Transcript Health Consequences of Nuclear, Chemical and Biological

Health Consequences of
War and Militarism
Martin Donohoe, MD, FACP
Outline

The history and epidemiology of war

Nuclear weapons

Chemical weapons

Biological weapons
Outline
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Economic and environmental
consequences of militarism and war
Health consequences of militarism and
war
Contemporary conflicts


Afghanistan, “War on terror”, Middle East
Solutions
History of War

Violent conflict ubiquitous in the animal
kingdom:
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Interspecies conflict – food, territory
Intraspecies conflict – food, territory, mates
(usually not directly fatal)
Violence among non-human primates

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Gorilla infanticide
Chimpanzee killing bands
History of war

10,000 yrs ago – agriculture
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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
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Forgotten until the 19th Century
1783 – Balloon
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Montgolfier brothers
Prussian general JCG Heyne – used for
bombing
History of War


1903 – Wright brothers/Kitty Hawk –
airplane
20th Century – nuclear submarines,
predator drones, weaponization of space
History of War


Belief that each new invention would
eliminate warfare
Instead, increased casualties, killing at a
distance
Epidemiology of Warfare

Deaths in war:
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17th
18th
19th
20th
Century
Century
Century
Century
=
=
=
=
19/million population
19/million population
11/million population
183/million population
Increasing casualties to civilians

85-90% in 20th Century (vs. 10% late 19th
Century)
War Deaths, 1945-2000
Legacies of Colonial Exploitation

Christopher Columbus’ log entry upon
meeting the Arawaks of the Bahamas:
“They…brought us…many…things…They
willingly traded everything they
owned…They do not bear arms…They
would make fine servants…With fifty men
we could subjugate them all and make
them do whatever we want.”
Legacies of Colonial Exploitation

Winston Churchill (speaking in favor
of RAF’s “experimental” bombing of
Iraqis in 1920s, which killed 9,000
people with 97 tons of bombs):
“I am strongly in favor of using
poisoned gas against uncivilized
tribes to spread a lively
terror…against recalcitrant Arabs as
an experiment”
Legacies of Colonial Exploitation

Cecil Rhodes (Rhodesia, Rhodes
Scholarship, DeBeers Mining Company):
“We must find new lands from which we
can easily obtain raw materials and at the
same time exploit the cheap slave labour
that is available from the natives of the
colonies. The colonies would also provide
a dumping ground for the surplus goods
produced in our factories.”
Contemporary Wars

250 wars in the 20th Century

Incidence of war rising since 1950

Most conflicts within poor states
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27 separate civil wars currently underway

19 involve U.S.-supplied weapons
Contemporary Wars



72 million lives lost in 20th Century wars,
another 52 million through genocides
US dropped the equivalent of one 500 lb.
bomb on every person in Vietnam
Vietnam War: 11.5 to 3 million
Vietnamese casualties; 58,000 American

More US soldiers died of suicide after Vietnam
than died in combat during the war.
Contemporary Wars
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
Gulf War I: US planted one land mine for
every Iraqi citizen
310,000 direct war-related deaths in 2000
(0.5% of worldwide mortality); indirect
deaths much larger
Consequences of War
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Deaths, injuries, psychological sequelae
Collapse of health care system affecting
those with acute and chronic illnesses
Famine
Environmental degradation
Increasing poverty and debt
All lead to recurrent cycles of violence
Consequences of War

Contributes, along with persecution,
poverty, and environmental degradation,
to the 240 million people “on the move”

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International migrants – 168 million
Refugees, including Palestinians – 16 million
Internally displaced due to conflict or
persecution (25 million) or natural disasters
and other causes (30 million)
Asylum seekers – 940,000
Atomic Weapons - History

Hiroshima, August 6, 1945
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“The day that humanity started taking its final
exam” – Buckminster Fuller
15 kiloton bomb, 140,000 deaths
Nagasaki, August 9, 1945
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22 kiloton bomb, 70,000 casualties
The Hiroshima Bomb
Atomic Explosion
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
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Atomic Weapons – Other Victims

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Thousands of illnesses and deaths, higher
CA risk in 600,000 former employees
- DOE
Bush administration trying to limit
payments mandated by Congress in 2001
($150,000 plus lifetime medical benefits)
Atomic Weapons Today
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20,000 nuclear weapons
Several thousand megatons (100,000
Hiroshimas)
GW Bush - Nuclear Posture Review
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Possible targets: Russia, China, Iran, Iraq,
Libya, North Korea, and Syria
First strike
Atomic Weapons Today
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US and Russia have 13,000 actively
deployed warheads
2500 (US) and 2000 (Russia) on high alert

