weapons of mass destruction martin donohoe. outline the history and epidemiology of war nuclear...

Weaponsof

Mass DestructionMartin Donohoe

Outline

The history and epidemiology of war

Nuclear weapons

Chemical weapons

Biological weapons

Outline

Economic and environmental consequences of militarism and war

Health consequences of militarism and war

Contemporary issues

History of war

10,000 yrs ago – agriculture– Stable populations, division of labor, warrior class

3500 yrs ago – bronze weapons and armor 2200 yrs ago – iron 1900 yrs ago - horses

History of war

Ninth Century China - bombs developed Thirteenth Century China – rockets

– Forgotten until the 19th Century

1783 - Balloon 1903 - Airplane

20th Century - WMDs

History of War

Belief that each new invention would eliminate warfare

Instead, increased casualties, killing at a distance

Epidemiology of Warfare

Deaths in war:– 17th – 19th Century = 11-19/million

population– 20th Century = 183/million population

Increasing casualties to civilians– 10% late 19th Century– 85-90% in 20th Century

Contemporary Wars

250 wars in the 20th Century Incidence of war rising since 1950 Most conflicts within poor states 27 separate civil wars currently underway

– 19 involve U.S.-supplied weapons

War Deaths, 1945-2000

Consequences of War

Deaths, injuries, psychological sequelae

Collapse of health care system affecting those with acute and chronic illnesses

Famine

Consequences of War

RefugeesEnvironmental degradationIncreasing poverty and debtAll lead to recurrent cycles of

violence

Atomic Weapons - History

Hiroshima, August 6, 1945– “The day that humanity started taking

its final exam” – Buckminster Fuller– 15 kiloton bomb, 140,000 deaths

Nagasaki, August 9, 1945– 22 kiloton bomb, 70,000 casualties

Atomic Weapons – Other Victims

Hundreds of thousands of hibakusha – atomic bomb survivors

1054 U.S. nuclear tests since 1940s, 331 in atmosphere

80,000 cancers (15,000 fatal) in US citizens as a result of fallout from atmospheric testing

– NCI/CDC

Atomic Weapons Today

Approximately 23,360 nuclear weapons at 11 sites in 14 countries (1/2 active or operationally-deployed)– Down from over 71,000 at height of Cold War

5,200 active U.S. warheads today (more than ½ on hair-trigger alert); 8,000 in Russia– Several thousand megatons (100,000

Hiroshimas)

Atomic Weapons Today

High alert– Fired within 15 minutes, reach targets in

30 minutes Vastly redundant arsenal

– 150-200 weapons adequate to destroy all major urban centers in Russia

Atomic Weapons Today

Accidental intermediate-sized launch of weapons from a single Russian submarine would immediately kill 6.8 million Americans in 8 cities

Nuclear Weapons – Oops!

Pentagon: 32 nuclear weapons accidents since 1950

GAO: 233 Since 1950, 10 nuclear weapons lost and

never recovered– All laying on seabed, potentially leaking

radioactivity

Effects of a Nuclear Explosion

Immediate:

– Vaporized by thermal radiation

– Crushed by blast wave

– Burned and suffocated by firestorm

Effects of a Nuclear Explosion

Intermediate:– Suffering, painful deaths– Health care personnel/resources

overwhelmed– Famine– Refugees– Devastated transportation infrastructure

Effects of a Nuclear Explosion

Late effects:– Cancer– Psychological trauma– Nuclear winter (mass starvation due to

disruption of agricultural, transportation, industrial and health care systems)

Effects of a 20 megaton nuclear explosion

Ground zero → 2 miles:– Fireball hotter than sun– everything vaporized

2 - 4 miles:– Buildings ripped apart and leveled

Effects of a 20 megaton nuclear explosion

4 - 10 miles:– Sheet metal melts; concrete buildings

heavily damaged (all others leveled) 16 miles:

– 100 mph winds, firestorm, T = 1400° C– 100% mortality

Effects of a 20 megaton nuclear explosion

21 miles:– Shattered glass, flying debri

29 miles:– 3° burns over all exposed skin

40 miles:– Retinal burns blind all who witness

explosion

Effects of a 20 megaton nuclear explosion over Boston

Death toll:– 1,000,000 within minutes– 1,800,000 survivors:

