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Many social scientists referred to guerrilla warfare as the “weapon of the weak” and terrorism as the “weapon of the weakest,” using violence to generate fear, and thereby to achieve their political goals, when direct military victory is not possible. Today terrorists usually prefer to avoid attacking heavily defended “hard targets” such as military installations. Instead they often look to lightly protected targets, such as civilian infrastructure, and mass transportation targets that will generate a higher number of casualties and more media attention. Therefore, we should be aware of the potential for attacks. Hospitals in particular can be added to the list lightly or under-defended civilian “soft targets.” They are important symbols of our society and an attack on one would further undermine the perception of the ability of the government to protect its citizens. Be aware that this is not a new concept; periodic intelligence reports raise concerns that terrorists have contemplated carrying out such attacks here and have plotted to do so:

• In November 2002 the FBI issued an alert to hospitals in San Francisco, Houston, Chicago and Washington, D.C. warning of a vague, un-corroborated terrorist threat.
• In August 2004 the FBI and DHS issued a nationwide terrorism bulletin warning that al-Qaeda may attempt to attack VA Hospitals throughout the U.S.
• In November 2005, Police in London arrested two suspected terrorists accused of plotting a bomb attack.  One of the suspected terrorists was found to have a piece of paper with the words in Arabic, “Hospital = Target.”
• In April 2005 the FBI and DHS investigate incidents of imposters posing as hospital accreditation surveyors, prompting the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to send a security alert to hospitals.

Consider that terrorism today is transnational and decentralized. Al-Qaeda now is a network of terrorist groups scattered all over the world, with a presence in practically every country. The core group primarily provides ideological guidance to these semi-autonomous cells. As a result now we see different people, different groups in different parts of the world, copying the “modus operandi” used by al-Qaeda linked groups of attacking vulnerable civilian targets with no warning. These kinds of attacks have become commonplace throughout the Middle East and South Asia, and have become increasingly routine in parts of Southeast Asia, Russia and Africa. Consider the scenario of an attack on hospitals, shopping malls, sports arenas, hotels, restaurants, bars, nightclubs, movie theaters, housing complexes and other “soft” targets, that remain relatively unprotected and in reality, unless there is an adjustment in our free and open society there is precious little that can be done to prevent them.