Continuing promise 2009—assessment of a recent pediatric surgical humanitarian mission

Walk, Ryan M.; Glaser, Jacob; Marmon, Louis M.; Donahue, Timothy F.; Bastien, John L.; Safford, Shawn D.

doi:10.1016/j.jpedsurg.2011.09.063

Cited by 22 publications

(8 citation statements)

References 6 publications

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“…Currently, most data published from humanitarian missions are observational reports of care provided, with limited outcomes reporting. Examples include military hospital ships or forward surgical team missions,7–10 short-term trips with a singular focus such as inguinal hernia repair11 12 or cleft lip/palate repair,13 and larger volume reports from entities like Médecins Sans Frontières14 and the Cinterandes Foundation’s mobile surgical unit 15. The outcomes reporting in these studies is largely intraoperative morbidity/mortality, immediate postoperative morbidity (within 2–3 days), and rarely 30-day morbidity, with follow-up rates around 20%–30%.…”

Section: Current Climate Of Outcomes Reporting In Global Surgerymentioning

confidence: 99%

Accountability in global surgery missions

2018

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Section: Current Climate Of Outcomes Reporting In Global Surgerymentioning

confidence: 99%

Accountability in global surgery missions

2018

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“…Of the 24 articles reviewed, mission trips were reported on 4 different continents. The majority went to Africa (9), [7][8][9][10][11][12][13][14][15] North America (8), [16][17][18][19][20][21][22][23] South America (5), 9,21,[24][25][26] and Asia (5) 9, 27-30 ; 67% of these trips included surgical trainees, 42% were plastic surgery-focused, and 37% were general/orthopedic surgery-focused (Graph 1). No manuscript detailed a mission trip specific to endocrine surgery.…”

Section: Resultsmentioning

confidence: 99%

Pay It forward: Strategies for Successful Implementation of Short-term Endocrine Surgical Mission

Long

Cohen

Perrier

2016

World Journal of Endocrine Surgery

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Introduction:With increasing interest in humanitarian surgical efforts, numerous opportunities for specialized mission trips have developed. Extreme short-term surgical "blitzes" of specialist teams have offered much-needed surgical care but lack efforts for patient continuity and local sustainability. We sought to define characteristics that aid in the long-term success of short-term international surgical missions to better apply this insight toward future dedicated humanitarian endocrine surgical efforts. Materials and methods:A broad search engine review identified 1,954 reports of medical and surgical missions. One hundred and sixty-six of these abstracts involved surgical missions from 2009 to 2014 with 24 articles including details of specific mission trips. We identified factors deemed essential for improving patient care and affecting local infrastructure for longterm sustainability and included our prospective experience with an endocrine surgery-specific mission trip for comparison. Results:Of the 24 articles reviewed, missions went to Africa (9), North America (8), South America (5), and Asia (5). Factors for mission sustainability and success included the following: (a) ability to educate local physicians and trainees, (b) multiple return trips to the same location, and (c) formal pre-mission planning and site visits. Emerging interest is on optimizing patient outcomes and cost-effectiveness.Conclusion: Short-term surgical missions require a local infrastructure for optimal patient outcomes. Sustainability hinges on education and involvement of local physicians and surgical trainees, pre-mission planning, and return trips to the same location. For endocrine surgical missions, preoperative evaluation and postoperative follow-up by the operating surgeon is important for optimizing performance and outcomes.

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“…However, large, multi-country descriptions of pediatric surgical care from humanitarian surgical assistance projects during crisis have not been published. Continuing Promise, a surgical assistance project of the United States Navy, deployed to seven peace-time countries in Central and South America, and treated 340 children between April and July 2009 [31]. The most frequently performed procedures were inguinal and umbilical hernias (23% and 14%, respectively), followed by circumcision (9%), mass excision (8%), and hydrocele/varicocele/orchiopexy (5%) [31].…”

Section: Discussionmentioning

confidence: 99%

“…Continuing Promise, a surgical assistance project of the United States Navy, deployed to seven peace-time countries in Central and South America, and treated 340 children between April and July 2009 [31]. The most frequently performed procedures were inguinal and umbilical hernias (23% and 14%, respectively), followed by circumcision (9%), mass excision (8%), and hydrocele/varicocele/orchiopexy (5%) [31]. Surgical sub-specialists performed 36% of cases [31].…”

Section: Discussionmentioning

confidence: 99%

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Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience

Flynn-OʼBrien

Trelles

Dominguez

et al. 2016

Journal of Pediatric Surgery

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Purpose Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams. Methods Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death. Results Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1 year, use of general anesthesia with a definitive airway, and operation during conflict. Conclusion Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions.

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Continuing promise 2009—assessment of a recent pediatric surgical humanitarian mission

Cited by 22 publications

References 6 publications

Accountability in global surgery missions

Accountability in global surgery missions

Pay It forward: Strategies for Successful Implementation of Short-term Endocrine Surgical Mission

Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience

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