1. Weapons of Mass Destruction Martin Donohoe

2. Outline The history and epidemiology of war Nuclear weapons Chemical weapons Biological weapons

3. Outline Economic and environmental consequences of militarism and war Health consequences of militarism and war Contemporary issues

4. 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

5. History of war Ninth Century China - bombs developed Thirteenth Century China – rockets – Forgotten until the 19 th Century 1783 - Balloon 1903 - Airplane 20 th Century - WMDs

6. History of War Belief that each new invention would eliminate warfare Instead, increased casualties, killing at a distance

7. Epidemiology of Warfare Deaths in war: – 17 th – 19 th Century = 11-19/million population – 20 th Century = 183/million population Increasing casualties to civilians – 10% late 19 th Century – 85-90% in 20 th Century

8. Contemporary Wars 250 wars in the 20 th Century Incidence of war rising since 1950 Most conflicts within poor states 25 separate civil wars currently underway

9. Consequences of War Deaths, injuries, psychological sequelae Collapse of health care system affecting those with acute and chronic illnesses Famine

10. Consequences of War Refugees Environmental degradation Increasing poverty and debt All lead to recurrent cycles of violence

11. 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

12. Atomic Weapons – Other Victims Hundreds of thousands of hibakusha – atomic bomb survivors 80,000 cancers (15,000 fatal) in US citizens as a result of fallout from atmospheric testing – NCI/CDC

13. Atomic Weapons Today 20,000 nuclear weapons Several thousand megatons US and Russia have 13,000 actively deployed warheads

14. Atomic Weapons Today 2500 (US) and 2000 (Russia) on 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

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

16. 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

17. Effects of a Nuclear Explosion Immediate: – Vaporized by thermal radiation – Crushed by blast wave – Burned and suffocated by firestorm

18. Effects of a Nuclear Explosion Intermediate: – Suffering, painful deaths – Health care personnel/resources overwhelmed – Famine – Refugees – Devastated transportation infrastructure

19. 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)

20. 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

21. 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

22. 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

23. Effects of a 20 megaton nuclear explosion over Boston Death toll: – 1,000,000 within minutes – 1,800,000 survivors: 1,100,000 fatally injured 500,000 with major injuries 200,000 without injuries

24. Types of Injuries Burns Blindings Deafenings Collapsed lungs Fractures Shrapnel wounds

25. Radiation Sickness Medium to high doses: death within 1-7 days Low doses: BM failure, infections, bleeding, sores, ± death

26. Effects on health professionals 70% killed or fatally wounded 15% injured < 1000 survive

27. Effects on health care system Most major hospitals destroyed EMS system debilitated No X-ray machines, electricity, water, antibiotics or other meds, blood/plasma, bandages

28. Effects on health care system 2000 burn unit beds in US (100 per major city) – essentially destroyed No bone marrow transplant capability

29. Effects on Health Care System 1500 patients/doctor 10 min/pt 4 hours sleep/noc 2 weeks to see all injured

30. 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

31. 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

32. 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 gas 91,000 deaths and 1.3 million injuries

33. Chemical Weapons Egypt vs. South Yemen (1963-7) Iran/Iraq War (1980s) Gulf War (versus Kurds, ? Others) 1995 Tokyo subway attack by Aum Shrinko cult using sarin – 12 dead, 5000 injured or incapacitated

34. 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)

35. 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

36. Types of Chemical Weapons Pulmonary toxicants – E.g., chlorine, phosgene – S/S: pneumonitis, laryngeal spasm, pulmonary edema, ARDS – Rx: O2, bronchodilators, corticosteroids, ?ibuprofen, ?acetylcysteine

37. 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

38. Other Chemical Weapons Tear gas, pepper spray Calmatives: mind-altering or sleep- inducing weapons (benzo-, SSRI-, and anesthetic derivatives) Cramp-inducing agents

39. Other Chemical Weapons Stink bombs (“?Race specific?”) Colored smoke as an obscurant Crowd control vs use in warfare US pilot amphetamine use

40. Biological Weapons - History Ancient Greeks, Romans and Persians US Civil War (General Johnson at Vicksburg) 14 th Century: Tatars catapulting plague- infested corpses

41. 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

42. 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

43. Biological Weapons Post WWII Swerdlosk - anthrax Zimbabwe - anthrax

44. 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

45. 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)

46. Biological Weapons - Agents AnthraxBrucellosisCholera GlandersPneumonic plague TularemiaQ FeverSmallpox Venezuelan Equine Encephalitis Viral Hemorrhagic Fevers (e.g., Ebola) BotulismStaph enterotoxin B RicinMycxotoxins

47. Biological Weapons of the Future Genetic weapons – targeted at specific ethnic groups

48. Smallpox DNA virus; decimated native American populations; eradicated by WHO vaccination campaign in 1972 ?Only remaining viral stocks at CDCP and in Siberia?

49. Smallpox Incubation period 7-17 days (avg. = 12) Spread by droplet infection; highly contagious Symptoms: abrupt onset of F/HA/myalgias → rash → MSOF → death

50. Smallpox Rx: isolation, post-exposure vaccination, supportive care, ?antivirals 30 % fatality rate

51. 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

52. Inhalational Anthrax Case fatality rate approx. 50% Rx: – Post-exposure antibiotics (doxycycline, ciprofloxacin, penicillin) – Supportive care Vaccine

53. 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

54. 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 states Anti-immigrant laws dangerous

55. Priorities and Mass Destructions Warning: Progressive Rhetoric Ahead….

56. Military Spending US: ½ of discretionary tax dollars spent on the military US military budget represents 34% of total world military budget ($1.035 trillion in 2004) $400+ billion defense budget for 2003 (excluding costs of war in Iraq)

57. Military Spending 4.6% increase in spending on nuclear weapons 11.5% decrease in spending to prevent the spread of chemical, biological, and nuclear weapons ($773 million)

58. Missile Defense Shield The 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

59. Missile Defense Shield The 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

60. 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”

61. Social Injustices Abound 46 million Americans lack health insurance → 18,000 deaths per year 20-25% 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

62. Social Injustices Worldwide – poverty increasing – maldistribution of wealth – corporatization – global debt crisis

63. 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)

64. 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

65. 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

66. 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”

67. 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.”

68. 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.”

69. US Foreign Aid US ranks 21 st 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

70. Current Problems Budget surplus → budget deficit Iraq Afghanistan Others? War on Terror

71. New US Nuclear Weapons Policies Under 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

72. 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

73. 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

74. The US: Rogue Nation In 2002, the US spent about $1,211 per US citizen on defense – vs. $2.27 per citizen on international peacekeeping efforts The US maintains military bases in 69 “sovereign” nations around the world

75. 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)

76. 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

77. 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

78. The US: Rogue Nation Death Penalty: – US executes more of its citizens than any other country – 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)

79. 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

80. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org