Written By Prof. Boaz Ganor & Dr. Miri Halperin Wernli
In recent decades, hospitals have found themselves unwittingly involved in one of the most severe security dangers of the modern era: terrorism. At first, their involvement was reflected in the development of a new type of emergency medicine to deal with multi-casualty terrorist attacks. Bomb attacks, and especially those in which the bomb was made of homemade explosives along with ball bearings, nails, and other metal projectiles meant to increase the harm to life and property, essentially created a new branch of emergency medicine, one meant to treat acute, multi-system physical trauma.
However, treating victims of terrorism was not the only challenge facing hospitals and other medical facilities. Terrorist organizations realized that hospitals themselves make an attractive primary or secondary target of attack. In the latter case, an attack on a hospital can distract security and response staff from the primary target of attack, and also confound the removal and treatment of the wounded from the site of the primary attack. For example, a bomb placed in a hospital, or a suicide attacker who detonates himself at a hospital entrance, will most likely interfere with the ability of emergency rescue teams to bring the wounded from the scene of a terrorist attack to the emergency room. This causes the loss of precious time, thereby increasing the damage inflicted by the primary attack.
As the primary target of attack, hospitals may be set upon by suicide attackers, bombs, kidnapping and negotiation attacks, and shooting attacks (including from mortars and rockets). The large number of patients, visitors and medical staff on hand all but ensure that an attack on a hospital will produce multiple casualties. Both for this reason and because of the perversity of targeting a place that is dedicated to health and healing, a primary attack on a hospital may be expected to receive extensive media coverage. Above all, since hospitals serve entire populations, an attack on a hospital is more anxiety-provoking than an attack on almost any other site, because of what is known as “personalization”: prior personal familiarity with a hospital would cause anyone to fear that such an attack could easily have involved him or those close to him.
Hospitals are an attractive target for terrorist organizations for another reason, they house materials and knowledge that could easily be put to dastardly use: medications, poisons, radioactive materials, biological cultures. Hospital laboratories are the repository of chemical and biological substances that, in irresponsible or evil hands, could become poisonous, spreading illness or even causing an epidemic. For this reason, hospitals as a rule, and their store rooms and laboratories in particular, must be treated as sensitive security installations.