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EDITORIALS: Erica Frank Funding the public health response to terrorism BMJ 2005; 331: 526-527 [Full text]

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Terror is much more than the net death toll

Shmuel C Shapira M.D M.P.H   (11 September 2005)

Terror is much more than the net death toll 11 September 2005
Shmuel C Shapira M.D M.P.H, Deputy Director General Hadassah University Hospital POB 12,000 Jerusalem Israel Send response to journal: Re: 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