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Primary Care as Primary Target: A Review of Terrorist Attacks Against Primary Care Providers and Their Offices

Published online by Cambridge University Press:  01 July 2022

Bart Wirken ,
Dennis G. Barten Open the ORCID record for Dennis G. Barten [Opens in a new window] ,
Harald De Cauwer Open the ORCID record for Harald De Cauwer [Opens in a new window] ,
Luc J.M. Mortelmans ,
Derrick Tin  and
Jochen Cals
Bart Wirken
Affiliation:
Department of Emergency Medicine, VieCuri Medical Center, Venlo, the Netherlands
Dennis G. Barten*
Affiliation:
Department of Emergency Medicine, VieCuri Medical Center, Venlo, the Netherlands
Harald De Cauwer
Affiliation:
Department of Neurology, Dimpna Regional Hospital, Geel, Belgium and Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
Luc J.M. Mortelmans
Affiliation:
Center for Research and Education in Emergency Care, University of Leuven, Leuven, Belgium Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
Derrick Tin
Affiliation:
Senior Fellow, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
Jochen Cals
Affiliation:
Department of Family Medicine, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands
*
Correspondence: D.G. Barten, MD Department of Emergency Medicine VieCuri Medical Center P.O. Box 1926 5900 BX VenloThe Netherlands E-mail: [email protected]
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Abstract

Background:

Violence against primary care providers (PCPs) has increased during the current pandemic. While some of these violent acts are not defined as terrorist events, they are intentional events with an aim to disrupt, kill, or injure. Despite their pivotal role in health care, little is known about the risk for PCPs as targets of terrorism.

Methods:

Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database search functions for all terrorist attacks against PCPs and their offices from January 1, 1970 - December 31, 2019. Years 2020 and 2021 were not yet available at the time of the study. Primary attack and weapon type, location (country, world region), and number of deaths and injuries were collated. Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis.

Results:

There were 29 terrorist attacks against PCPs and their offices from 1970-2019. The majority of attacks occurred during or after 2010. There were 58 fatalities, 52 injured, and 13 hostages. Most documented attacks took place in Pakistan, the United States, and Sri Lanka. Bombings concerned 55% of cases and 21% were hostage-takings.

Conclusion:

Although less common than attacks on other health care related targets, terrorist attacks against PCPs have occurred. The majority of attacks occurred during the last decade. Future studies are warranted to further assess the risk of terrorist attacks against PCPs: before, during, and beyond the current pandemic.

Keywords

counter-terrorism medicineprimary careterrorismviolence
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 4 , August 2022 , pp. 451 - 454
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Note: Authors Wirken and Barten contributed equally to the manuscript.

References

Schmeitz, CTJ, Barten, DG, van Barneveld, KWY, et al. Terrorist attacks against Emergency Medical Services: secondary attacks are an emerging risk. Prehosp Disaster Med. 2022;37(2):185–191.CrossRefGoogle Scholar
Ulmer, N, Barten, DG, De Cauwer, H, et al. Terrorist attacks against hospitals: world-wide trends and attack types. Prehosp Disaster Med. 2022;37(1):25–32.CrossRefGoogle ScholarPubMed
Jasani, GN, Alfalasi, R, Cavaliere, GA, Lawner, BJ, Liang, SY. Terrorist attacks against vaccinators: a review. Health Secur. 2021;19(5):541–545.CrossRefGoogle ScholarPubMed
Bailey, SR. AMA statement on ongoing attacks on physicians treating COVID patients. American Medical Association. https://www.ama-assn.org/press-center/press-releases/ama-statement-ongoing-attacks-physicians-treating-covid-patients. Accessed April 2022.Google Scholar
BMA Media Team. BMA calls for government action to protect GPs and practice staff after horrific violent attack in Manchester GP surgery. British Medical Association. https://www.bma.org.uk/bma-media-centre/bma-calls-for-government-action-to-protect-gps-and-practice-staff-after-horrific-violent-attack-in-manchester-gp-surgery. Accessed April 2022.Google Scholar
Maassen, H, Kleijne, I. Bedreiging van artsen: het nieuwe normaal? Medisch Contact. 2021.Google Scholar
van Stekelenburg, BCA, De Cauwer, H, Barten, DG, Mortelmans, L. Attacks on Health Care Workers in Historical Pandemics and COVID-19. https://osf.io/rw4es. Accessed April 2022.CrossRefGoogle Scholar
Tin, D, Hart, A, Ciottone, GR. Rethinking disaster vulnerabilities. Am J Emerg Med. 2021;45:660–661.CrossRefGoogle ScholarPubMed
Tin, D, Hart, A, Ciottone, GR. Hardening hospital defenses as a counter-terrorism medicine measure. Am J Emerg Med. 2021;45:667–668.CrossRefGoogle Scholar
National Consortium for the Study of Terrorism and Responses to Terrorism (START). The Global Terrorism Database (GTD). https://www.start.umd.edu/. Accessed 2021.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefGoogle ScholarPubMed
Cavaliere, GA, Alfalasi, R, Jasani, GN, Ciottone, GR, Lawner, BJ. Terrorist attacks against health care facilities: a review. Health Secur. 2021;19(5):546–550.CrossRefGoogle ScholarPubMed
De Cauwer, HG, Somville, F. Health care organizations: soft target during COVID-19 pandemic. Prehosp Disaster Med. 2021;36(3):344–347.CrossRefGoogle ScholarPubMed
Ritchie, H, Hasell, J, Appel, C, Roser, M. Our World in Data: Terrorism. https://ourworldindata.org/terrorism. Accessed May 2022.Google Scholar