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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!
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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
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Immediate:
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Vaporized by thermal radiation
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Crushed by blast wave
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Burned and suffocated by firestorm
Effects of a Nuclear Explosion
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Intermediate:
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Suffering, painful deaths
Health care personnel/resources overwhelmed
Famine
Refugees
Devastated transportation infrastructure
Effects of a Nuclear Explosion
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Late effects:
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Cancer
Psychological trauma (PTSD, anxiety,
depression)
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:
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Within 1/100 second fireball hotter than sun;
everything vaporized
2 - 4 miles:
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25 psi pressures; 650 mph winds
Buildings ripped apart and leveled
Effects of a 20 megaton nuclear
explosion
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4 - 10 miles:
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7 – 10 psi; 200 mph winds
Sheet metal melts; concrete buildings heavily
damaged (all others leveled)
16 miles:
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100 mph winds, firestorm, T = 1400° C
100% mortality
Effects of a 20 megaton nuclear
explosion
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21 miles:
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29 miles:
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2 psi; 100 mph winds
Shattered glass, flying debri
3° burns over all exposed skin
40 miles:
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Retinal burns blind all who witness explosion
Effects of a 20 megaton nuclear
explosion over Boston
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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

Types of Injuries

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Burns
Blindings
Deafenings
PTX
Fxs
Shrapnel wounds
Radiation Sickness
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Very high dose: cerebral edema, N/V/D,
speech and gait difficulties, convulsions,
coma, death within 1-2 days
Medium doses: N/V/D → resolves →
recurrent hematemesis, bloody D →
majority die
Low doses: BM failure, infections,
bleeding, sores, ± death
Effects on health professionals

70% killed or fatally wounded
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15% injured

< 1000 survive
Effects on health care system
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Most major hospitals destroyed
EMS system debilitated
No X-ray machines, electricity, water,
antibiotics or other meds, blood/plasma,
bandages
2000 burn unit beds in US (100 per major
city) – essentially destroyed
Effects on Health Care System

1500 patients/doctor
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10 min/pt
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4 hours sleep/noc

2 weeks to see all injured
Ultimate Outcomes

Boston (pop. 2.8 million in 1998)
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> 2.5 million dead after one month
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More than 6x as many Americans as died in
WW II
Health hazards of the Nuclear Cycle
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Ecosystem degradation: e.g., Bikini Island
Uranium mining: 5-fold increase in lung
cancer
Depleted uranium:
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increased stillbirths, birth defects, childhood
leukemias, other cancers in Southern Iraq
Possible increase in lung CA in U.S. soldiers
(data sparse)
Nuclear Waste Disposal

