Responding to Terrorism: A Medical Handbook, 1e

426 Pages·2011·6.236 MB·English

by  Ian Greaves QHS OStJ FRCP FCEM FIMC RCS(Ed) FRGS DTM&H DMCC DipMedEd RAMC, Paul Hunt Mbbs DipIMC(RCSed) MCEM MRCSed DMCC RAMC

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CHAPTER
Terrorism in
Perspective
Contents TerrorismAct2006 .................19
Nationalresponsetoaterrorist
Whatisterrorism? .........................2 incident......................................19
Background–terrorismtoday .........3 TheCivilContingencies
Terroristtimelines–keyeventsin Act2004 ..............................20
terrorism ......................................4 COBRA .................................22
I Pre-historyto1900 .................4 Governmentalagenciesand
II1900–2001 .........................4 responsibilities.........................23
IIIContemporary(from Regionalarrangements .............24
September11th,2001) ..........6 Devolvedadministrations...........27
Keyterroristgroupsand CounterTerrorismCommand ........27
affiliations ....................................7 Theintelligenceandsecurity
MiddleEast..............................7 services ......................................27
Europe ..................................10 Assistancecentres .......................28
Africa....................................11 Massfatalities .............................29
Asia......................................12 Informationandthemedia............29
LatinAmerica..........................12 Thebroadcastmedia ...............30
NorthAmerica(USAandCanada)..13 Othermethodsofdisseminating
NorthernIreland ......................13 information .............................30
Non-geographicallyaligned Usefulwebsites ...........................31
groups ..................................14 Obtaininginformationinan
UKanti-terroristlegislation ............14 emergency .................................32
TerrorismAct2000 .................14 Usefulcontactdetails ...................33
Anti-terrorism,Crimeand Casualtyprediction......................42
SecurityAct2001 ...................18 Nationalresponseandthreatlevels42
PreventionofTerrorismAct2005 ...19 Educationalinitiatives ..................43
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RespondingtoTerrorism: AMedicalHandbook
Whatisterrorism?
Terrorism is not as easy to define as might initially be thought,
althoughweallaresureweknowitwhenweseeit.Initsmostgeneral
form,terrorismistheuseofterrortoachieveaparticularreligious,social,
politicalormoralgoal.Thismayinvolveeithertheuseof,orthethreat
of, violence. By definition, when violence is used, it usually takes a
formcalculatedtocausethemaximumdistressbothtothoseinvolved
and to witnesses and communities at large. Terrorism also needs the
media,asanatrocitythatnooneknowsaboutisnotlikelytoachieve
its aim. However, as well as violence, terrorism may include the
dissemination of distressing ideas intended to undermine public
confidence or the structure of society. It may also involve direct or
indirectattacksonutilities ormeansofcommunications.
Theproblemisthatthesituationisnotalwaysclearcut.Fewpeople
would admit to being a terrorist. Considerably more would claim
to be a freedom fighter, a nationalist or a liberator. It might be
claimed that terrorism, unlike conventional military action, is aimed
against civilian non-combatants, yet ‘collateral damage’ occurs in
war and the civilian populations of opposing countries have been
attacked as a matter of course in both world wars and by both sides.
Most of us who are not absolute pacifists can imagine circumstances
inwhichwewouldconsiderresortingtoviolencelegitimateandmor-
ally justified. For most of us, there is a spectrum with peaceable
persuasion at one end, legitimate force in the middle and terrorism
atthe other.
Itisclearthattheboundarybetweenterrorismandlegitimateaction
isporous.Anumberoffigureshaveapparentlysuccessfullycrossedit.
Mainstreampoliticianswithpreviousinvolvementinterroristactivity
include Yasser Arafat and Nelson Mandela. Conversely, the morality
of the actions of people such as Bomber Harris has raised serious
questionsalthoughveryfewquestioneditatthetime.
InEngland,anyassessmentofatypicalIRAbomberwouldleadtoa
near-universal condemnation as a terrorist. In Northern Ireland the
actions of such a figure would be condoned, or at the very least not
condemned, by a significant minority of the population who in all
respects might otherwise be considered law-abiding citizens. Thus
historical context is a key determinant in deciding whether an
individual’s activities are terrorism or not. This ‘baggage’ may be
inconvenient, but it has to be considered when counter-terrorist
actions are contemplated. Terrorist actions arising from centuries of
perceivedoppressionareunlikelytobeeliminatedbycenturiesmore.
