by
comparing crude mortality rates. Terror is not just a death toll. It is
the most severe form of trauma(1) associated with severe injuries and
often with permanent disability. There are long term psychological
consequences to terror violence experienced by the affected and non
affected individual and the entire society(2). Terror threat affects the
individual, society and medical systems in many aspects(3). Terror may
endanger the stability of democratic societies. Therfore, funding
dedicated to public health preparedness to terror attacks, should be
weighed in accordance with this wide spectrum of threats.
Professor Shmuel C Shapira M.D. M.P.H
Hadassah University Hospital
1. Shapira SC, Mor-Yosef S. Applying lessons from medical management of
conventional terror to responding to weapons of mass destruction terror:
The experience of a tertiary university hospital.Conflicts and Terrorism
2003;26:379-5.
2. Kroll J. Posttraumatic symptoms and the complexity of responses to
trauma. JAMA 2003; 290:667-70.
3. Shapira SC, Mor-Yosef S. Terror politics and medicine: The role of
leadership.Conflicts and Terrorism 2004; 27:65-71.
Competing interests:
None declared
Competing interests: No competing interests