Understanding Sept 11.

Supercourse A project designed to create a free lecture library of PowerPoint prevention slides, 9212 Academic Faculty from 120 countries with over 800 available Free Powerpoint Lectures The lecture has been developed by Supercourse team for the Global Health Network. This is an international program designed to bring the Internet into the prevention of Terrorism and all forms of disease. http://www.pitt.edu/~super1/

Terrorism What is it? Where does it come from? Why is it used? How can we prevent it? What do we fear about Terrorism? The objective of this lecture is to present some scientific facts about terrorism, so that teachers can educate the next generation, to understand terrorism and help to prevent terrorism. This is a template lecture for teachers. Please feel free to add or take out any slides. For example, you might want to include information about terrorism in your country, rather than the examples used in this lecture. The lecture is designed to be apolitical. The objectives are to 1) provide information to students about terrorism in general, 2) to show that terrorism has had a long history, 3) to demonstrate that terrorism has taken place in all areas of the world and 4 to demonstrate that terrorism although scaring many people is very rare. We must be concerned about terrorism, however, we cannot be paralyzed due to fear.

We have all seen pictures of terrorism during the past year since Sept We have all seen pictures of terrorism during the past year since Sept. 11. This has frightened all of us, and lead to major changes in our society. The Homeland of the United States has been invaded, and we want to feel safe again. Terrorism has taken place in many other regions across the world. This is a lecture for Sept. 11, it overviews what we know about terrorism. Little girl image: http://www.corona.bell.k12.ca.us/teach/swa/girl.gif Plane image: http://www.ehr.nsf.gov/ehr/ehr/science_home/images/plane.gif FALLOUT SHELTER

Terrorism Is an unlawful act of violence Intimidates governments or societies Goal is to achieve political, religious or ideological objectives Terrorism is a political act designed by groups to have their message heard. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

“…warfare seeks to conquer territories and capture cities; terrorism seeks to hurt a few people and to scare a lot of people in order to make a point” NYTimes, 1/6/2000 Often we talk about terrorism, without really defining it. Terrorism is not warfare, the goals are different. Terrorists want to seed a political message into our minds, murder, and violence are secondary. Hitchcock is a perfect spokesperson for terrorism as he is the master of terrorism. Terrorist make us afraid, which makes them heard. “Putting the horror in the minds of the audience, and not necessarily on the screen”

On Sept. 11 the Twin Towers received a body blow by a terrorist On Sept. 11 the Twin Towers received a body blow by a terrorist. Please close your eyes and think about what you felt. Where were you? What type of emotions swept over you? Were your afraid? Most people were.

We want to prevent our children, and us from being afraid We want to prevent our children, and us from being afraid. Educators, teachers, and mentors need the best possible information quickly to prevent the buildup of fear, and to dissipate fear after it has arisen. In many ways fear, for the survivors, is more disruptive than death.

Educational Deterence Fear always springs from ignorance. Emerson, 1837 The major destructive force of terrorism is fear. However, we can reduce fear by building up our knowledge of terrorism.

The teacher in the classroom teaches, and reduces fear The teacher in the classroom teaches, and reduces fear. S/he is a calming influence, siphoning off the fear. By learning the history and facts about terrorism, we can understand how best help ourselves, family and friends. Classroom image: http://www.west.asu.edu/itweb/services/classroom.gif http://www.west.asu.edu/itweb/services/classroom.gif

