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Hospitals: Soft Target for Terrorism?

  • Harald De Cauwer (a1), Francis Somville (a2) (a3), Marc Sabbe (a4) (a5) and Luc J. Mortelmans (a5) (a6)


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):94100.


Corresponding author

Correspondence: Harald De Cauwer, MD AZ St Dimpna, Department of Neurology JB Stessenstraat 2 2440 Geel, Belgium E-mail:


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