Maintaining Baseline, Corrective Surgical Care during Asymmetrical Warfare: A Case Study of a Humanitarian Mission in the Safe Zone of a Neighboring Country

Abstract

The current insurgency warfare in Iraq is of an unconventional or asymmetrical nature. The deteriorating security has resulted in problems recovering and maintaining essential health services. Before the 2003 war, Iraq was considered a developed country with the capacity to routinely perform baseline medical and surgical care. These procedures now are performed irregularly, if at all. Due to the unconventional warfare, traditional Military Medical Civilian Assistance Programs (MEDCAPs) and civilian humanitarian missions, which routinely are mobilized post-conflict, are unable to function. In December 2005, an international medical mission conducted by the Operation Smile International Chapter in neighboring Jordan employed civilian physicians and nurses to provide surgery and post-operative care for Iraqi children with newly diagnosed cleft lip and palates and the complications that had occurred from previous surgical repair. Seventy-one children, their families, and a team of Iraqi physicians were safely transported to Jordan and returned to Iraq across the Iraqi western province war zone. Although complications may occur during transport, treatment within a safe zone is a solution for providing services in an insecure environment.

Demonstration of the Effectiveness of Augmented Reality Telesurgery in Complex Hand Reconstruction in Gaza

“… 4 , 5 Although this may benefit certain patient groups, it can leave others with limited access to advanced surgical care, 6 especially those in areas of conflict or surgically austere environments. 7 Although it is sometimes possible to transfer either patients or surgeons, this is not always feasible owing to border restrictions, time pressures, or cost.…”

Pediatric plastic surgery research needs in global health: A scoping review

“…Recommendations included incorporating local leadership [14,15,17,36,51], teaching [14,17], sustainable follow up [17,39,52]. Standardized monitoring and evaluation [17,39,53,54] (n=15). Limitations cited from these publications included interfering with the local healthcare system, selection of sites based on volunteer preference rather than site need [14,15], lack of appropriate follow up and monitoring [36,55], and the infamous 'body count [14][15][16]39,49] (n=10).…”

“…Limitations cited from these publications included interfering with the local healthcare system, selection of sites based on volunteer preference rather than site need [14,15], lack of appropriate follow up and monitoring [36,55], and the infamous 'body count [14][15][16]39,49] (n=10). Articles identified the following as a research need: public education [14,17,48,55], development of sustainable local healthcare infrastructure [14][15][16][17][18]36,39,[50][51][52] and standardized monitoring and evaluation (n=10) [17,39,53,54].…”

Burden of Surgical Disease: Strategies to Manage an Existing Public Health Emergency

“…Even though few in number, IOs that have currently established surgical data monitoring and outcome measures include Médecins sans Frontières (MSF), Operation Smile, and Konbit Sante/Cap Haitien Health Partnership, and serve as examples for other IOs that are looking to include similar expertise into their programs. [5][6][7][8][9] Available data suggest that annually, relief organizations perform approximately one-quarter of a million operations in resource-poor countries. 10 The members of MSF performed approximately 50,000 surgical cases during 2008.…”