Early History of Terrorism Terror has been used to achieve political ends and has a long history As early as 66 – 72 A.D. Resistance to Roman occupation, terrorists killed Roman soldiers and destroyed Roman property. Terror was used to resist occupation. Terror in many ways has been the weapon of groups who want their message heard, and want a political change, but do not feel that they have a way to be heard or have a voice. Terrorism is viewed as a means to be heard. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Early History of Terrorism Suicidal martyrdom represented being killed by invaders which resulted in rewards in heaven. It dates back thousands of years in most societies and religions. Terrorism against the enemy is often viewed as a religious act. Terrorism has been viewed as honorable by the side who practices it. It is viewed as a crime against humanity by the victims of the countries attacked. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Modern History of Terrorism The term “terrorism” was coined in the French Revolution’s Reign of Terror (1793 – 1794). . This was the birth of Government-Sponsored Terrorism The line between terrorism and political violence is often blurred Goal: of State terrorism was to eliminate opposition, consolidate power, e.g., the Vanished in Argentina . Governments will sometimes try to suppress dissent. In the Military regime in Argentina in the 1960, young protestors sometimes even your age would sometimes “disappear” because of their views. The goal was to eliminate dissent, and maintain power. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Modern History of Terrorism Anarchists were seen in the late 19th century Individual terrorism The use of selective terror against an individual in order to bring down a government, e.g. Lincoln assassination Propaganda by deeds …terrorists acts Terrorism became tool of communication, propaganda Anarchists are those who rebel against the ruling power. One of their tools has been the killing of public officials, e.g. the killing of a president or ruler. Terrorism has become a statement. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Modern History of Terrorism: Middle 20th century, terrorism became a tool used by both sides of colonial conflicts. The last 20 years of of the 20th century religious based terrorism became more and more frequent. Another format is economic terrorism, which destructs industry and agriculture system. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Modern History of Terrorism Terrorism is Asymmetric Warfare. Asymmetric warfare is the use of apparently random/unpredictable violence by an weak military against a stronger military to gain advantage. (Allen, 1997). The key of Asymmetric warfare is using unexpected, unconventional tactics in combat (Craig, 1998). There has been much discussion of Asymmetric Warfare. This is where a superior power is confronted with an unconventional, much smaller enemy. However, the enemy has a fervent belief in a cause, but attacks using new, often never used before approaches often to the surprise of the dominant force. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Terrorism conclusions Terrorism is an ancient tactic. Terrorism is a mode of communication. Terrorism is a special type of violence and Asymmetrical warfare. Terrorism is used in times of peace, conflicts and war. Terrorism is designed to make a point, through psychological means, fear. Terrorism is a political act. We were surprised on Sept. 11. However, it is very important to recognize that terrorism is not new, and it’s primary goal is not to kill, but to communicate a message. Terrorism is a form of violence, and has been used throughout history. Terrorism most certainly has a psychological impact, and is a very powerful political act. It gets people heard. Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001 http://www.state.de.us/cjc/history.ppt Arthur H. Garrison

Anatomy of a Bioterrorist Attack Terrorism takes much Time and planning Preparation 5 years The problem is that few recognize the time course of terrorism. There is a long, protracted time period of planning, followed by a short execution phase and short diagnosis phase. The terrorist on Sept. 11 prepared for almost 5 years before finally attacking. The time between execution and first death is typically small. For example, if a nuclear devise were to be detonated, death would arise within seconds. We want to be able to intervene to prevent children and adults from experiencing a terrorist attack, and death. Execution 1 day Diagnosed case 3 days First Death Multiple deaths

Property of Terrorism Terrorism is different from regular crime because of its strong political properties The definition of terrorism can vary from people to people due to the differences in standpoint One person’s terrorist can be another’s fighter

Prevention of Terrorism Primary prevention: Education!!! Understand the differences in cultures, religions, beliefs and human behaviors Think of the peace, freedom and equality of all human beings, not just “my group of people” Eliminate the root of terrorism Just because of its uncertainty, it is hard to collect unbiased data on terrorism and it is hard to propose specific prevention measures. Here we present the general approaches of prevention from the epidemiological and public health point of view.

Prevention of Terrorism Secondary prevention: Establish surveillance and monitoring system on terrorism attack Improve protective system for citizens

Prevention of Terrorism Tertiary prevention Early detection of the sources Prevent the extension of impairments Rescue the survivors Console the rest of the population

Types of Terrorism Domestic terrorism involves groups whose terrorist activities are directed at elements of our government without foreign involvement. Oklahoma City is a primary example. International terrorism involves groups whose terrorist activities are foreign-based and/or directed by countries or groups outside the United States. Sept. 11 is an example of International Terrorism. Recent Trends in Domestic and International Terrorism, the Center for National Security Studies, http://nsi.org/Library/Terrorism/tertrend.html the Center for National Security Studies

Methods of Terrorism Firearms Explosive and Incendiary Devices Chemical Agents Biological Agents Nuclear Weapon

Suspicious Thing to Look for http://www.emergency.com/pkgbomb.htm From Emergency Net NEWS Archives, 1994 Document Courtesy of the U.S. Postal Inspector's Office

Chemical Agents Chemical agents kill or incapacitate people, destroy livestock or ravage crops Some agents are odorless and tasteless They can have an immediate or a delayed effect Chemicals have also been used in terrorist attacks. Recent Trends in Domestic and International Terrorism, the Center for National Security Studies, http://nsi.org/Library/Terrorism/tertrend.html

Example of Chemical Terrorism Sarin nerve agent attacked the Tokyo subway system in March 20, 1995 12 people were killed and 53 were seriously injured Source:Disaster and hospital functions, Genro Ochi M.D., Ph.D. http://www.pitt.edu/~super1/lecture/lec0581/016.htm Picture from: www.jal.co.jp/information/ branch/index-e.html Genro Ochi M.D

Biological terrorism Dispersal of microbes or their toxins to produce illness, death and terror The paths of infection can be contaminated water, food, air and packages. Microbes Bacteria Viruses Toxins Source: Chemical and Biological Terrorism, an overview of the threat. Phillip L. Coule, M.D. http://www.pemba.utk.edu/bt101/Chem%20and%20Biol%20Terrorism-%20Dr.%20Coule.ppt Phillip L. Coule, M.D.