Similarly, the fact that the terrorist’s methods are abhorrent does not
meanthathisaimsareunjust.
Thus,althoughitispossibletodefineterrorismfairlysimplyinterms
ofproscribedactionsforlegalpurposes,practicallythesituationismore
complex. Was Robin Hood a terrorist? Was George Washington, or
OliverCromwell?
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TerrorisminPerspective
WhenabombexplodesonaLondonbus,noright-thinkingindivid-
ualcandootherthancondemnasenselessatrocityandthosewhocar-
rieditout.Ourmaintasknowistoworktoreducethechancesofsuch
incidentshappeninganywhereelseinthefuture.Thisisamuchmore
complex task that requires understanding, knowledge, political cour-
age and the ability and willingness to understand the points of view
ofapparently implacableenemies.
Background–terrorism today
Thisintroductorysectionisdesignedtoprovidethe‘background’tothe
rest of the book. Terrorist incidents do not happen in a vacuum but
against a complex background. This chapter provides the necessary
information to understand the nature of the present terrorist threat
andtheresponsestoitofHMGovernmentandthesecurityagencies.
Given the prevailing international political situation, it would be
temptingtosubscribetothebeliefthatterrorismisanewphenomenon.
Thisisnotthecase,afactwhichwillcomeaslittlesurprisetothosewho
have lived through the campaigns of, amongst others, the IRA and
UnionistterroristsintheUK,JewishandIslamicterroristsintheMiddle
EastandtheRedBrigades,ETAandothersinEurope.
What has really changed is that terrorism and the responses to it
have moved to the top of the international agenda since September
11th,2001, whenthe devastating attackson the TwinTowersinNew
YorkmadeterrorismamatterofUSinternalandexternalnote.Inreal-
ity,wheneverandwherevertherearepoliticalorreligiousdifferences
and an unwillingness on the part of the organisations involved to
compromise,thentherewill beterroristacts.
President George W. Bush famously declared ‘war on terrorism’
after the ‘9/11’ attacks, and this has been the stated driving motive
behindmuchofUS,andindeedUK,foreignpolicyintheyearssince.
Whilstfewpeoplewoulddenythatthereisaroleformilitaryactionin
the global fight against terrorists (although many would question its
currentfocus),itisimportanttorememberthatterrorismcannomore
beeradicatedbymilitaryactionalonethanburglarycanbeeradicated
byarrestingburglars.
Theonlyeffectiveresponsesmustsurelybemorecomplex.Terrorism
will never be eradicated worldwide, but certain groups and factions
may be dissuaded from their current actions if the intellectual argu-
mentscanbewon,iftheyhavealegitimatefocusfortheexpressionof
theirgoalsandiftheybelievetheyhaveaccesstointernationaljustice
unbiasedbynarrownationalinterestandlongstandingprejudice.
It is less glamorous, but no less true, that we are far more likely to
stop frustrated young men or women (the majority of terrorist acts
are committed by men) turning to terrorist methods by convincing
them that these are morally wrong, spiritually flawed and ultimately
unproductive than we are by military action. Just because the
terrorist’smeansarerepellentdoesnotmeanthathiscauseisnotjust.
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RespondingtoTerrorism: AMedicalHandbook
Itisinthenatureofterrorismthatitisalltooeasytocreatemartyrs.
Given the human costs involved, it is essential that, at the very least,
responsestotheterroristthreatdonotexacerbatetheproblembycon-
verting moderate opinion into extremism. It is also essential that the
needtorespondtoterrorismdoesnotbecomeanexcuseforsignificant
infringements of civil liberties. Ultimately, freedom under law is
surelyimportantenoughforustotoleratethereallyverylimitedrisks
toourpersonalsafety.
Terrorism, as already stated, has always been with us and will
alwaysbewithus.Mostofuswillneverhavetodealwithaterrorist
incident or even a hoax. Unfortunately, many of us will. This hand-
book has two aims: to provide rapid easily accessible information
which will serve as guidance if the unthinkable actually happens,
andtoprovidematerialwhichisnototherwiseeasilyavailablesothat
readersarewellinformedandcantakeafull,activeandeducatedpart
inthe‘greatterrorismdebate’.