On-site storage:
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118 commercial reactors
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10 weapons plants
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37 research reactors
Nuclear Waste Disposal
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Skull Valley, Goshute Indian Reservation,
Utah
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Private fuel storage consortium
Temporary storage of 44,000 tons of highlevel nuclear waste
Bribes to tribes; environmental injustice
Waste Isolation Pilot Plant, New Mexico
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Defense Dept. waste
Nuclear Waste Disposal – Yucca
Mountain
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On DOE land claimed by
Western Shoshone Nation
under the Ruby Valley
Treaty of 1863
100 miles from Las Vegas
Near aquifer and
earthquake fault
Nuclear Waste Disposal – Yucca
Mountain
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Est. 100,000 shipments of 70,000 –
120,000 tons of waste over 25 yrs
Coming within ½ mile of 50 million
Americans
Est. 200-350 accidents
Nuclear roulette
Nuclear Power Plants
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103 plants in US
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Aging, equipment
failures (8 from 3/004/01 → shutdowns)
440 plants worldwide
(generate 16% of
planet’s electricity)
60 plants in Russia
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? Condition, safety
Nuclear Power
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Supply of uranium for fission to run out by
2050
Alternate sources:
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MOX (mixed oxide) fuel (reprocessed spent
fuel – plutonium and uranium)
Breeder reactors – make more fuel
(plutonium) than they consume
Fission – currently impractical
Nuclear Power Plant Accidents
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Three Mile Island (1979)
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50,000 to 100,000 excess deaths
Chernobyl:
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50 deaths (among highly exposed emergency
workers)
4000 thyroid cancers (most have survived)
Expected 3940 deaths from radiation-induced cancers
Greatest problem anxiety
Nuclear Power Plants
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For every US plant that has its license renewed,
12 additional cancer deaths (NRC)
 Plus any deaths from accidents, non-routine
releases, high level waste and spent fuel
Nuclear power industry receives $10 billion/yr in
taxpayer subsidies
Precautionary principle
Nuclear Power Plants
Nuclear Terrorism
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Attack on nuclear power plant or other nuclear
installation
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47% of nuclear plants failed to repel mock terrorist
attacks conducted by the NRC in the 1990s
Dirty bomb
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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
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Collapse of Soviet Union –15,000 nuclear
warheads and enough highly-enriched uranium
and plutonium to make 60,000 more
More than 90% of Russia’s fissile materials are
located in 171 buildings, only 11 of which have
been fully secured
175 cases of nuclear trafficking from 1993 –
2001 (NRC)
Nuclear Terrorism
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Reports of weapons missing from Soviet
arsenal
Non-proliferation efforts, including the DOE’s
Nuclear Cities Initiative, get a fraction of 1%
of the defense budget, further cuts planned
The Nth Country experiment (1964): 3
science post-docs with no nuclear know-how
designed a working atom bomb
Chemical Weapons
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428 BC – Athenians and Spartans burned wax,
pitch and sulfur
Davinci – arsenic and sulfur shells
WW I
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Italians vs. Ethiopians
Japanese vs. Chinese
Germans vs. Allies
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Franz Haber – chlorine gas
91,000 deaths and 1.3 million injuries
Chemical Weapons
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Egypt vs. South Yemen (1963-7)
Iran/Iraq War (1980s)
Gulf War (versus Kurds, ? Others)
 Gulf War Syndrome (real per Congressionallymandated scientific panel, 2008)
1995 Tokyo subway attack by Aum Shrinko cult
using sarin
 12 dead, 5000 injured or incapacitated
Types of Chemical Weapons
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Nerve gasses / paralytics
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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
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Blistering agents:
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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
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Pulmonary toxicants
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E.g., chlorine, phosgene
S/S: pneumonitis, laryngeal spasm,
pulmonary edema, ARDS
Rx: O2, bronchodilators, corticosteroids,
?ibuprofen, ?acetylcysteine
Chemical Weapons:
Vietnam and Napalm
Chemical Weapons:
Vietnam and Napalm
Chemical Weapons:
Vietnam and Napalm
Chemical Weapons
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1972 Biological and Toxic Weapons
Convention prohibits development,
production, and stockpiling
1989 stockpiles:
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US – 36,000 tons
Russia – 270,000 tons (1/2 = nerve gas)
Other Chemical Weapons:
Tear gas
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Use in civil and political unrest
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Causes eye, skin and pulmonary toxicity, N/V,
photophobia and headache, trauma due to blast

Rx: wash skin, flush eyes, IVF, humidified O2,
bronchodilators prn, ±prophylactic antibiotics
Other Chemical Weapons:
Pepper Spray
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Derived from cayenne peppers (contains
10-15% oleoresin capsicum)
1.5-2 million Scoville unit heat rating
Jalapeño pepper = 2500-5000 Scoville
units
Habañero pepper (world’s hottest) =
300,000 Scoville units
Use in civil and political unrest
Other Chemical Weapons
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Calmatives: mind-altering or sleepinducing weapons (benzo-, SSRI-, and
anesthetic derivatives)
Cramp-inducing agents
Stink bombs (“?Race specific?”)
Colored smoke as an obscurant
Crowd control vs use in warfare
US pilot amphetamine use
Biological Weapons - History
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Sixth Century BC: Assyrians poison wells
with rye ergot
300 BC: Greeks pollute wells
Later: Romans and Persians, Classical,
Medieval and Renaissance periods, US
Civil War (General Johnson at Vicksburg)
14th Century: Tatars catapulting plagueinfested corpses
Biological Weapons - History


Koch’s postulates: anthrax – first linkage
of a specific disease with a specific
pathogen
Louis Pasteur: anthrax and cholera
vaccines
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

