Gulf crisis prompts Israel to implement emergency medical preparations

Gulf crisis prompts Israel to implement emergency medical preparations

POLICY AND PEOPLE Gulf crisis prompts Israel to implement emergency medical preparations well as immediate policies for protececent statements by Uni...

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POLICY AND PEOPLE

Gulf crisis prompts Israel to implement emergency medical preparations well as immediate policies for protececent statements by United tion and preparation for emergency Nations inspectors that Iraqi chemoprophylaxis with doxycycline, President Saddam Hussein had been augmented by vaccination. The proengaged in developing biological gramme would be modelled on that weaponry for at least 20 years, and of the US Armed Forces stationed in that he could have enough in his arsethe Middle East who nal “to wipe Tel Aviv are being vaccinated off the map”, were against anthrax. met with quiet by the The same day, the Israeli government. health and defence But on Jan 30, the ministries publicly Minister of Health acknowledged the Yehoshua Matza was threat of chemical or invited to the weekly biological attack, but security cabinet meetwith “no plans for ing. This unusal move prophylactic vaccinawas taken to mean tion”—they assessed that medical preparathe risk as small tions for an attack and the cost great. A with biological and gagging order preventchemical agents—the ing health officials “poor man’s nuclear Stocking up on gas masks from speaking about weapons”—are under anthrax or other pathogens used in consideration. germ warfare was partly lifted, Three days later, a team of publicalthough interviews are still “discourhealth experts led by Elihu Richter, aged”. head of the occupational and enviBy Feb 4, a special Knesset minisronmental medicine unit of the terial committee had approved Braun-Hebrew University-Hadassah NIS240 million (US$67 million) for School of Public Health and emergency preparedness, including Community Medicine (Jerusalem) the distribution of gas masks and urged the government to undertake nuclear, biological, and chemical the formulation of a national anthrax (NBC) warfare kits, as well as antiemergency response. This would biotics and vaccines to clinics and include development of long range as AP

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Ireland plans mandatory reporting of child abuse

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rish consultants are “very disappointed” by their exclusion from a working party set up to review the government’s plans for mandatory reporting of child abuse. The government has promised to introduce such a measure despite objections from the medical profession, social workers, and health boards, who maintain that the issue is much more complicated than perceived by the public. The Irish College of General Practitioners, which will be represented, stated on Feb 5 that it agreed with the aim of mandatory reporting: to ensure that all cases of child abuse come to the attention of the authorities as soon as possible. But the statement noted fears of damage to the doctor–patient relationship, acknowledging that obvious cases were easy to deal with but it was the less obvious situations that caused difficulty. The College favoured voluntary reporting and suggested that it should be based on the Dutch

THE LANCET • Vol 351 • February 14, 1998

model of the Confidential Doctors’ Bureau, from which anyone could seek advice on a specific situation. All professional groups admit that they fear legal actions if they are forced to report suspected cases that turn out not to be abuse. This concern may be addressed in legislation since last week the government accepted a private member’s bill “in principle” that would provide immunity for professionals. A recent opinion poll showed that 91% of the public wanted mandatory reporting. The minister responsible for bringing in the legislation, Frank Fahey, said that the term mandatory reporting was being used “like a magic wand”, but resources had to be put in place if it was to succeed. The country’s largest health board said last week that it was running months behind in its investigations of child abuse because of lack of staff.

hospitals. The Health Minister said that the logistic preparation of the hospitals was adequate but encouraged “more thought on the matter of preparedness in event of an attack”. Chief administrator of the Tel Aviv Medical Center at Ichilov Hospital, Avi Hasner, added: “We are well prepared for an attack. Medicinal treatment has not yet been supplied to the hospital, but will be delivered to us when the threat becomes actual.” For Israelis, the messages are mixed. While the government refused to name antibiotics effective against anthrax to discourage individuals from stockpiling, local pharmaceutical companies have stepped up their production. On Feb 8, the government promised masks to all foreign workers, journalists, and diplomats, and the next day announced that the German government was sending 180 000 gas masks. But some analysts have derided preparations as “panic attack”, “persecution mentality”, or “victim mind-set”. 20 000 Israelis disagree, as they queue to replace their 1991 gas masks with NBC warfare kits at the more than 40 newly opened distribution centres. Still thousands more are being turned away for lack of supplies. Rachelle H B Fishman

News in brief Editors scholarship Reuters and the British Medical Journal (BMJ) have launched a scholarship for medical journal editors in developing countries or the former eastern Europe. The successful applicant will spend 6 months at the BMJ offices (contact: Linda Beecham, BMA House, Tavistock Square, London WC1H 9JR, UK). Bugging law exempts doctors Germany has passed a law that allows police to put microphones in any public or private space. But the law will now exempt doctors (see Lancet 1997, Dec 20, p 1832). World Bank failing? According to a review Falling Short: The World Bank’s Role in Population & Reproductive Health by Population Action International, the World Bank should give more attention to reproductive and population issues.

Karen Birchard

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