Built To Last: A Scoping Review Of Surgical Capacity Building Approaches In Conflict-affected Settings

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2024-03-31 12:00:04

doi: 10.52648/JoGS.1162 Built To Last: A Scoping Review Of Surgical Capacity Building Approaches In Conflict-affected Settings Kristin Long, Kayla Pfeiffer-Mundt, Sofia Wagemaker, Alaa Ismail, Lynette Dominguez, Adam L Kushner, Christopher Hooper Lane

Global General surgery | Other | Public health | Trauma and orthopaedics
Keywords: surgery, humanitarian, conflict, capacity

As of 2019, approximately 80 million people were displaced from their homes due to conflict and 1.8 billion people lived in states prone to conflict. [1,2] Conflict has a profound impact on the health of a population, including death and disability, destruction of health infrastructure, and wide-spread displacement. [3] Acute surgical needs in conflicts include treatment of injuries and emergency procedures like C-sections.[4] In addition, baseline population surgical needs often go unmet and may become more complex due to delays in seeking care. Local health systems are unable to cope with demands for myriad reasons: surgical capacity is often low at baseline, existing facilities face threats of direct attack, infrastructure and supply chains are disrupted, and medical personnel may be killed or displaced.

In these settings, humanitarian organizations provide much-needed supplies, infrastructure, and human resources for surgical care. While these organizations are key for supplementing capacity acutely, they do not offer a long-term solution for limited surgical capacity. Funding is often for short-term projects and there is little local accountability. Disruptions in services are common when instability forces evacuation of international personnel. When humanitarian organizations leave due to instability or the end of the project, the burden of providing follow-up care and meeting ongoing population needs falls back upon the local health system.