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Unit 731, Manchuria, Shiro Ishii
British “Operation Vegetarian” (anthrax
cakes / Germany)
US military personnel received typhoid,
smallpox, yellow fever and tetanus
vaccines
Those who refused subject to court
martial

c.f., Gulf War – pyridostigmine, botulism
vaccine
Biological Weapons – WW II

Unlicensed yellow fever vaccine contaminated
with hepatitis B

330,000 infections

51,000 cases of symptomatic hep B

Long term outcomes good
Biological Weapons Post WWII

Swerdlosk

Zimbabwe

False alarms
Biological Weapons Today

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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
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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 Today
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
Genetic weapons – targeted at specific
ethnic groups
1999: FBI – “at least once a day a
politician, school, abortion clinic, or other
controversial person or institution receives
an envelope from a dissident containing a
powder and a note announcing a lethal
dose of anthrax”
Biological Weapons Today

Use, along with chemical weapons, in
“The Drug War”:
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Fusarium oxysporum fungus to eradicate coca
pants in Columbia; Fusarium oxysporum and
Pleaspora papaveracea fungus to eradicate
opium poppies in Central Asia
? Marijuana
Food crops also destroyed
US, UN Drug Control Program, others
Biological Weapons Today

Quarantine Issues:
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Quarantine versus Isolation
National versus foreign outbreaks / border
control
Adverse consequences – increased risk of
disease transmission in quarantined
population, violence, mistrust of government,
ethnic bias
Smallpox
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

DNA virus; decimated native American
populations; eradicated by WHO
vaccination campaign in 1972; genome
sequenced
?Only remaining viral stocks at CDCP and
in Siberia?
WHO Executive Board recommended
retaining stores
Smallpox
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

Incubation period 7-17 days (avg. = 12)
Spread by droplet infection; highly
contagious
Symptoms: abrupt onset of F/HA/myalgias
→ non-specific erythematous rash (most
prominent on face and extremities,
simultaneous; varicella – most prominent
on trunk, successive waves) → MSOF →
death
Smallpox
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
Dx: clinical, EM of vesicular fluid
Rx: isolation, post-exposure vaccination,
supportive care, ?antivirals
30 % fatality rate
Smallpox
Smallpox Vaccination
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Vaccinia
US ended in 1972
Waning (?negligible) immunity
Effects: local reaction. Lymphadenopathy
Side effects: postvaccinial encephalitis
(1/300,000), progressive vaccinia; eczema
vaccinatum, generalized vaccinia
Vaccinia immune globulin may modulate
Smallpox Vaccination

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
Acambis and subcontractor Baxter Int’l. $428 million contract to produce 155
million doses of smallpox vaccine by the
end of 2002
Would bring total to 286 million (enough
for every American)
Fed govt has ordered 209 million doses
from a British company
Smallpox Vaccination


Current recommendation: isolation and
vaccination / VIG for close contacts
Vaccination of all US citizens not feasible:

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Inadequate supplies
Several hundred deaths
? Diversion of resources from usual childhood
vaccines
? vaccinate health professionals, public
servants
Infectivity, disability, workman’s comp issues
Anthrax

Bacillus anthracis, aerobic, G+, sporeforming rod

Zoonosis

Invisible and odorless when aerosolized
Anthrax


1979 accidental release at Swerdlosk
(USSR): 250 cases, 100 deaths, town
abandoned due to contamination
Aum Shrinko cult attempted aerosol
dispersal – unsuccessful
Anthrax


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
Cutaneous Anthrax



2000 cases/yr worldwide
Due to exposure to infected animals /
animal products
Epidemic in Zimbabwe, 1989-1995:
10,000 cases
Cutaneous Anthrax





Incubation period 1-10 days (avg. = 5)
Pruritic macule or papule day 1
Round ulcer day 2
Black eschar follows; resolves over 1-2
weeks
Painful lymphadenopathy
Cutaneous Anthrax



Antibiotic Rx (doxy, cipro, pcn) decreases
likelihood of systemic disease
Fatality rate 20% without antibiotics; rare
with antibiotics
Following 9/11: 11 cases
Cutaneous Anthrax - Ulcer
Cutaneous Anthrax - Eschar
Gastrointestinal Anthrax




From ingestion of poorly cooked, infected
meat
Oropharyngeal ulcers – LAN – edema –
sepsis
Terminal ileal / cecal lesion - N/V/bloody
D/acute abdomen/ascites/sepsis
Rx: Abx (doxy, cipro, pcn), supportive
care
Inhalational Anthrax

