One of the aftermaths of the recent terrorist attacks on the United Sates has been a radical shift in how the world is perceived, and the matters that occupy ordinary discourses of ordinary people. Even though many recognized the complexities of international relationships, the idea of nations existing as isolated entities is no longer feasible. Suddenly, alliances between and among nations shifted from relatively predictable ideologic and political foundations defined by governmental powers, to complex, intricate, and much less predictable forces defined by interplays among many extremely complex and much less predictable factors. No longer can war be defined as waged among nations, but now, as waged against the abstract force of "terror" that knows no national boundaries. No longer are large governmental and political issues matters that ordinary citizens can easily dismiss. To the contrary, these issues are foremost in the most casual of conversations, among people who previously would barely give a passing thought to conceptual, ideologic, or political definitions of international affairs.
Many citizens worldwide have recognized the health effects created by war and violence, but prior to September 11, health-related outcomes of war and violence tended to be relegated to concerns for injury and death inflicted by physical injury. The Vietnam era introduced the short- and long-term effects of exposure to chemicals used in warfare, but such dangers were assumed to be associated directly with the tools and methods of traditional warfare, akin to the fallout of bombs and landmines. The waging of war and the infliction of violence using mass germ or biological methods directed at large civilian populations were phenomena drawn partly from science fiction, partly from far-away worlds, and partly from hints leaked through the secret walls of the military. Even though ordinary citizens have had vague ideas about possible biological methods of waging war, that possibility now has taken on a stark reality. Further, biological methods are now widely recognized as being a far more complex and difficult challenge than most had dared to imagine.
Suddenly, the woeful lack of knowledge that exists in many different dimensions is abundantly evident. Lack of knowledge spans a wide spectrum, including ordinary understandings among ordinary people on such matters as differing cultures, societies, and religions, to sophisticated scientific knowledge related to such matters as psychological dynamics involved in waging massive destruction, or knowledge related to the production of widespread disease as a weapon of war. It is becoming clear that perhaps world governments have not learned or incorporated important lessons from history, but more fundamentally, have regrettable limits on the ability to integrate complex possibilities into strategies that could lead to real solutions and interventions against terror.
The world has never been simple, but now no one can act as if it is. Nurses bring many important insights to bear on the challenges that are now before us, and on the new challenges that face everyone where knowledge is concerned. It is interesting to note that the articles that appear in this issue of Advances in Nursing Science (ANS 24:3) were submitted to be considered for publication in mid-July 2001, approximately 2 months prior to September 11. These articles appear in this issue as a result of a rigorous process of review, not because of deliberate selection to address our post-September 11 world. Yet, every article in this issue of ANS has something significant to offer concerning the possibilities and realities for the immediate and long-range future. I invite all readers to enter into the discourse around the issues presented here in light of the challenges that now lie ahead in creating knowledge and understanding.
-Peggy L. Chinn, RN, PhD, FAAN
Editor