Pediatric Annals

from the guest editors 

Terrorism: Its Impact on Primary Pediatrics, Part I

Gregory S Blaschke, MD, MPH, FAAP; Julia Lynch, MD, FAAP




More than a year has passed since the shocking events of the fall of 2001 that included the September 11 attacks, followed so rapidly by the still enigmatic anthrax attacks. These events have left us with a new sense of the vulnerability of our homeland. Many efforts are underway to lessen our vulnerability to future assaults. In spite of these efforts, we may be unlikely to completely eliminate the possibility of another terrorist event. So while we must dedicate effort at prevention, we must also learn to manage the consequences and limit the impact on the physical and mental health of our population, particularly our children. Children are not just another vulnerable group, they are the future of our society and culture. Their recovery from these catastrophic events should be preeminent

All disasters are first and foremost community events with secondary ramifications on our larger society. The preparation for and mitigation of disasters is thus an element of community medicine. Although community pediatrics has all too often been equated with poverty or the underserved population, the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (September 11, 2002/51 (Special Issue); 16-18) in fact highlights how the September 1 1, 2001, attacks struck a broad cross section of the local community in New York City. Additionally, the attacks affected the Pentagon, the Capitol, Pennsylvania, and our nation's and our world's community without regard to economic status, race, or religion. Our efforts at prevention and mitigation must also include many spheres.

In this and the next two issues of Pediatric Annals, our intent is to provide pediatric practitioners with a starting point for learning the medical consequence management aspects of possible terrorist events in this country. The American Academy of Pediatrics' Task Force on Terrorism has identified five major forms of terrorism for which we need to prepare as individuals, medical professionals, and members of our community. These include thermomechanical, chemical, biologic, radiation, and psychological terrorism. We have invited pediatric experts on these topics to provide a basic review of the subject with particular attention to unique effects on children, families, and communities.

In addition, with the help of colleagues at the University of California, San Diego, Division of Community Pediatrics, as well as those from San Diego State University School of Public Health, we explore a model community response plan that links providers, public health resources, government agencies, and individuals in disaster preparedness.

One of the groups in this country that has been significantly impacted by the war on terrorism is the military community, both those on active duty and reserves. Families and children in a wide array of communities across the nation are being impacted by the deployment of their loved ones. We have invited an expert to provide insight on resources available to support the families of those who serve our country in war. It is our hope that this will be useful to practitioners who will have contact with these families both within and outside of the military health care system.

We will bring the reflections of several residents on these events. Our resident essays will span the perspectives of a Muslim resident in Harlem reflecting on her experience during the World Trade Center attacks to current military pediatric residents who will be graduating during a time of war. Lastly, because we cannot afford to lose our most precious resource, we hope to empower you to become the advocate for children's needs in disasters in your community and our nation.


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