Stage I:

begins 2-43 days post-exposure

F/dyspnea/cough/HA/V/Ch/weakness/AP/CP

Lasts a few hours to a few days
Inhalational Anthrax

Stage II:





F/dyspnea/diaphoresis/shock
CXR with widened mediastinum due to
lymphadenopathy
±pleural effusions
50% develop hemorrhagic meningitis –
meningismus, delirium and obtundation
Rapid progression to cyanosis, hypotension
and death
Inhalational Anthrax
Widened Mediastinum
Inhalational Anthrax
Inhalational Anthrax



Dx: blood cultures, XR/CT, post-mortem;
serology not helpful
Case fatality rate approx. 50%
Rx:


post-exposure antibiotics (doxycycline,
ciprofloxacin, penicillin)
Supportive care
Anthrax Vaccine




3 or 4 dose series
US armed service members – approx 450K
vaccinated to date
Side effects: HA 0.4%, local rxn 3.6%,
mild systemic SEs in 1%
Manufacturer = Bioport

Contract to produce 4.6 million doses for the
DOD
Anthrax Vaccine

Pre/post exposure vaccination

Improved vaccine under development

?Groups to vaccinate?
Anthrax – The Band
Non-lethal weapons


High-power microwaves (crammed into
cruise missiles, discharge a huge energy
pulse to damage electronics)
Soft bombs

E.g., carbon fiber showers to short circuit
electrical power grids (used in former
Yugoslavia and in Gulf War I)
“Non-lethal” Weapons Proposed
and Under Development

Acoustic




Acoustic bullets
Curdler unit – shrieks, clangs
Infrasound – penetrates most buildings and
vehicles, causes nausea, diarrhea,
disorientation, internal organ damage and
even death
“Squawk box” – intolerable ultrasound pulses
“Non-lethal” Weapons Proposed
and Under Development

Acoustic and optical weapons


Photic driver – ultrasound plus stroboscopic
infrared flasher to penetrate closed eyelids
and cause seizures
Psycho-correction devices – send subliminal
visual and aural messages
“Non-lethal” Weapons Proposed
and Under Development

Barrier Weapons:



Obscurants:


Slick coatings – slippery like ice
Sticky foam (used by US in Somalia)
Colored smoke – felt to cause more psychological
panic than white smoke
Markers:



Fluorescent powder visible under UV light
Sponge grenades impregnated with infrared dye
To mark targets
“Non-lethal” Weapons Proposed
and Under Development

Riot Control


Invisible tear gas
Electrical:


Police or soldier’s jacket which jolts anyone
who touches it
Cattle prods (malicious and accidental use by
civilians)
“Non-lethal” Weapons Proposed
and Under Development

Biotechnical:





Biodegrading microbes (to destroy fuel)
Genetic code alterations (to create less-than-lethal
but long-term disablements, perhaps for generations,
thereby creating a societal burden)
Neuro-implants for behavior modification
Project Agile (1996) – race-specific stink bombs
Pheromones (to impair human and animal
reproduction; mark individuals for assaults by killer
bees, other animals or pests)
“Non-lethal” Weapons Proposed
and Under Development

Holograms:




God/gods/other religious figures or symbols
Soldier forces
Death, dead comrades
Others
Other WMDs

Small arms

Land mines

Cluster bombs
Health Care System Preparedness
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 states
Costs of Militarization





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)
Expected $400 billion defense budget for 2003
(excluding costs of war in Iraq)
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)
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
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
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”
Meanwhile...
Social Injustices Abound




46 million Americans lack health insurance
20-25% of US children live in poverty
Homelessness, public educational system
a shambles, increasing jail populations,
etc.
2.5 billion people worldwide live in abject
poverty (earn less than $500 per year,
lack access to clean drinking water)
Meanwhile...
Social Injustices Abound

Worldwide






poverty increasing
maldistribution of wealth
corporatization
global debt crisis
environmental destruction and global warming
AIDS epidemic in sub-Saharan Africa
Environmental Consequences of
Militarization

World’s single largest polluter

8% of global air pollution

2-11% of raw material use

Almost all high and low level radioactive waste
The US Military


Owns an amount of land equal to North Korea or
Kentucky (25 million acres)
Much of it polluted


Cleanup cost estimates in the hundreds of billions
2000 abandoned firing ranges


E.g., Kahoolawe
60 people killed by unexploded ordnance since WWII
Societal Costs of Militarization

