Establishing a Pacific Island Trauma System: Saving Lives and Supporting National Security

The WHO reports 8% of global fatalities each year, which are because of injury and violence. In addition to 4.4 million deaths, morbidity associated with injuries drains health care systems and leads to significant economic burden. The key to reducing injury-related death and disability is to develop and implement organized and inclusive trauma systems. Trauma systems and their components address the full continuum of injury care from prevention through rehabilitation, and consistently and predictably reduce injury-related morbidity and mortality. Trauma system development is a critically underused strategy for economic development and medical diplomacy. The U.S. DoD acknowledges the critical value of trauma systems in the expeditionary environment. Operations in Afghanistan and Iraq proved that an established trauma system (modeled after civilian systems) played a key role in sustaining military readiness, minimizing casualties, and enabling operational success. Data showed a 44% reduction in battlefield mortality because of the expeditionary trauma system. The DoD is attempting to scale these successes by building nascent trauma systems in each Geographic Combatant Command through a Combatant Command Trauma System. The Combatant Command Trauma System sets up a framework to aid deployed medical professionals in structuring downrange trauma systems to ensure casualties get to the right capability at the right time, while continuously gathering data to adapt and improve the expeditionary trauma system. Leveraging Combatant Command Trauma System expertise in collaboration with regional partners to build a Pacific Island Trauma System (PITS) would be one of many potential opportunities where regional and DoD interests align. Establishing an integrated PITS supports 5 U.S. Government priorities: (1) integrated deterrence, (2) build partnerships, (3) support veterans, (4) optimize global health engagement, and (5) enhance self-reliance. The PITS concept could be applied to other geographic regions and combatant commands, such as U.S. Southern Command, which experiences similar natural disasters, and struggles with limited resources, physical dispersion, and Chinese competition. Given these global challenges and opportunities, now is the time with a newly elected administration for the U.S. Government to chart a novel course in saving lives and supporting national security; a PITS would be a great place to start.