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Terrorism in China and the Emerging Needs for Counter- Terrorism Medicine Following a Decade of Deaths and Injuries

Published online by Cambridge University Press:  26 February 2021

Derrick Tin Open the ORCID record for Derrick Tin [Opens in a new window] ,
Alexander Hart  and
Gregory R. Ciottone
Derrick Tin*
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC) Disaster Medicine Fellowship; Department of Emergency Medicine, BIDMC; Harvard Medical School, Boston, MassachusettsUSA
Alexander Hart
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC) Disaster Medicine Fellowship; Department of Emergency Medicine, BIDMC; Harvard Medical School, Boston, MassachusettsUSA
Gregory R. Ciottone
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC) Disaster Medicine Fellowship; Department of Emergency Medicine, BIDMC; Harvard Medical School, Boston, MassachusettsUSA
*
Correspondence: Derrick Tin, MBBS, Senior Fellow, BIDMC Disaster Medicine, Fellowship Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA, E-mail: derrick@tacmedaustralia.com.au
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Abstract

Background:

China is ranked 42nd on the Global Terrorism Index (2019), a scoring system of terrorist activities. While China has a relatively low terrorism risk, events globally have wide-ranging repercussions for future attacks, putting first responders and emergency health workers at risk. This study aims to provide the epidemiological context for the past decade detailing the unique injury types responders are likely to encounter and to develop training programs utilizing these data.

Methods:

The Global Terrorism Database (GTD) was searched for all attacks in China between the years 2008-2018. Attacks met inclusion criteria if they fulfilled the terrorism-related criteria as set by the GTD’s Codebook. Ambiguous events, as defined by the GTD’s Codebook, were excluded. English language grey literature was searched to ensure no events meeting these criteria were missed. A focused search of online English language newspaper articles was also performed for any terrorist events between 2008-2018.

Results:

One-hundred and eight terrorist events occurred in the study time period. Of the 108 incidents, forty-seven (43.5%) involved Explosives/Bombs/Dynamite (E/B/D) only, with an average fatality count of 2.9 and injury count of 7.5 per event. Twenty-seven (25.0%) used bladed or blunt weapons in melees with an average fatality count of 9.7 and an injury count of 8.8 per event. Five (4.6%) involved incendiary weapons with an average fatality count of 2.4 and an injury count of 7.2 per event. Two used only chemical weapons (1.8%) with no recorded deaths and an injury count of 27.0 per event. Two events had unknown weapon types (1.8%) with one recorded death and no injury count. One event used a firearm (0.9%) and led to one death and no injuries. One event used a vehicle (0.9%), which also led to one death and no recorded injuries. Twenty-three attacks used a mix of weapons (21.2%) with an average fatality count of 17.1 and an injury count of 12.0 per event.

Conclusions:

One-hundred and eight terrorist attacks were recorded between 2008-2018 on Chinese soil using well-understood modalities. This resulted in a total of 809 recorded fatalities with 956 non-fatal injuries. The most commonly chosen methodology was E/B/D, followed by melees and the use of bladed weapons. Three events individually recorded a combined casualty toll of over 100 people.

Keywords

Chinacounter terrorism medicineCOVID-19disaster medicineterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 3 , June 2021 , pp. 270 - 275
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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