An 8.5% cut in the Pentagon’s 2003 budget
could:
rebuild America’s public schools over the next 10
years - $12 billion
 Feed and provide basic health care to all the world’s
poor - $12 billion
 Buy health insurance for every uninsured American
child - $6 billion
Military experts agree that a cut double this size would
not affect our war-making powers

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
3 days of US arms spending = amount
spent on health, education and welfare
programs for US children in one year
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: 2/3 of US scientists work in
military-industrial complex
Skewed Priorities


The world spends $780 billion/year on
military goods and services
For 30% of this, we could:





Eliminate starvation and malnutrition
Provide shelter for all
Eliminate illiteracy
Provide clean and safe water
Prevent soil erosion
Skewed Priorities





Prevent global warming
Stop deforestation
Aid all refugees
Retire developing nations’ debt
Provide clean, safe energy (through efficiency
and renewables)
Skewed Priorities





Prevent acid rain
Fix the ozone hole
Stabilize world population
Provide basic universal health care and AIDS
control
Eliminate nuclear weapons and land mines
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 second largest arms exporter
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)
Iraq War costs up to $2 trillion
Arms Exports
Arms Imports
Top Pentagon Prime Contractors
Fiscal Year 2001





General Dynamics
United Technologies
TRW
SAIC
General Electric


Owns NBC; Westinghouse used to own CBS
Effect on news reporting?
Top Pentagon Prime Contractors
Fiscal Year 2001





Lockeed
Boeing
Newport News Shipbuilding
Raytheon
Northrup Gruman
September 11, 2001
World Trade Center Bombing


3300 fatalities - foreign nationals outnumbered
Americans
Environmental health consequences unknown:




300-400 tons asbestos
130,000 gallons of transformer oil contaminated with
PCBS
Lead, sulfuric acid, silicon
Fine dust particles
September 11, 2001


Pentagon: 286
casualties
Pennsylvania:
approximately 100
casualties
The War on Terror
(The War on Afghanistan, Iraq, and ?)

“May last 50 or more years” – Cheney
Afghanistan:



Ruled by repressive
human-(women’s-)rights abusingTaliban
Potential transit route for oil and gas pipeline
from Central Asia
Strategic importance in Middle East
Afghanistan

Population = 27 million

Life expectancy = 46 years

Literacy rate = 32%

Avg. annual income = $280
Afghanistan




Negligible infrastructure secondary to
decades of civil war
1 of every 230 persons is a land mine
amputee
Infant mortality = 146/1000
50% of children malnourished; 33% are
orphans
The War in Afghanistan





Estimated 6000 civilians killed
Up to 5 million refugees in border states,
many more internal refugees
9000 US troops remain
Bin Laden not caught
US abandoning commitment to rebuilding

Bush: war “yes”, nation building “no”
Afghanistan/Iraq Parallels




10 years of sanctions, bombings resulting
in 500,000 to 1,000,000 deaths (per UN)
UN Devt. Index 126/174
Infant mortality rates jumped from
65/1000 (pre-Gulf War I) to 103/1000
(2003)
Life expectancy decreased from 62 to 56
Afghanistan/Iraq Parallels



Literacy decreased from 89% to 57%
Infrastructure devastated, Environment
degraded
Rebuilding post-war?

Bush’s 2003 budget does not even request the
money the US promised Afghanistan for rebuilding
What goes around comes around



1980s: CIA arms Afghan rebels with hundreds of
Stinger missiles
Late 2002: Terrorists using a similar Russianmade version of Stinger almost bring down
Israeli passenger airline over Kenya
CIA trying to buy back, but most unaccounted
for


Can shoot down a plane at up 6000-8000 feet
24 diverted to Iran
Before Gulf War I

US sells weapons to Iraq/Hussein



Including components to produce WMDs
Rumsfeld visits Baghdad to promote US
weapons sales
US minimally perturbed when Hussein
gasses 4000 Kurds, torpedoes US naval
vessel
Gulf War I



105,000 military and 110,000 civilian deaths
(almost all Iraqis)
2/3 of US casualties from “friendly fire”
Cost $61 billion ($82 billion in 2003 dollars)


US pays only 10% of costs (most from Saudi Arabia,
Kuwait, Germany and Japan)
Environmental devastation