1,100,000 fatally injured500,000 with major injuries200,000 without injuries

Types of Injuries

Burns Blindings Deafenings Collapsed lungs Fractures Shrapnel wounds

Radiation Sickness

Medium to high doses: death within 1-7 days

Low doses: BM failure, infections, bleeding, sores, ± death

Effects on health professionals

70% killed or fatally wounded

15% injured

< 1000 survive

Effects on health care system

Most major hospitals destroyedEMS system debilitatedNo X-ray machines, electricity,

water, antibiotics or other meds, blood/plasma, bandages

Effects on health care system

2000 burn unit beds in US (100 per major city) – essentially destroyed

No bone marrow transplant capability

Effects on Health Care System

1500 patients/doctor

10 min/pt

4 hours sleep/noc

2 weeks to see all injured

Nuclear Terrorism

Attack on nuclear power plant or other nuclear installation

Dirty bomb– Potential tens to hundreds of thousands of

deaths, billions of dollars of damage, chaos

– Numerous radiation sources left over from Cold War in post-Soviet countries

Nuclear Terrorism

Reports of weapons/numerous radiation sources missing from Soviet arsenal

The Nth Country experiment (1964): 3 science post-docs with no nuclear know-how designed a working atom bomb

Chemical Weapons

428 BC – Athenians and Spartans burned wax, pitch and sulfur

Davinci – arsenic and sulfur shells WW I

– Italians vs. Ethiopians– Japanese vs. Chinese– Germans vs. Allies

chlorine gas91,000 deaths and 1.3 million injuries

Chemical Weapons

Egypt vs. South Yemen (1963-7) Iran/Iraq War (1980s) Gulf War (versus Kurds, ? Others)

– Gulf War Syndrome (real per Congressionally-mandated scientific panel, 2008)

1995 Tokyo subway attack by Aum Shrinko cult using sarin– 12 dead, 5000 injured or incapacitated

Types of Chemical Weapons

Nerve gasses / paralytics– E.g., sarin, VX– S/S: paralysis (incl. resp. muscles), headache,

dizziness, N/V– Rx: ± gas masks, pretreatment with

pyridostigmine, decontamination, antidotes (atropine, pralidoxime, diazepam, tropicamide)

Types of Chemical Weapons

Blistering agents:– E.g., sulphur mustard– S/S: burns, blindness, pulmonary

toxicity, BM suppression, N/V/D– Rx: decontamination, analgesia,

pulmonary and eye care

Types of Chemical Weapons

Pulmonary toxicants– E.g., chlorine, phosgene– S/S: pneumonitis, laryngeal spasm,

pulmonary edema, ARDS– Rx: O2, bronchodilators,

corticosteroids, ?ibuprofen, ?acetylcysteine

Chemical Weapons

1972 Biological and Toxic Weapons Convention prohibits development, production, and stockpiling

1989 stockpiles:– US – 36,000 tons– Russia – 270,000 tons (1/2 = nerve gas)

Current amounts unclear

Other Chemical Weapons

Tear gas, pepper sprayCalmatives: mind-altering or sleep-

inducing weapons (benzo-, SSRI-, and anesthetic derivatives)

Cramp-inducing agents

Other Chemical Weapons

Stink bombs (“?Race specific?”)Colored smoke as an obscurantCrowd control vs use in warfareUS pilot amphetamine use

Biological Weapons - History

Ancient Greeks, Romans and PersiansUS Civil War (General Johnson at

Vicksburg)14th Century: Tatars catapulting plague-

infested corpses

Biological Weapons - History

Sir Jeffrey Amherst (French and Indian Wars - smallpox): “You would do well to try to inoculate the Indians, by means of blankets, … to extirpate this execrable race”

