Medical assistance to civilians during peacekeeping operations: wielding the double‐edged sword

Abstract

Peacekeeping operations have become the main operational activity of the armed forces of the developed world over the past 10 years — a trend which appears likely to continue. Peacekeepers often remain deployed long after the armed conflict has ceased to help reconstruct civilian infrastructure. It is often possible to use the excess capacity of medical support units deployed with military forces to provide help to the local population. While this is appropriate immediately after a conflict when civilian clinics are overwhelmed, in the more prolonged reconstruction phase the seemingly simple clinical imperative to treat as many patients as possible becomes more complex.

Anesthesia during deployment of a military forward surgical unit in low income countries: A register study of 1547 anesthesia cases

“…Among MSP patients, we found an important sex disparity, as a large majority of men (72.8%) have benefited from surgical management during our study. However, there is a strong male preponderance in both conflict-related and non-conflict-related trauma worldwide that may explain this disparity, at least in part [41]. Yet, in non-trauma-related pathologies, the majority of those who received surgical care by FSTs were still men (69.1%).…”

Provision of emergency surgical care in a unique geopolitical setting

“…Other potential disadvantages arising from the active participation of a foreign medical cadre in the provision of care to a local community include a denigration of the status of local graduates, an abuse of the system by local practitioners, the development of a secondary dependent economy and the creation of an atmosphere of unrealistic expectations with subsequent disillusionment. These, together with an outline of the potential advantages, are considered in detail by Reade, who based his discussion on experience with the North Atlantic Treaty Organization (NATO) Stabilization Force (SFOR) in Bosnia– Herzogovina between July and August 2000 5 …”

“…These, together with an outline of the potential advantages, are considered in detail by Reade, who based his discussion on experience with the North Atlantic Treaty Organization (NATO) Stabilization Force (SFOR) in Bosnia-Herzogovina between July and August 2000. 5 Decision making, even with clear guidelines and extensive clinical experience, is not easy when dealing with variable and unpredictable pathological processes. The determination of a patient's priority status can be subjected to considerable discussion.…”

Battlefield euthanasia — courageous compassion or war crime?

“…These decisions are based on the futility of ongoing medical treatment and on the potential harm of continuing care. Although the outcome is the same — the death of the patient — the distinction lies in intent, method and responsibility 10 , 11 …”