$48 billion in claims to UN
Kuwaiti Oil Fires
Gulf War II





48,000 – 260,000 deaths predicted during
conflict
20,000 deaths from potential resultant
civil war
Up to 200,000 post-war deaths
Est. 900,000 refugees
Massive humanitarian crisis
Gulf War II

Financial cost of war: $100 billion - $200 billion






$810 million to $16.2 billion to Oregon
US likely to bear majority of costs
Cost of rebuilding: $50 billion
Global travel industry expected to lose $460
billion
Distraction from North Korea, other threats
Shock and awe battle plan: targeting
infrastructure explicitly prohibited by the Geneva
Conventions
George W Bush’s Military Record


February, 1968: States desire to be pilot;
scores in 25th percentile in pilot aptitude
section of Air Force officers test.
May, 1968: Enlists in Texas Air National
Guard; jumps list with assistance of Texas
House Speaker; pledges two years of
active duty and four years of reserve duty
George W Bush’s Military Record



June, 1968: Student deferment expires
September, 1968: Pulls inactive duty to
serve on Florida Senator’s re-election
campaign
November, 1968: Re-activated
George W Bush’s Military Record



November, 1970: Promoted to First
Lieutenant, rejected by UT Law School
Spring, 1970: Hired by Texas agricultural
importer to shuttle plants to/from Florida
June, 1970: Joins Guard’s “Champagne
Unit,” flying with sons of Texas’ elite
George W Bush’s Military Record

May, 1972: Transfers to Alabama Guard
unit so he can work on Senator Blount’s
re-election campaign


His commanding officer states he never
showed up for duty
Grounded for missing a mandatory
physical
George W Bush’s Military Record



Returns to Houston but never reports for
Guard duty
December, 1972: DUI arrest
October, 1973: Air National Guard relieves
him from commitment 8 months early,
allowing him to attend Harvard Business
School
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
Possible use of nuclear-powered predator drones
Phillip Berrigan
“Nuclear weapons are the scourge of the
earth; to mine for them, manufacture
them, deploy them, use them, is a curse
against God, the human family, and the
earth itself.”
Disturbing Trends:
The “Patriot Bill”




Passed with minimal debate, most
Congresspersons acknowledge not reading
Increased governmental and corporate secrecy –
polluters subject to decreased public scrutiny
Erosion of civil liberties – deportations, accused
held without charge/access to legal counsel
70,000 individuals on government’s list of
suspected terrorists
Disturbing Trends:
The Homeland Security Agency

The HSA absorbs two dozen agencies,
170,000 employees, $38 billion budget



TIPS program (citizen spying program)
Total Information Awareness System
(Poindexter)
Paranoia: alert levels, duct tape and
plastic sheeting
Special Interest Provisions in the
Homeland Security Law



Vaccine liability protection (incl. existing
thimersol lawsuits) – Eli Lilly
US corporations setting up offshore business
fronts to avoid paying taxes allowed to contract
with HSD
US government prohibited from publicly
releasing information related to “vulnerabilities”
– incl. safety of nuclear reactors, environmental
toxins, etc
Special Interest Provisions in the
Homeland Security Law

Immunity from liability for manufacturers of
anti-terrorism products and technologies



Army investigations show 60-90% of soldiers’ CBW
protective gear malfunctions
Liability protection for airport screening
companies
Secret advisory meetings with industry
permitted, even if meeting not related to
national security

C.f. Cheney’s Energy Commission
Disturbing Trends:
Censorship and Propaganda



US blacks out names of corporations which sold
weapons to Iraq on UN inspectors’ reports
Covering of Picasso’s Guernica for news
conferences outside UN Security Council
Armed Services Edition books for soldiers:


WW II – the Classics to popular fiction
Gulf War II – Henry V, Art of War, War Letters,
Profiles of American Military Heroes
Disturbing Trends:
Censorship and Propaganda


“No Child Left Behind” Education Act
contains amendment requiring that all
public schools allow recruiters in their
buildings and provide military with contact
numbers and addresses for all students
21st Century McCarthyism
Disturbing Trends


Hate crimes, intolerance
Media jingoism:


New shows planned: “Profiles From the Front
Line,” “Military Diaries,” “AFP: American
Fighter Pilot”
Army to ignore FDA safety standards in
experiments on soldiers (legacy of 20th
Century crimes)
Disturbing Trends



