Complications of dysgerminoma: meeting the health needs of patients in conflict zones

Abstract

A symptom of prolonged conflict is the destruction of infrastructure and healthcare systems. While the need for acute trauma services is obvious in conflict zones, patients with chronic diseases also require care. This report describes the clinical course of a young teenage girl with a large mid pelvic tumour originating from the left ovary and reaching the umbilicus. She presented with acute abdominal pain and underwent surgery in a healthcare facility within a conflict zone. She was then transferred to a neighbouring country for continuing care. The tumour is malignant. After further surgery, she required chemotherapy and will need ongoing surveillance. She has since returned to her home country. It is doubtful that she will be able to access all the care she needs. We describe her healthcare needs and discuss the disastrous effects of conflict on meeting the health needs of civilian populations in war zones.

Global Health Education and Advocacy: Using BMJ Case Reports to Tackle the Social Determinants of Health

“…Conflict prevents access to essential health-care delivery and increases the vulnerability of patients to injury, infectious disease and the complications of chronic disease. The effects of conflict are explored by Hayari et al in a case report about surgical and oncological care delivered to a young woman from a war-torn country ( 37 ). The infrastructure of her country is destroyed by conflict.…”

“…For example, an author may be interested in how gender affects global health. On review of BMJ Case Reports global health case reports, the reader can see the literature on how women are made vulnerable in conflict ( 37 ), the risk of culturally sanctioned sexual abuse ( 29 ), the stigma for females with sexually transmitted illness ( 74 ), disease that affects women cosmetically ( 75 ), and how poverty affects educational and economic opportunity for women ( 26 ). This informs more nuanced history taking from female patients, and more inquiry into specific determinants and risks to health.…”

“…The example of professionals advocating for change in individual lives in a case describing the importance of rapport in managing chronic conditions is highlighted by Taylor and Neff ( 81 ). Further examples are in the efforts to provide treatment for a patient from a neighboring country engaged in military conflict ( 37 ), the tragic case of paired suicide in a young refugee couple facing cultural barriers in the diagnosis and detection for risk of depression and suicide among refugees on the Thai–Myanmar border ( 82 ), and a patient stigmatized by achondroplasia, facing multiple barriers to care, treated for severe hypothyroidism. The patient explains the significant change in her activities of daily living by saying, “[N]ow I feel better, it is easier to take the bus to the market because I don’t have pain in my body and no fever” ( 83 ).…”