Is this something new? 14th Century – Kaffa City on Crimean Peninsula Hurled plague infested corpses over walls of city to infest it The history of bioterrorism goes back a very long time. The first record of bioterrorism was 600 years ago. Source: Chemical and Biological Terrorism, an overview of the threat. Phillip L. Coule, M.D. http://www.pemba.utk.edu/bt101/Chem%20and%20Biol%20Terrorism-%20Dr.%20Coule.ppt World-wide biologic warfare is not new. As early as the 14th century, plague infested corpses were used as weapons. Phillip L. Coule, M.D.

Is this something new? 18th Century French and Indian War British Officers gave blankets from smallpox victims to Indians aligned with French Caused an epidemic in tribes Effective means of incapacitating group Source: Chemical and Biological Terrorism, an overview of the threat. Phillip L. Coule, M.D. http://www.pemba.utk.edu/bt101/Chem%20and%20Biol%20Terrorism-%20Dr.%20Coule.ppt In the United States at the time of the French and Indian War, the British provided tainted blankets to Indians with the goal of disabling the opposing forces. Phillip L. Coule, M.D.

Motives for bioterrorism Source: the History of Bioterrorism. Fred T. Muwanga M.D. Msc Reasons for the use of bioterrorism was varied, and not much different for other weapons systems. A primary reason that they were used is that in general the weapon system was inexpensive, and could wreak havoc on an enemy not only as a result of morbidity, but also fear. These systems have some major disadvantages, however, in that one needed a high level of expertise in order to produce them. Also, targeting the systems is most difficult, thus there was the fear of wiping out ones own troops when attacking the enemy. Fred T. Muwanga M.D. Msc

Responses to Bioterrorism Early detection of active and potential cases Emergency measures to save lives Prevention and management of secondary contamination Bioterrorism can be attacked from several different levels. This presents the public health perspective whereby the response begins at the finding of the first case. A complimentary view is that of law enforcement where prevention begins before any event takes place, in the 5 year period of preparation. This could be a simple as identifying people who want to take flying lessons but who do not want to learn how to land, or those purchasing Anthrax from web sites. Both of these approaches have to go hand and hand to prevent attacks.

Nuclear Terrorism Spreading of radioactive materials through ventilation system or explosion Disable nuclear reactor cooling system and cause leakage of radioactive materials Detonate a nuclear weapon No use of nuclear material for non-military terrorism has ever occurred Picture from: http://www.state.nv.us/nucwaste/graphics/nuclear.gi

Proportion of death from terrorism in total death in the United States Average death per year From terrorism From all causes Proportion (%) 1990’s 8 2534203 0.0003 2001 2893 2404624 0.12 Terrorist acts are episodic, not continuous. Usually death from terrorism only occupies a very small proportion in all causes of deaths. When serious attack occurs, like in 2001, the death rate may be increased a lot. Total International Terrorist Attacks, 1981-2000. Department of State Publication, Office of the Secretary of State, Released by the Office of the Coordinator for Counter terrorism, April 2001. http://www.usis.usemb.se/terror/rpt2000/totaluscasualties.html * Used projected data of year 2000 National Vital Statistics Report, Vol.49 No. 12, Oct 9, 2001 National mortality data: http://wonder.cdc.gov/mortICD9J.shtml Death from September 11th: http://www.cnn.com/2002/US/05/30/rec.wtc.remains/index.html

Risk of Dying Smoking 10 cigarettes a day One in 200 All natural causes age 40 One in 850 Road accident One in 8,000 Playing soccer One in 25,000 Homicide One in 100,000 Terrorism attack in 2001 Hit by lightning One in 10,000,000 Terrorism attack in 1990’s One in 50,000,000 The purpose of this slide is to have some general comparison between the risk of terrorism attack and that of other more familiar causes, so that we can have a general feeling of the level of the risk of terrorism. Data on other risks is adopted from the BMA Guide to Living with Risk. British Medical Association, Penguin Books, 1987. It is not scientifically correct to compare the general estimate on risks and the specific death rate of one cause from one year. Also, lightning may be more predictable and random than terrorism attack. Again, this slide just wants to show the general position of the risk of terrorism attack. The point is : there are more important health threats to worry about and we can do something about it. If you want to compare the death rate from different causes, the CDC and WHO web site can provide more information. The following slide is an example from USA Death rate of terrorism was calculated from the data of U.S. population and the deaths from terrorism Resident Population Estimates of the United States by Age and Sex: April 1, 1990 to July 1, 1999, with Short-Term Projection to November 1, 2000. http://eire.census.gov/popest/archives/national/nation2/intfile2-1.txt http://www.cnn.com/2002/US/05/30/rec.wtc.remains/index.html Penguin Books, 1987