Terroristtimelines –keyeventsinterrorism
I Pre-history to1900
Thesetimelinesarenotcomprehensivebutareintendedtoillustratethe
developmentofterrorismanditslonghistory.Eventsofrelevancetoter-
rorismsuchastheAmericandevelopmentoftheatomicbombanddevel-
opmentsininternationalterroristlawandconventionarealsoincluded.
500BCE By500BCEtheByzantineshaddeveloped‘Greek fire’,a
highly flammable,probablynaphtha-basedmixturewhich
burns onwaterandformsthe basisfor aneffectiveflame
thrower.
200BCE Hannibalcatapultspotsofpoisonoussnakesattheshipsof
KingEumenesofPersia.
1346CE Tartarsattack thecity ofKaffaandcatapultthe bodiesof
plaguevictimsover thecitywalls, causinganepidemic.
1763 SirJeffreyAmherst, CommanderinChiefofthe British
ArmyinNorth America,orders smallpox-contaminated
blanketstobedistributedtoNativeAmericans.
1899 TheHagueagreementprohibitstheuse ofprojectilescon-
tainingchemical weapons.
II 1900–2001
1915 FirstuseofchlorinegasbytheGermansagainsttheBritish
ontheWesternFrontat Ypres.
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TerrorisminPerspective
1916 PhosgenedevelopedbytheGermans.
1917 MustardgasdevelopedbytheGermans.
1925 TheLeagueofNations(forerunneroftheUnitedNations)
issuestheGenevaProtocol,FortheProhibitionoftheUseof
Asphyxiating,PoisonousorOtherGasesandBacterialMethodsof
Warfare.
1938 Germanscientistsdiscover sarin.
1942 TheUSatomicbombproject(ManhattanProject) is
established.TheUSAalsobeginsdevelopmentofbiological
weapons.
1943 TheBritishtestanthraxbombsontheislandofGruinard
offtheScottishcoast.
1946 July22–KingDavidHotelinPalestinebombedbyJewish
terrorists.
1955 TheAlgerianNationalLiberation Frontmurdersandthen
mutilates37men,womenandchildren(thePhilippeville
Massacre).
1969 Palestinianterrorists bombtheJewish-owned Marksand
Spencer’sinLondon.
1972 TheConventiononthe ProhibitionoftheDevelopment,
ProductionandStockpiling ofBacteriological andToxin
WeaponsandtheirDestructionissignedby146countries,
includingtheUSAandUSSR.
1978 TheBulgarian defectorGeorgyMarkovisassassinatedin
Londonusingaricinpellet injectedinto hislegwithan
umbrella.
1979 TheThreeMileIslandmeltdownleadstothereleaseof
radioactivityintothe environment.
1980s SaddamHusseinusesmustardandnerveagents inthe
Iran–Iraqwar,resulting in10000deaths.
1981 TheHouseholdCavalryisbombedinHydePark,London–
25injuredandkilled.
1981 Turkish-bornterroristMehmetAliAgcaattemptstoassas-
sinatePopeJohnPaulII.
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RespondingtoTerrorism: AMedicalHandbook
1983 Harrodsbombing,London– 95killedorinjured.
1986 TheChernobyl nuclearpowerplant catastropheresults in
grossenvironmentalcontaminationandleadstothousands
ofdeaths.
1987 InBrazil,249peopleareexposedtoanabandonedmedical
radiationsource,resultingin4deaths.
1987/88 Iraqusesnerveagents againstKurdishcivilians, resulting
inseveralthousanddeaths.
1988 AbombexplodesonaPanAmtransatlanticflightover
Lockerbie,killingall259passengersandafurther11onthe
ground.
1991 Fiftythousandshellsandbombscontainingsarin,mustard
gasandcyclohexylsarinarefoundbycoalitionforcesinIraq.
1994 TheJapaneseapocalypticcultAumShinrikyoreleasessarin
intotheTokyoundergroundsystem,killing12andinjuring
3800.
1998 EightsmugglersfromTurkeyandthe formerSoviet
republicsofAzerbaijanandKazakhstanarearrestedafter
attemptingtoselluraniumandplutoniumtoundercover
policeofficers.
