NUCLEAR WEAPONS and other cheerful things

1. NUCLEAR WEAPONS and other cheerful things Easy ways for doctors to make a difference and why we should Dr Sue Wareham President, Medical Association for Prevention of War (MAPW) MAPW is the Australian affiliate of the International Physicians for the Prevention of Nuclear War (IPPNW) GP in Giralang, ACT May 2008

2. Our task as doctors… prevention, prevention, prevention, especially when we have no cure. • In the event of a nuclear war, our profession will have very little, if anything, to offer the survivors. • The imperative to prevent such an occurrence is overwhelming.

3. IPPNW and MAPW • IPPNW formed in 1980 to abolish nuclear weapons • MAPW formed in 1981 primarily for the same purpose • Both organisations also work for the prevention of all wars • ~90% victims of war are civilians

4. Nuclear weapons • are different from every other type of weapon • No other weapon comes close to causing the destruction, death and suffering caused by a single nuclear bomb

5. Nuclear explosions • Explosive power measured by the mass equivalent of TNT: • 1 kiloton bomb has an explosive yield equivalent to 1000 tons of TNT • 1 megaton bomb has an explosive yield equivalent to 1,000,000 tons of TNT

6. August 6, 1945 US detonated a 15 kiloton bomb over Hiroshima, Japan • Deaths – approx 90,000 immediately, 140,000 total by the end of the year • 180 out of the city’s 200 doctors killed • Ground temperatures reached about 3,800 degrees Celsius

7. August 9, 1945 US detonated a 21 kiloton bomb over Nagasaki,Japan • Deaths – approximately 40,000 immediately, 75,000 total by the end of the year • Many modern nuclear weapons tens to hundreds of times more destructive than theHiroshima and Nagasaki bombs

8. Hiroshima and Nagasaki • Most survivors with burn and blast injuries received little or no medical care. • Large numbers of those who survived the immediate damage died in the following weeks from radiation sickness • Death toll from cancers is still rising

9. One-megaton bomb detonated in the air • Intense flash of light, which can cause blindness to those tens of kms away. • Fireball expands and rises rapidly and develops into a mushroom cloud; practically everything within 3 kms vapourised. • Firestorms spread over a wide area, causing burns and asphyxiation. Hurricane force winds within 4 kms • Radiant heat causes deep burns up to 10 kms away, superficial burns up to 15 kms away

10. One-megaton bomb detonated in the air • Powerful blast wave - starts immediately, but travels more slowly than the flash and fireball • Buildings collapse • Major damage to buildings within 14 km • Shattered windows and other flying debris up to 20 – 30 km radius

11. One-megaton bomb detonated in the air • Acute radiation exposure • Gastrointestinal damage • Uncontrolled internal bleeding • Bleeding from gums or within the skin • Massive infections • Death

12. One-megaton bomb detonated in the air • Delayed radiation exposure • Everything in vicinity of explosion radioactive • Hiroshima - radioactive rainstorms • Increased risk of developing cancer for survivors and those who enter the affected area to deliver aid

13. One-megaton bomb detonated in the air In case of a nuclear bomb… don’t bother to call your doctor! • No significant medical response possible • Hospitals destroyed, many health care providers killed • Supplies, communications, roads and power supply destroyed

14. NEJM April 30, 1998; Lachlan Forrow et al “Accidental Nuclear War – a Post-Cold War Assessment” • Studied likely effects of attack on the US by 48 nuclear warheads from a single Russian Delta-IV submarine • Immediate deaths 6,838,000 • “Most of the major medical centres in each urban area lie within the zone of total destruction……The number of patients with severe burns and other critical injuries would far exceed the available resources of all critical care facilities nationwide, including the country’s 1,708 beds in burn care units (most of which are already occupied).”

15. Nuclear terrorism Possibilities: • Attacking a nuclear reactor • Stealing or making a nuclear weapon • Using a “dirty bomb” (dispersal of radioactive material by conventional explosive) Only 20kg of HEU or 10kg of plutonium or less is needed to make a nuclear weapon

16. Nuclear Terrorism Scenario • 12.5 kT nuclear explosion in cargo container in the port of New York City • Immediate blast and burn deaths: 52,000 • Acute radiations sickness: 44,000, including 10,000 fatal • Fallout: additional 200,000 deaths Helfand I et al. BMJ2002;324:356-9

17. Weapons grade uranium and nuclear medicine • There are two possible types of fuel for nuclear weapons: HEU (highly enriched uranium) and plutonium. LEU (low enriched uranium) cannot be used for weapons • Currently the vast majority of reactors used to produce medical isotopes globally use HEU targets for neutron bombardment • Therefore large amounts of HEU are stored in poorly secured commercial locations around the globe. This is a serious security risk • There are no technical impediment to converting reactors that produce medical isotopes to LEU. Our profession is well placed to call for the elimination of weapons grade uranium from medical isotope production.

