Introduction

WHAT THIS REPORT CONTAINS

This report sets out the findings of a three-year civilian project led by health professionals.

Chapter One, "Path Towards Suicidal Terror", traces origins of suicide bombing, and intensive use of suicide bombing as a strategic choice against civilians. It draws on international examples of using lethal weapons primarily directed at civilians during conflict.

Chapter Two, "Deadly Profile", outlines the pattern of suicide bombings in Israel from September 2000 to February 2005.

Chapter Three, "When The World Explodes – Who Helps?" explores the provision of primary assistance at the bombing scene, from passersby, ambulance crews, and volunteers who collect body parts for burial. 'Testimony boxes' contain interviews with key informants such as members of ambulance teams.

Chapter Four, "Terror-taught Innovations", looks at examples of what needs to be in place in hospitals in order to accommodate the often huge influx of casualties in a very short time. Testimony boxes reflect voices and experiences of front-line hospital staff. Some medical and surgical innovations are outlined, such as new ways to treat wounds caused by bombs packed with nails and screws. Examples describe how innovations are being shared with other countries during international training courses and study tours.

Chapter Five, "Coping with the Consequences of Suicide Bombings", looks at what happens after the dead are buried, the wounded leave hospital, families of survivors attempt to rebuild their often shattered lives and passers-by retreat into a state of silent and painful memory. Examples outline coping approaches used by organizations, communities, families and individuals, especially those who come from disadvantaged sections of society. Newer coping and therapeutic approaches include use of art, music and horticulture.

Chapter Six, "Wounds of the Mind", looks at psycho-emotional consequences resulting from suicide bombings, such as post traumatic stress disorder. It contains testimonies of survivors and families of
victims, interviews with psychologists, trauma counselors, psychiatrists and bereavement counselors.
Examples outline how Israeli experiences are being adapted to help other countries and international
organizations in post-conflict situations.

Chapter Seven, "Breaking the Silence – Testimonies of Survivors and Families of Victims", is the central chapter of the report. The testimonies of survivors and families of victims provide a unique 'insider' view set within the diverse cultural context of Israeli society. Among them are a young jazz musician, two widows, a therapist, a schoolteacher, an overseas worker, a police family, a hi-tech family, a restaurant owner and a vascular surgeon.

Chapter Eight, "Bombs With Eyes", focuses on the human bombs, myths about suicide bombers, their motivation, their dispatchers, and social support networks. It considers the role of female bombers, indoctrination of children, funding of suicide bombing, religious incitement, and international attitudes towards suicide bombing.

Chapter Nine, "Expressing the Inexpressible", considers international media coverage of suicide
bombings. It looks at examples of biased and less-biased coverage, underlying motivations and outcomes. It focuses on characteristics of Arab media coverage of suicide bombing.

Chapter Ten, "Burning Flowers and Burning Dreams", questions why the world appears to tolerate suicide bombing against civilians in Israel and discusses escalation of suicide bombing against civilians elsewhere. It considers Israeli actions to protect its citizens and some differing interpretations of Israeli-Palestinian history. It looks briefly at suicide bombing in relation to international humanitarian law, the role of the UN, humanitarian agencies and spiritual leaders. It cites examples from the evolving field of terrorism law. Finally, it asks what can be done to prevent those who support terror from 'burning the flowers of peace and burning the dreams of peace' of those who value – and still dream of – a world free from terror.

The report concludes with a glossary, references, and the interview questionnaires.

HOW THE PROJECT WAS CARRIED OUT

In August 2002, the project coordinator, together with a group of health professionals and other volunteer colleagues, drafted an 8-page project proposal. The objective of the project was to illustrate the consequences of suicide bombings on civilians in Israel between 2000 and 2005. The proposal was refined through 23 sets of feedback from Israeli experts in trauma, terror studies, social sciences, psychology, and conflict-related medicine.

When realistic objectives had been identified, the project was put into action by an informal network of around 100 volunteers in various locations around Israel. The volunteers represented a wide variety of social, political and religious standpoints, but coalesced regarding the objectives of the project. They participated in designing the research tools, interviewing survivors and families of victims, raising funds, appraising the cover design, and editing the report.

Beginning in 2001, multi-source information on suicide bombings has been collected from the Israeli and
international press, academic and professional journals, television and media reports, international published and unpublished literature, and through library and electronic searches in Israel, England, the United States and Switzerland.

Early in 2003, new information was collected through interviewing key informants such as 'front-line' emergency health personnel, specialists in trauma, experts in rehabilitation, psychologists, psychiatrists, trauma therapists, bereavement counselors, social workers, media representatives and terror experts. The project was assisted by terror victims' organizations in Jerusalem, Tel Aviv, and Netanya.

A two-part questionnaire was designed with the assistance of Israeli trauma experts. It was field tested in Jerusalem in English and French, with victims' families of the Sbarro and French Hill bombings. The
questionnaire was then adjusted and translated by volunteers from English into Hebrew, Russian, French and Arabic. Six volunteer interviewers carried out the interviews.

Seventeen suicide bombings were selected which are familiar to people around the world, including the
Dolphinarium discotheque bombing in Tel Aviv, the Sbarro Pizzeria bombing in Jerusalem, and the Maxim
Restaurant bombing in Haifa. From the painful testimonies of survivors and families of victims emerged a
profile of the real consequences of suicide bombings. Those interviewed included a mother who lost a
daughter and was herself wounded in a bus bombing in Jerusalem, a young jazz musician who survived the bombing in the seafront pub 'Mikes Place' in Tel Aviv, families who lost teenage children in the
Dolphinarium bombing, and two families who lost several family members in the Maxim Restaurant
bombing in Haifa.

Project Coordinator/Editor Dr. M F is an Independent Senior Consultant who has worked for four decades in 31 countries in Europe, North and South America, Africa, South East Asia, the Far East and Pacific region, and the Middle East, for UN agencies, international organizations and nongovernment agencies, in the fields of international health, community development, adult education, poverty and health, conflict-related issues, humanitarian action and international peace initiatives.