WW I: Cholera, plague, glanders, anthrax

Biological Weapons – WW II

Unit 731, Manchuria, Shiro Ishii British “Operation Vegetarian” (anthrax cakes

/ Germany) US military personnel received typhoid,

smallpox, yellow fever and tetanus vaccines

Biological Weapons Post WWII

Swerdlosk - anthrax

Zimbabwe - anthrax

Biological Weapons Today

17 countries possess (+ Al Qaeda?) US role in supplying other nations:

– e.g., 1985-1989: US companies sold to Iraq: Bacillus anthracis, Clostridium botulinum, Histoplasma

capsulatum, Brucella melitensis, Clostsridium perfringens, Clostridium tetani, and E. coli

Despite evidence of use of chemical weapons against Kurds

Biological Weapons Today

1972 Biological Weapons Protocol: signed by 158 nations

Lacks adequate enforcement mechanisms US has rejected enforcement (wary of foreign

inspectors discovering military secrets and/or trade secrets of biotechnology and pharmaceutical companies)

Biological Weapons - Agents

Anthrax Brucellosis Cholera

Glanders Pneumonic plague

Tularemia Q Fever Smallpox

Venezuelan Equine Encephalitis

Viral Hemorrhagic Fevers (e.g., Ebola)

Botulism Staph enterotoxin B

Ricin Mycxotoxins

Biological Weapons of the Future

Genetic weapons – targeted at specific ethnic groups

Smallpox

DNA virus; decimated native American populations; eradicated by WHO vaccination campaign in 1972; genome sequenced in 1992; recreation of virus in lab possible in 2002

?Only remaining viral stocks at CDCP and in Siberia?

Smallpox

Incubation period 7-17 days (avg. = 12)

Spread by droplet infection; highly contagious

Symptoms: abrupt onset of F/HA/myalgias → rash → MSOF → death

Smallpox

Rx: isolation, post-exposure vaccination, supportive care, ?antivirals

30 % fatality rate

Anthrax

Cutaneous, GI and Pulmonary forms

Est. 50kg release over urban center of 5 million people would sicken 250K and kill 100K

100 kg release would have the same # of casualties as a hydrogen bomb explosion

Inhalational Anthrax

Case fatality rate approx. 50%Rx:

– Post-exposure antibiotics (doxycycline, ciprofloxacin, penicillin)

– Supportive careVaccine

Other WMDs

Small arms

Land mines

Cluster bombs

Health Care System Preparadness for Weapons of Mass Destruction

¾ of US ERs not fully prepared for treating mass casualties

Only 12% of US hospitals have bioterrorism response measures developed and in place

Congressional panel estimates > 50% chance of terrorist act involving WMDs by 2013

Health Care System Preparedness for Weapons of Mass Destruction

US public health / emergency care system already in disarray

80% of states facing budget cuts or holdbacks

Medicaid over budget in 23 statesAnti-immigrant laws dangerous

Priorities and Mass Destructions

Warning:

Progressive Rhetoric Ahead….

Military Spending

US: over ½ of discretionary tax dollars spent on the military

US military budget represents 43% of total world military budget ($1.5 trillion in 2009)

Iraq War costs could reach $2-3 trillion

2009 Federal Budget$2.65 trillion

Economic Cost of War, U.S.

Military Spending

Increased spending on nuclear weapons

Inadequate spending to prevent the spread of chemical, biological, and nuclear weapons

Arms Exports

Arms Imports

Missile Defense ShieldThe Militarization of Space

Star Wars program proceeding, despite:– Astronomical cost – est. $100 billion– Strong opposition by scientific community– Spectacular failures in 2/4 tests, despite highly

structured conditions

Abandonment of ABM Treaty by Bush administration

Missile Defense ShieldThe Militarization of Space

“Shield” or very porous umbrella Easily overwhelmed and fooled by

inexpensive decoys No protection against internal accidents or

terrorists bringing weapon onto US soil or “dirty bomb”

Proposed use of moon for spy observatories and weapons

Dwight Eisenhower

“The problem in defense spending is to figure out how far you should go without destroying from within that which you are trying to protect from without”

Social Injustices Abound

51 million Americans lack health insurance → 18,000 deaths per year

25% of US children live in poverty Worsening homelessness, public educational

system, other social indicators 1.2 billion people have no access to clean

drinking water-2 million child deaths/year

Social Injustices

Worldwide

– poverty increasing– maldistribution of wealth– corporatization– global debt crisis