18. Nuclear winter • Airborne contaminants from destroyed cities would absorb and reflect the sun’s rays • Would result in an extended period of semi-darkness, large temperature drops, agricultural collapse and famine • Potentially generated from as few as 100 detonations (current global arsenals 26,000 weapons)

19. Nuclear winter The view of the Earth from Apollo 10 (18 May 1969) from 26,000 nautical miles on its journey to the Moon

20. Nuclear winter This is what the world would look like after a large-scale nuclear holocaust

21. Climatic Consequences of Nuclear Conflict Brian Toon, Alan Robock et al. 2006 Rutgers University, University of Colorado at Boulder, University of California at Los Angeles. • Even a small-scale regional nuclear war - 100 Hiroshima-sized nuclear weapons used in South Asia - could disrupt the global climate for a decade or more, and affect nearly every person on earth. This is 0.03% current world arsenals. • Smoke emissions from the firestorms would be vast – could exceed 5 million metric tons

22. …..This would cause cooling of several degrees over large areas of North America and Eurasia, including most of the grain-growing regions. Ira Helfand, 2007. Royal Society of Medicine conference London: From the above scenario, “it seems reasonable to postulate a total global death toll in the range of 1 billion from starvation alone….would lead to major epidemics of infectious diseases … “ • .

23. Current Arsenals

24. Current nuclear arsenals • 26,000 nuclear weapons • Russia: 15,000 • United States: 10,000 • France: 350 • United Kingdom: 200 • China: 130 • Israel: 75-200 • India: 50 • Pakistan: 50 • North Korea: 0-10

26. Nuclear testing • 2,059 nuclear test explosions by 8 countries: • United States 1,030 • Russia (USSR) 715 • France 210 • United Kingdom 45 • China 45 • India 7 • Pakistan 6 • North Korea 1

27. Effects of nuclear testing • Estimated 430,000 cancer deaths from radioactivity taken up by the year 2000 alone • Total cancer death toll 2.4 million for radiation exposure over infinity. • Tests sites around the world contaminated

28. Launch on Warning (LoW) • Retaliation with nuclear weapons to a perceived (by radar or satellite) nuclear attack by another state • Decision on whether or not to retaliate must be made in minutes • Approx 4,000 Russian and US nuclear weapons still on high alert

29. January / February 2007

30. Bulletin of the Atomic Scientists January 17, 2007 • Minute hand of “Doomsday Clock” moved closer to midnight; now five minutes to midnight, reflecting growing concerns about a “second nuclear age”

31. 1996 Canberra Commission on the Elimination of Nuclear Weapons • The world faces threats of nuclear proliferation and nuclear terrorism. These threats are growing. They must be removed. • ... NW diminish the security of all states. Indeed states which possess them become themselves targets of nuclear weapons. “ ”

32. Sure it’s a health problem but what can we do about it?

33. Initiated by MAPW, now a major focus of IPPNW activity, and gaining strength globally

34. About ICAN • ICAN’s goal is a Nuclear Weapons Convention (NWC), a treaty to ban the development, testing, production, use and threat of use of nuclear weapons. • A Model (draft) NWC already exists as an official UN document.

35. ICAN’s message is one of hope • Can you imagine a world without nuclear weapons? I CAN! www.icanw.org

36. Things busy doctors can do to help abolish nuclear weapons • Raise awareness. Speak with your colleagues, friends and family about this issue. • Ask your professional college to adopt a policy to support the abolition of nuclear weapons. • Request space in any newsletters and other publications you know of for an article on nuclear weapons or ICAN. • Join MAPW • Arrange for a speaker from MAPW to address a group, small or large.

37. Doctors have a unique role to play in educating about threats to health.

38. Doctors are listened to • “The International Physicians for the Prevention of Nuclear War has come to exercise a tremendous influence on world public opinion within quite a short period of time….It is impossible to ignore what these people are saying. …..For what they say and what they do is prompted by accurate knowledge and a passionate desire to warn humanity about the dangers looming over it. ….No serious politician has the right to disregard their conclusions or neglect the ideas by which they take world public opinion a stage ahead. “ Former President of the USSR, Mikhail Gorbachev, in his book Perestroika