Military humanitarian efforts in pediatric surgery and ethical considerations

Pediatric surgical conditions contribute substantially to the global burden of disease, yet children in low- and middle-income countries (LMICs) continue to face profound barriers in access to safe and timely surgical care. In disaster and conflict settings, these gaps are often magnified. Military humanitarian missions provide a unique, but understudied platform for delivering pediatric surgical care while supporting host-nation surgical capacity. In this narrative review, we summarize the current landscape of pediatric global surgery and examine the role of military surgical teams in humanitarian assistance and disaster response. We review models of military engagement, the development of telehealth capabilities to extend pediatric surgical expertise, and the ethical challenges that arise when providing care in politically complex, resource-limited environments. We further explore considerations in surgical decision making in LMICs, including disease severity, nutritional compromise, and limited rehabilitation resources. Finally, we highlight the importance of coordinated partnerships between military teams, local providers, and non-governmental organizations (NGOs) to promote sustainable, context-appropriate pediatric surgical care. Lessons from military pediatric disaster response have broad implications for global surgery, underscoring the need to prioritize children in emergency preparedness, invest in ethical and operational frameworks, and leverage telehealth and collaboration to strengthen local health systems.