An analysis of the Tokyo subway sarin attack
Introduction
One of Japan’s worst terrorist attacks is the Sarin Gas attack on the Tokyo subway system which
happened on the morning of March 20, 1995. While five members with getaway cars waited outside
at different stations, five other Aum Shinrikyo attackers equipped with sarin gas carried out the
attack in Tokyo's crowded subway system. The attackers were very well trained for their tasks. Each
attacker boarded one subways carrying a package with the deadly chemical sarin. To ensure that the
impacts were widely distributed, the gas was unleashed at five different stations in the Tokyo subway
during rush hour. The packages with sarin were carefully concealed in unobtrusive objects like plastic
containers and drink bottles. After they entered the trains, they poked the bags using their umbrellas
with sharpened tips to unleash the sarin. The passengers got poisoned when it turned into gas and
fused in the air. The attack led to an – at the time – unforeseeable disaster due to a chemical terrorist
attack that led to 12 fatal and over 5500 injured casualties (Okumura et al., 1998). Since sarin
poisoning was new and unusual at the time, the authorities, relevant institutions and healthcare
professionals struggled to accurately diagnose and treat the patients. Most of the injured are even
now suffering from long-term complications such as several traumas and respiratory difficulties.
Making key decisions to secure the safety and security of people during a crisis full of uncertainties
with little to no available information about the cause of a disaster, requires crisis management to
attain control of the situation. This essay will focus on the different aspects of safety and security,
relevant stakeholders, key decision moments for the management and how Japan’s authorities and
St Luke’s hospital dealt with the situation.
Analysis
Attaining security implies the preparation and mitigation of the consequences that arose
immediately after the sarin gas attack. The stakeholders directly involved in patient care had not
been able to secure the safety of their staff and the victims due to the lack of a chemical disaster
plan, valid information of the situation and the required Personal Protection Equipment (PPE). The
lack of a hospital disaster plan resulted in not being able to control the flow of people coming into
the hospital through 3 entrances, ultimately resulting in a chaotic state. Pre-hospital care by the
Tokyo Metropolitan Fire Department (TMFD) and hospital care at the St. Luke’s Hospital had been
carried out without chemical-resistant PPE, which led to secondary toxic exposure, jeopardizing the
safety of the staff. The first action taken by the hospital management was cancelling all routine
operations and outpatient examinations. This key decision secured the availability of the hospital
resources for the mass of victims, also unconsciously preventing secondary contamination with
outpatients. The absence of a decontamination area and insufficient ventilation of the hospital added
up to the rise of contaminations within the hospital.
Japan is a vertically structured system with central leadership, where the government is at the top of
the hierarchy, along with the emperor as head of state (Saltman, 2006). Being at the top of the
hierarchy requires precise crisis management and delegation of the needed stakeholders to engage
after a terrorist attack. Even though Japan suffered from a sarin attack in Matsumoto, approximately
8 months prior to the Tokyo Subway Sarin Attack, The Japanese government lacked a disaster
information network on a national level, leaving the engaging stakeholders no choice but to act
independently and make decisions with limited information.
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