1998 BombingoftheFederalBuildinginOklahomaCity,killing
168.
2000 AbombexplodesinaMoscowunderpass,killing atleast
8andinjuringmore than90.The atrocityisattributed to
Chechenseparatists.
2000 Abombcarriedona boatblowsa holeinthe sideof
USSColeinAdenHarbour, killing17servicepersonnel.
Themost likelyorganisationresponsible isAlQaeda.
2001 Frenchauthorities arrestthreemen caughtsmuggling
uranium.
III Contemporary (fromSeptember11th,2001)
2001 AlQaedahijackfouraeroplanes,crashingtwooftheminto
theWorldTradeCenterandoneintothePentagon–over3000
peoplearekilled.
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TerrorisminPerspective
2001 AnthraxsporesaresentthroughtheUSmail,resultingin22
clinical casesand5 deaths.
2002 BalinightclubbombingbyIslamicterrorists–202peopleare
killed.
2002 TwomenarearrestedinTurkeycarryingweapons-grade
uraniumworth US$5million,allegedlytoattemptasaleto
IraqorSyria.
2003 LetterscontainingricinandaddressedtotheUSDepartment
ofTransportandtheWhite Housearediscovered.
2004 Occupation ofa highschoolinBeslan byChechen terrorists
anditssubsequentstorming byRussiantroops leadstothe
death ofmorethan330,mainlychildren.
2004 Islamic terroristscarry outa seriesofbombingsinMadrid,
resulting in191deadandmorethan1700injured.
2005 LondonUndergroundandbusbombings–52peoplearekilled.
2007 Twobombsexplode inPhilippine cities,killingat least6 and
injuring manymore.Islamic militantsarebelievedtobe
responsible.
Keyterroristgroupsandaffiliations
Thereareliterallyhundredsofterroristgroupings,asbecomesevident
every time claims of responsibility are made for a terrorist atrocity.
Many incidents are not the responsibility of recognised organisations
but of loose cooperatives of like-minded individuals who may or
maynotclaimallegiance toa largergroup.
MiddleEast
The Middle East is currently the major focus of both terrorist activity
andanti-terroristinitiatives.Theorganisationsdescribedbelowrepre-
sent only a fraction of those involved in terrorist activity. The main
motivating factors in Middle Eastern terrorism are the conflict over
landfortheIsraeliandPalestinianstatesandtheriseofmilitantIslam
and demands for Sharia law. The demand for Sharia law has led
extremists into conflict not only with the West but also with more
moderateIslamic regimes.
AbuNidalOrganisation(ANO)
Named after its founder, the ANO is a blanket term used for a
collectionoforganisationsputtogetherbyAbuNidal(Sabrial-Banna)
after he split from the Palestine Liberation Organisation (PLO).
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RespondingtoTerrorism: AMedicalHandbook
TheseorganisationshavealsousedthetitlesFatahRevolutionaryCoun-
cil, Arab Revolutionary Council and Black September. Black September
claimed credit for the murders of Israeli athletes at the 1971Olympic
GamesinMunich.
Al-Gama’aal-Islamiyya
Al-Gama’aal-Islamiyyaisafundamentalistgroupingseekingtoestab-
lishanIslamicstateinEgypt.Itstargetshaveincludedsecularestablish-
ments,thesecurityforces,touristsandminoritieswithintheEgyptian
population.
AlQaeda
OfalltheterroristorganisationswhichhaveoriginatedintheMiddle
East, Al Qaeda (‘The Base’) has the highest profile and is the cause of
most international concern. Al Qaeda was established by Osama Bin
Laden (Box 1.1), the millionaire son of an immensely wealthy Saudi
building contractor, and Ayman al-Zawahiri around 1990. During
the first Gulf War Bin Laden offered his assistance to the Saudi
Box1.1 OsamaBinLaden
(cid:129) BornMarch10th,1957,Riyadh,SaudiArabia
(cid:129) Oneof55childrenofMuhammedAwadbinLaden,awealthybusinessman
withlinkstotheSaudiroyalfamily
(cid:129) RaisedasadevoutSunniMuslimandexposedtotheMuslimBrotherhood
duringarelativelyseculareducation
(cid:129) Marriedforthefirsttimeaged17in1974,settledinJeddah
(cid:129) In1979movedtoPeshawartotakepartinanti-RussianfightinginAfghanistan
(cid:129) By1984establishedtheOfficeofOrder(Maktabal-khadamat)tochannel
money,armsandfighterstoAfghanistan
(cid:129) AllegedlyarmedandfundedbytheCIAduringthe1980s
(cid:129) In1988splitfromMaktabal-khadamat,foundsAlQaeda
(cid:129) In1990hisoffertohelpSaudiArabiaduringfirstGulfWarisrejected.
