The hidden war: humanitarian surgery in a combat zone.

Area of Science:

• Military Medicine
• Surgical Care
• Global Health

Background:

• Humanitarian surgical care (HSC) is critical in wartime military operations.
• Previous descriptions of HSC are limited to anecdotal accounts.

Purpose of the Study:

• To describe and quantify HSC provided by military surgeons during deployments.
• To assess surgeon preparedness and perceived benefits of HSC.

Main Methods:

• A prospective survey was administered to military members deployed to Iraq or Afghanistan from 2002 to 2011.
• The survey collected data on surgeon experience, procedures performed, and preparedness.

Main Results:

• 266 responses were analyzed, with surgeons averaging 3 years of practice at first deployment.
• HSC encompassed all body systems and patient types, including malignancy cases.
• Despite 30% performing novel surgeries, 84% felt residency-prepared; most saw benefits in unit readiness, local populations, and counterinsurgency.

Conclusions:

• Hundreds of military surgeons performed numerous HSC cases over a decade in Iraq and Afghanistan.
• The majority of surgeons perceived significant benefits from providing HSC.