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Surgical Care during Humanitarian Crises: A Systematic Review of Published Surgical Caseload Data from Foreign Medical Teams

Published online by Cambridge University Press:  17 May 2012

Jason W. Nickerson ,
Smita Chackungal ,
Lisa Knowlton ,
Kelly McQueen  and
Frederick M. Burkle Jr.
Jason W. Nickerson*
Affiliation:
Centre for Global Health, University of Ottawa, Ottawa, Ontario Canada
Smita Chackungal
Affiliation:
Division of General Surgery, University of Western Ontario, London, Ontario Canada Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Lisa Knowlton
Affiliation:
Division of General Surgery, University of British Columbia, Vancouver, British Columbia Canada Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Kelly McQueen
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Frederick M. Burkle Jr.
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA Senior Public Policy Scholar, Woodrow Wilson International Center for Scholars, Washington, D.C.
*
Correspondence: Jason Nickerson, RRT, PhD (Candidate) Centre for Global Health University of Ottawa 1 Stewart St. Ottawa K1N 6N5 Ontario Canada E-mail jason.nickerson@uottawa.ca
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Abstract

Objective

Humanitarian surgery is often organized and delivered with short notice and limited time for developing unique strategies for providing care. While some surgical pathologies can be anticipated by the nature of the crisis, the role of foreign medical teams in treating the existing and unmet burden of surgical disease during crises is unclear. The purpose of this study was to examine published data from crises during the years 1990 through 2011 to understand the role of foreign medical teams in providing surgical care in these settings.

Methods

A literature search was completed using PubMed, MEDLINE, and EMBASE databases to locate relevant manuscripts published in peer-reviewed journals. A qualitative review of the surgical activities reported in the studies was performed.

Results

Of 185 papers where humanitarian surgical care was provided by a foreign medical team, only 11 articles met inclusion criteria. The reporting of surgical activities varied significantly, and pooled statistical analysis was not possible. The quality of reporting was notably poor, and produced neither reliable estimates of the pattern of surgical consultations nor data on the epidemiology of the burden of surgical diseases. The qualitative trend analysis revealed that the most frequent procedures were related to soft tissue or orthopedic surgery. Procedures such as caesarean sections, hernia repairs, and appendectomies also were common. As length of deployment increased, the surgical caseload became more reflective of the existing, unmet burden of surgical disease.

Conclusions

This review suggests that where foreign medical teams are indicated and requested, multidisciplinary surgical teams capable of providing a range of emergency and essential surgical, and rehabilitation services are required. Standardization of data collection and reporting tools for surgical care are needed to improve the reporting of surgical epidemiology in crisis-affected populations.

Nickerson JW, Chackungal S, Knowlton L, McQueen K, Burkle FM Jr. Surgical care during humanitarian crises: a systematic review of published surgical caseload data from foreign medical teams. Prehosp Disaster Med. 2012;27(2):1-6.

Keywords

disasterdisaster reliefforeign medical teamhumanitarian reliefsurgical emergency
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 2 , April 2012 , pp. 184 - 189
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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