In his 2008 book Jihad and American Medicine, Dr. Adam Frederic Dorin considers what "thinking like a terrorist" would entail in terms of attacks on our healthcare system. According to the blurb "Dr. Dorin's unique book offers the first in-depth exposé and loud alert to the risks and gaping weak spots in our healthcare system." Dr. Dorin asks "[i]sn't it odd that in our post-9/11 world we should choose to ignore facts that implicate the extremely lax degree of security in American medical institutions? Do we really believe that our suppression of reality -- and our state of indifference -- will protect us from attack against relatively helpless victims in hospitals, surgery centers, and other health care facilities?" Dr. Dorin asserts that the title of his book was "chosen carefully, because the battle waged by extremists (who would like nothing better than to lay ruin to our freedoms) is moving our way. It is only a matter of time before our homeland is struck again; it is only a matter of time before American medical facilities are targeted."

Dorin cites examples of suspicious incidents involving unknown individuals who were found in protected and restricted areas of hospitals. Yet, very little information was ascertained about these intruders. Dorin applauds the University of Kentucky Chandler Medical Center that planned to implement a perimeter security system around the medical campus to provide a layered approach to security protocols and limiting access to public entrances. But how many other medical facilities have done this?

In their 2013 article titled "The Infiltration of Terrorist Organizations into the Pharmaceutical Industry: Hezbollah as a Case Study" authors Boaz Ganor and Miri Halperin Wernli discuss how terrorist organizations have long been involved in "extensive international ties, which they exploit for fundraising and money laundering, weapons and goods smuggling, and the transportation of activists." In fact, Hizb’allah members have "been found to be engaged in the production and sale of counterfeit medications in Lebanon and elsewhere" as a source of income.

Distribution of such medications is worldwide. Crime groups already cooperate with terrorists in drug trafficking and punishment is minimal for making and distributing counterfeit medications. But consider if terrorists, as part of the global jihad, were to taint the medications as a means to kill infidel users.

According to Ganor and Wernli, "Hezbollah members were arrested and indicted for smuggling and distributing counterfeit Viaga and pseudoephedrine (used to treat nasal and sinus congestion) in the United States." In fact, Hizb’allah had been "smuggling counterfeit medications into Canada, and from there selling them directly to American consumers who sought inexpensive medications."

Certainly one motivation of "terrorist organizations to infiltrate the pharmaceuticals industry is the use they can make of counterfeit medications in their attacks -- that is, terrorist-motivated adulteration of medications (TEMA)." Thus, "...a terrorist organization may choose to use counterfeit medications to physically harm the people who take them by adding poisonous ingredients, removing active therapeutic ingredients, or intentional improperly storing, handling, or transporting them, which will result in the medication being ineffective or deliberately harmful. Use of adulterated medications can lead to death, thereby meeting a root goal of the modern terrorist organization: to spread fear and anxiety among large target populations and to destroy the confidence in the whole health care system."

Consequently, the "increasing involvement in the manufacture, smuggling, and sale of counterfeit medications is a 'wake-up call,' a warning sign that terrorist attacks may yet be perpetrated using counterfeit and purposely adulterated medications. Those terrorist organizations that are already involved in manufacturing and distributing counterfeit medications are liable to use their production centers, international smuggling and distribution networks, and ties to international crime syndicates to insert deadly adulterated drugs into the pharmaceuticals market."

In another vein, ISIS has "long tried to recruit medical students." Robert Spencer wrote in January 2016 that "[t]he numbers of UK-born medics being recruited to [the] vile jihadi cause is so worrying that British officials have been sent to Sudan in a desperate attempt to stop the flow. ISIS has already persuaded doctors from Australia, Russia, and nearly 20 from Britain to join their makeshift health ministry. British officials are now coordinating efforts to prevent more Britons from joining the terrorist health service by sending a delegation to Sudan. Many of those who have already joined up with ISIS include at least 17 British doctors who were studying at Sudan’s University of Medical Sciences and Technology (UMST). Parents had sent their children to Sudan to study medicine to reconnect with their African and Islamic roots before returning to work as doctors in the NHS."

Even more astonishing is that "[a] British Home Office source said the students would not automatically face prosecution if they returned to Britain under anti-terror legislation, so long as they could prove they have not been fighting." Does this mean that ultimately these medical personnel who may harbor jihadist tendencies would return and work for the British National Health Service?

Rob Pattinson notes that "An NHS consultant has been suspended for revealing how a Muslim surgeon refused to remove her hijab for an operation -- even though [wearing] it broke hospital health rules." Furthermore, the hijab was blood-stained from a previous operation but the Muslim surgeon refused to remove it. But in our irrationally-functioning world, the whistleblower "anesthetist was accused of racial discrimination" and was eventually "suspended." The article cites the fact that no other physicians "dared to highlight the issue about the blood stained hijab because they feared being accused of racism." It should be noted that religious head scarves are "excluded in areas such as theatre, where they could present a health and cross-infection hazard" but clearly hygiene and patient safety play second fiddle to charges of alleged racism.

An Australian-accented Muslim doctor has joined ISIS and is promoting the Islamic State's launch of its own healthcare service in Syria. Abu Yusuf is calling on foreign doctors to travel to the ISIS stronghold Raqqa to help the Islamic State Health Service. Yusuf claims that he sees this as "part of [his] jihad for Islam, to help the Muslim Ummah or community" in the medical field.

And we should not forget that jihadist Maj. Nidal Malik Hasan was a psychiatrist who spouted jihadist ideology well before he went on a rampage that left 13 people dead in Texas.

In Kenya, a Muslim medical intern at Wote District Hospital was placed under arrest by anti-terror police. Ryan Healy writes that "Kenya's General of Police announced that they had a cell of jihadist medics linked to ISIS that planned on conducting biological attacks against innocent Kenyans." The head of the group is Mohammed Badi Ali and his "network included medical experts" who planned "on unleashing a biological attack in Kenya using anthrax."

Inside Jihad: How Radical Islam Works, Why It Should Terrify Us, How to Defeat It, is the autobiographical book by Tawfik Hamid. He explains that "[m]edical students are often more attracted to religion because they see the power of God in nature on a regular basis.” In fact, Hamid asserts that "Westerners are often astonished to observe highly accomplished Muslim doctors in the terrorist ranks." Hamid cites the example of Dr. Ayman al-Zawahiri, the Egyptian surgeon currently leading al-Qaeda. In fact, "Dr. Ayman,” as he was known through his involvement in various Islamist groups... 'came from a wealthy, well-known and well-educated family and was a top postgraduate student.'”  

In Jihad and American Medicine, Dr. Dorin highlights the fact that a December 2006 report by the Trust for America's Health came down "extremely critical of [America's] general level of preparedness for various health care crises." Prevention must be the hallmark and identification and correction of the numerous weaknesses within the medical infrastructure must be made, i.e., arming security; dealing with power grid failure; preventing contamination of hospital cafeteria food that could potentially disable hospital staff; and establishing regional response teams are but a few of his recommendations.

Dorin recalls that on September 11, 2001, "several Middle-Eastern physicians stood around the lone television and cheered. The cheering doctors, who happened to be foreign-trained surgeons from Islamic countries, were commenting 'The U.S. is getting what they deserve... let's see what these Jew-lovers have to say now.'" The good doctor reminds us that "these doctors who jumped for joy upon seeing the carnage of the Twin Towers in New York and the attack on the Pentagon, are still among us."

Eileen can be reached at middlemarch18@gmail.com