Death Rate of Various Causes in 2000 USA and that from Terrorism Heart disease* One in 400 Cancer * One in 500 Cerebrovascular diseases* One in 2,000 Accidents * One in 3,000 Diabetes* One in 4,000 Suicide* One in 10,000 Homicide* One in 20,000 Terrorism in 2001 One in 100,000 Terrorism in 1990’s One in 50,000,000 * Age adjusted death rate in 2000. National Vital Statistics Report, Vol. 49, No. 12, Oct 9, 2001.

What occupation has had the greatest risk of death from Terrorism? It is important to put risk in context. Most people would think the great risk is a pilot, police man, or fire man. The occupation at great risk is that of President of the US where 3/44 presidents have died from terrorists. The risk for a president of the US, it over 50 million times great than for a student in a classroom.

Why did terrorism draw considerable attention in 2001? The risk of dying from terrorism was extremely low in 1990’s, and was still relatively low compared with some diseases in 2001 But the death rate increased by 500 times in 2001 due to Sept. 11 Overall the death rate of terrorism has not been high Despite the low risk, shock, surprise and fear engulfed the United States and world The risk of dying from terrorism was even lower than that from hitting by lightening. Assume how surprised you will be, if someone tell you that your chance of hitting by lightening will be as high as that of homicide.

Conclusion Terrorism is unlawful act Terrorism has a long history of being used to achieve political, religious and ideological objectives Terrorism can be conducted through firearms, explosive devices and biological, chemical, nuclear materials Even through the events of 2001,the risk of dying from terrorism has remained much lower than that from motor vehicles, smoking, and alcoholic beverage. Sources: Information on how to help children understand the terrorist attacks: Suggestions for Adults: Talking and Thinking with Children About the Terrorist Attacks http://www.ed.gov/inits/september11/adults.html Suggestions for Educators: Meeting the Needs of Students http://www.ed.gov/inits/september11/educators.html A Letter to Elementary School Students from First Lady Laura Bush http://www.whitehouse.gov/news/releases/2001/09/letter2.html A Letter to Middle and High School Students from First Lady Laura Bush http://www.whitehouse.gov/news/releases/2001/09/letter1.html President Bush Participates in Launch of Friendship Through Education Consortium http://www.friendshipthrougheducation.org/ School Officials Urged to Prevent Harassment of Muslim and Arab-American Students http://www.ed.gov/PressReleases/09-2001/09192001c.html Where you can find additional information and resources: American Academy of Child and Adolescent Psychiatry http://www.aacap.org/ American Counseling Association http://www.counseling.org American Psychological Association Online: Help with Trauma http://www.apa.org/psychnet/coverage.html Emergency Services and Disaster Relief Branch, Center for Mental Health http://www.mentalhealth.org/cmhs/emergencyservices/ Helping Children and Adolescents Cope with Violence and Disasters http://www.nimh.nih.gov/publicat/violence.cfm Helping Children Cope with Disaster, National Parent Information Network http://npin.org/library/2001/n00563/n00563.html High Schools for Heroes http://www.hs4heroes.org National Association of School Psychologists http://www.nasponline.org National Center for Post-Traumatic Stress Disorder http://www.ncptsd.org/what_is_new.html Post-Traumatic Stress Disorder (PTSD), Trauma, Disasters, and Violence http://www.nimh.nih.gov/anxiety/ptsdmenu.cfm Talking with Children When Disaster Strikes http://www.tpt.org/TPTspecial_edition/walsh.html Ten Tips to Help Your Kids Deal with Violence, Parenting Press http://www.parentingpress.com/resp_10_tips.html Terrorism and Children, Purdue University Extension http://www.ces.purdue.edu/terrorism/children/index.html University of Oklahoma, Department of Pediatrics http://peds.ouhsc.edu/ U.S. Government Information and Resources in Response to September 11th Events http://www.firstgov.gov/featured/usgresponse.html

The only thing we have to fear is fear itself. FDR, 1933 Fears are educated into us & can, if we wish, be educated out. — Karl A. Menninger