The last known nuclear explosion happened in 1945, when on 6 August the United States dropped an atomic bomb on Hiroshima, Japan, and released another one in Nagasaki three days later. The blast killed over 200,000 people and resulted in genetic mutations affecting generations after the explosion. Witnessed by humanity for the first time, the unprecedented impact left by the fallout increased tensions worldwide against the nuclear arms race.
Today, with the global geopolitical instability happening in Ukraine, nuclear weapons and biochemical terrorism are once again a significant concern. Developments in biological, chemical, and nuclear technologies, each with the potential for dual-use, pose new challenges to the healthcare field and nursing workforce that is still barely recovering from the COVID-19 pandemic.
In 2017, I was fortunate to be a recipient of the United Nations' Women Scholarship for Peace in Global South and attend special training held in Bangkok, Thailand. Back then, my knowledge about nuclear weapons, biochemical warfare, international relations, or even peacemaking strategies was less than rudimentary. I was the only nurse at the conference, while the other scholars—who later became my friends—had degrees in economics, atomic research, foreign policy, and international relations, which I thought then was more relevant. I learned terminologies I never heard in nursing school, like WMD (Weapon of Mass Destruction), P-5 (Permanent 5 members of Security Council), IAEA (International Atomic Energy Agency), CTBT (Comprehensive Nuclear-Test-Ban Treaty), CWC (Chemical Weapons Convention), BTWC (Biological and Toxin Weapons Convention), etc.
The course lasted several months, but the impact it left on me was immeasurable. I realized how critical my role as a nurse is during disasters and public health emergencies and how unprepared I am if a WMD is to happen right now. With the ongoing war in Ukraine and the effects of COVID-19 pandemic, the stakes are higher than ever. As frontliners and healers, do we have the resources to withstand another disaster?
As you think about the answer to that, here are some historical examples of WMDs:
- Chemical: The use of chemical substances combined with standard ammunition that can be hard to contain once released.
- Chlorine and phosgene – A choking agent used in World War I.
- Lewisite – An arsenic blister agent used by the Japanese against China during World War II.
- Mustard gas – Invented by Germans and used in World War 1 in 1917.
- Ricin – A poison used in 2003 in packaged letters in South Carolina, USA.
- Sarin gas – A nerve agent used in 1995 in the Tokyo, Japan subway system.
- Biological: A virus or disease than can affect millions of people.
- Anthrax – Utilized in World Wars I and II, but most recently in 2001 by Al-Qaeda in envelopes.
- Plague – Used by Russia, which used plague-infested corpses to fight Sweden in 1710.
- Salmonella – Used by the "Rajneeshies" in 1984 to contaminate groceries, restaurants, and the water supply in Oregon, USA.
- Tularemia – Used by the US military for research and development in the 1960s.
- Nuclear
- Atomic bomb (fission bomb) – Hiroshima and Nagasaki, Japan
- Thermonuclear/hydrogen bomb (fusion bomb)
According to Arms Control Association, the world's nuclear-armed states possess nearly 13,000 nuclear warheads—more than 90% belong to Russia and the United States. The 2021 Estimated Global Nuclear Warhead Inventories as of January 2022 are:
- Russia: 6,257
- United States: 5,550
- China: 350
- France: 290
- United Kingdom: 225
- Pakistan: 165
- India: 156
- North Korea: 40-50
The first five countries are recognized as nuclear-weapon states who signed the Non-Proliferation of Nuclear Weapons Treaty (NPT). It was intended to prevent new countries from developing nuclear weapons and confine the arms race to the five nuclear weapons countries of the time—the United States, Russia, China, France, and Britain. Today the NPT is nearly universal. Only Israel, Pakistan, and India refused to sign the treaty and subsequently built nuclear arsenals. A fourth, North Korea, left the treaty in 2003 and tested a weapon in 2006. A CFR Working Paper says in a little over a decade Britain and France could find their arsenals "eclipsed by those of Pakistan, Israel, and India." Experts say the likelihood of the outliers joining the NPT or disarmament efforts is small, making them a significant challenge for the nonproliferation regime. They also pose difficulties for US diplomacy and nonproliferation goals since the United States enjoys significant ties to all the outliers except North Korea.
After finishing my training, I realized how critical a nurse’s role is in response to public health emergencies—both in healthcare leadership and at the bedside. Nursing by far is the largest healthcare profession, and it is high time for all of us to engage and be informed about situations that carry the greatest risk for the health profession. Because when disaster strikes, nurses and doctors are needed. Nurses need to know there is a lot more than just responding to disasters. Just like any disease, I believe WMD disaster is preventable. And most likely, prevention in terms of WMD is our only cure.
If you want to learn more about WMD, I encourage you to stay curious and engaged. The United Nations Office for Disarmament Affairs (UNODA), Arms Control Association, International Atomic Energy Agency, and the Organisation for the Prohibition of Chemical Weapons (OPCW) are some of the agencies that are committed to advancing peaceful use of our nuclear energy; restricted use of firearms and chemical agents; and making the world safe for all. Though there is vast information on the internet about WMD, I cannot wait for the day that WMD courses are taught in academia, in practice, and even in research and development.
Whether it is a global war, pandemic, or any disaster, nurses are called to be on the frontlines. Over the last century, medicine, nursing knowledge, technology, health informatics, and how we care for our patients have rapidly evolved. The revolution in biotechnology, for instance, carries the risk that new types of weapons will be created and its potential risk of misuse. Although much has changed in healthcare innovation, the demand for a disaster- and pandemic-prepared healthcare workforce is higher than ever. The question I have for bedside nurses, nurse leaders, educators, and researchers—myself included—is, “Are we ready for WMD?”
Kathleen Eviza, MSN, RN-BC, is an intensive care nurse in Charlottesville, Virginia, USA. In addition to being a member of Sigma’s Alpha Eta and Pi Iota at-Large Chapters, Kathleen is a Sigma United Nations Youth Representative.