Social Injustices

Worldwide– environmental destruction and global

warming– Air pollution kills 70,000/yr in US, >500K/yr

worldwide– AIDS epidemic in sub-Saharan Africa– 70,000 die of hunger every 2 days (i.e.,

one Hiroshima every 2 days)

Health Costs of Militarization

3 hours of world arms spending = annual WHO budget

½ day of world arms spending = immunization for all the world’s children

Health Costs of Militarization

3 weeks of world arms spending = primary health care for all in poor countries, including safe drinking water and full immunizations

Brain drain: 1/2 of US research scientists work entirely on military R and D

Dwight Eisenhower

“Every gun that is made, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and not clothed”

Dwight Eisenhower

“This world is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.”

Martin Luther King

“A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual death.”

US Foreign Aid

US ranks 21st in the world in foreign aid as a percentage of GDP (0.7%, versus UN recommended 0.15%)

Foreign Aid:– 1/3 military– 1/3 economic– 1/3 food and development

US world’s largest arms exporter – many weapons later used against us

Current Problems

Budget surplus → budget deficitIraqAfghanistanOthers?War on Terror

US Nuclear Weapons PoliciesUnder GW Bush

Nuclear Posture Review – expands scope of use of nuclear weapons, including first-strike against non-nuclear states

Withdrawal from ABM Treaty Boycotted Comprehensive Nuclear Test Ban

Treaty Conference Budgeted money to resume nuclear testing

and development

U.S. Nuclear Policy Under Obama

U.S. retains first strike option against nuclear states

START treaty signed by Obama, Putin– Awaiting Senate approval– Will limit US and Russia to 1,550

long-range warheads (still overkill)

The US: Rogue Nation

History: Native Americans, slavery, current disparities and injustices

5% of the world’s population; responsible for 25% of its energy consumption, 33% of its paper use, and 72% of its hazardous waste production

Co-opting Nazi and Japanese WWII scientists

The US: Rogue Nation

Minimum 277 troop deployments by the US in its 225+ year history

Since the end of WWII, the US has bombed:– China, Korea, Indonesia, Cuba, Guatemala, Congo, Peru,

Vietnam, Laos, Cambodia, Nicaragua, El Salvador, Grenada, Libya, Panama, Afghanistan, Sudan, Yugoslavia, and Iraq

– Conservative estimate = 8 million killed

The US: Rogue Nation

In 2009, the US spent about $2,210 per US citizen on defense– vs. a few dollars per capita on peacekeeping

efforts

The US maintains military bases in 69 “sovereign” nations around the world

The US: Rogue Nation

Continued funding of the Western Hemisphere Institute for Security Cooperation– Formerly the School of the Americas– Over 60,000 graduates, including many of the

worst human rights abusers in Latin America (e.g., Manuel Noriega, Omar Torrijos, and the assassins of Archbishop Oscar Romero)

International Non-Cooperation/Isolationism

Failure to sign or approve:– Kyoto Protocol on Climate Change– Convention on the Prohibition of Anti-Personnel

Land Mines– Comprehensive Nuclear Test Ban Treaty– Convention on the Rights of the Child

International Non-Cooperation/Isolationism

Failure to sign or approve:– Convention on the Elimination of Discrimination

Against Women– Convention on Economic, Social and Cultural

Rights– Convention for the Suppression of Traffic in

Persons

The US: Rogue Nation

Death Penalty:– US executes more of its citizens than any other

country except China, Iran, and Saudi Arabia– US is the only country to execute both juveniles

and the mentally ill Failure to follow World Court Decisions Oppose International Criminal Court Largest debtor to the UN (only 40% of dues

paid)

The role of the doctor in society

World Health Organization:

– “The role of the physician … in the preservation and promotion of peace is the most significant factor for the attainment of health for all.”

Physicians for Social Responsibility

Contact Information

Public Health and Social Justice Website

http://www.phsj.org

martindonohoe@phsj.org