2000: budget surplus = $5.6 trillion
2003: Budget deficit = $2.1 trillion
Cities and states facing $68 billion budget
shortfall


Bush: “States are on their own.”
Patriot II…
George W. Bush
August 5, 2004
 “Our
enemies are innovative and
resourceful, and so are we. They
never stop thinking about new
ways to harm our country and our
people, and neither do we."
James Madison
“The fetters imposed on liberty at home
have ever been forged out of the weapons
provided for defense against real,
pretended, or imaginary dangers from
abroad.”
Samuel Johnson
“Patriotism is the last refuge
of a scoundrel”
Responses to Terror:
Just War Theory




The cause must be just
A lawful authority must decide to resort to
force
The intention of the war must be in accord
with international law
The use of force must be a last resort
Responses to Terror:
Just War Theory



The probability of success should be high
The cost-benefit ratio must be high
The means used must conform with
international humanitarian law
How to Win Without War in Iraq




Border monitoring in Jordan, Syria and
Turkey
Advanced X-ray scanning technology and
an electronic pass system at borders
Sanctions assistance missions to enforce
military sanctions
Political assurances and economic
incentives to neighboring states
How to Win Without War in Iraq



Improve cargo monitoring at port of
Azqaba, Jordan (high-volume port for seagoing cargo to Iraq)
Create a green list of approved oil
companies to purchase Iraqi oil – i.e.,
those not providing kickbacks to Hussein
Require audited financial reports from oil
purchasers to enforce above
How to Win Without War in Iraq



Control or shut down the Syria-Iraq pipeline
Expose and penalize arms embargo violations
Justice in Palestine


Israel = most UN Security Council Violations
Economic and humanitarian assistance to poor
Muslim countries – build alliances, good will


Middle Eastern Marshall Plan
Truth and Reconciliation Commissions (c.f. South
Africa, El Salvador)
The US: Rogue Nation



History: Native Americans, slavery, current
excesses, disparities and injustices
Co-opting Nazi and Japanese WWII
scientists
Minimum 277 troop deployments by the
US in its 225+ year history
The US: Rogue Nation

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
The US: Rogue Nation
Conservative estimate = 8 million
killed
 US invasions/bombings often largely
at behest of corporate interests

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
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)
School of the Americas Watch, arrests
International NonCooperation/Isolationism

Failure to sign or approve:



Kyoto Protocol on Climate Change
Convention on the Prohibition of AntiPersonnel Land Mines
Comprehensive Nuclear Test Ban Treaty
International NonCooperation/Isolationism

Failure to sign or approve:



Convention on the Rights of the Child
Convention on the Elimination of
Discrimination Against Women Convention on
Economic, Social and Cultural Rights
Convention for the Suppression of Traffic in
Persons
International NonCooperation/Isolationism

Failure to sign or approve:


Protocol 1, Article 55 of the Geneva Conventions,
which bans methods or means of warfare which are
intended, or may be expected, to cause widespread,
long-term and severe damage to the natural
environment
The Basel Convention on the Control of
Transboundary Movements of Hazardous Wastes
(designed to control dumping of hazardous wastes
from the industrialized world in developing countries)
The US: Rogue Nation

Death Penalty:




US executes more of its citizens than any
other country
Until recently, the US was the only country to
execute both juveniles and the mentally ill
Failure to follow World Court Decisions
Largest debtor to the UN (only 40% of
dues paid)
Solutions





Physician activism (PSR,
IPPNW, etc.)
Increased education:
public, medical and public
health students
Tolerance and
appreciation of diversity
Conservation measures
Assist victims of war
(PHR, MSF, etc.)
Thomas Jefferson
“Nothing can keep (government) right but
(the people’s) vigilant and distrustful
superintendence”
Harvey Cushing
“A physician is obligated to consider more
than a diseased organ, more even than
the whole man. He must view the man in
his world.”
Rudolph Virchow
“Doctors are natural attorneys for
the poor … If medicine is to really
accomplish its great task, it must
intervene in political and social
life…”
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.”
Pastor Niemoller
“First they came for the Jews, and I did not speak
up, for I was not a Jew.
Then they came for the communists, and I did not
speak up, for I was not a communist.
Then they came for the trade unionists, and I did
not speak up, for I was not a trade unionist.
Then they came for me, and there was no one left
to speak up for me.”
Contact Information
Public Health and Social Justice
Website
http://www.phsj.org
[email protected]