BecomescriticalofSaudimonarchy.EscapesfromSaudiArabiaandsettlesin
Sudan(1991)
(cid:129) 1992GoldMihorHotalbombing,Yemen
(cid:129) 1995BombingofUS-runSaudiNationalGuardtrainingcentre
(cid:129) 1996ExpelledfromSudan,returnstoAfghanistan.Providesmilitaryand
financialsupporttoTaliban,becomesclosetotopTalibanleaders,including
MullahOmah
(cid:129) 1998USEmbassybombings
(cid:129) 2001WorldTradeCenterandPentagonattacks
(cid:129) USattemptstocaptureBinLadenfail
(cid:129) 2005–6RumoursofBinLaden’sdeathcirculate.Ifstillalive,whereabouts
unknown(possiblyPakistan)
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TerrorisminPerspective
monarchy but was rejected when King Fahd turned to the USA.
Shortly after being openly critical of the monarchy, Bin Laden was
forcedtoleaveSaudiArabiaandhispassportwasrevoked.BinLaden
moved to the Sudan and Al Qaeda was formed shortly afterwards.
In 1993, Al Qaeda associate Ramzi Yousef bombed the World Trade
Center. In 1996, Al Qaeda announced Jihad against foreign troops.
In 1996, after being expelled from the Sudan, Bin Laden and his
associates moved to Afghanistan, establishing training camps and
enjoyingtheprotectionoftheTalibangovernmentuntilitsoverthrow
in2001.
In1998,afatwawasissued,declaringitthedutyofMuslimstokill
Americans and their allies, both civilians and military personnel, the
aimbeingtoliberatethelands theyconsideredtobelongtoIslam.
Al Qaeda’s early recruits were mainly Arabs who had fought the
RussiansinAfghanistan.In1998,attacksonUSEmbassiesinNairobi,
KenyaandDaresSalaamkilledmorethan300andinjuredmorethan
5000, the vast majority not being Americans but citizens of the host
countries. Following this, the US Government carried out cruise
missile strikes against Al Qaeda training facilities in Afghanistan.
In 2000, Al Qaeda attacked the US destroyer Cole, killing 17 service
personnel.
AlQaedareallycametoworldprominenceaftertheirattacksonthe
World Trade Center on September 11th, 2001, when aeroplanes flew
into the Twin Towers of the World Trade Center and the Pentagon.
Over 3000 people died. As a result military action was taken which
destroyed training camps and much of the Al Qaeda infrastructure.
The security forces have been successful in killing or arresting many
senior Al Qaeda figures. Although it has been suggested that Bin
Laden is now dead, this has not been confirmed. If he is still alive,
hislocationiscurrentlyunknown.
Al Qaeda operates from semi-autonomous cells which work inde-
pendently to achieve its aims. Assuming he is still alive, its head is
BinLaden,whoisadvisedbyaShuraCouncilof20–30people.Ayman
al-Zawahiri is believed to be operations chief. Separate committees
dealwithmilitaryoperations,finance,SharialawandIslamicstudies.
Howeveritwould beunwisetooverestimate theorganisationalcom-
plexity of Al Qaeda, which is best seen as a diffuse grouping of
individualsandgroupswith asharedideology.
Taliban associates were known to be active in the insurgence
against coalition forces in Iraq, having fled Afghanistan after the fall
of the Taliban, the most prominent (until his death in a coalition air
strike in 2006) being Abu Musab al-Zarqawi. Their actions included
suicide bombings and attacks on Sunni Muslims supporting the new
settlement. Zarqawi’s replacement is believed to be Abu Ayyub
al-Masri.
AlQaedaretains a strong footprint inPakistan,workingwith radi-
cal Muslims within the country and the resurgent Taliban in
neighbouring Afghanistan.
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