Post-cold war United Nations peacekeeping operations: a review of the case for a hybrid level 2+ medical treatment facility.

Ralph Jay Johnson

doi:10.1186/s40696-015-0006-z

Abstract

Post-Cold War, UN peacekeeping operations (UN PKOs) have become larger, more mobile, multi-faceted and conducted over vast areas of remote, rugged, and harsh geography. They have been increasingly involved in dangerous areas with ill-defined boundaries, simmering internecine armed conflict, and disregard on the part of some local parties for peacekeepers’ security and role. Yet progressively there have been expectations of financial restraint and austerity. Additionally, UN PKOs have become more “robust,” that is, engaged in preemptive, assertive operations. A statistically positive and significant relationship exists between missions’ size, complexity, remoteness, and aggressive tenor and a higher probability of trauma or death, especially as a result of hostile actions or disease. Therefore, in the interest of “force protection” and optimizing operations, a key component of UN PKOs is health care and medical treatment. The expectation is that UN PKO medical support must conform to the general intent and structure of current UN PKOs to become more streamlined, portable, mobile, compartmentalized, and specialized, but also more varied and complex to address the medical aspects of these missions cost-efficiently. This article contends that establishing a hybrid level 2—a level 2 with level 3 modules and components (i.e., level 2+)—is a viable course of action when considering trends in the medical aspects of Post-Cold War UN PKOs. A level 2 medical treatment facility has the potential to provide needed forward mobile medical treatment, especially trauma care, for extended, complex, large-scale, and comprehensive UN PKOs. This is particularly the case for missions that include humanitarian outreach, preventive medicine, and psychiatry. The level 2 treatment facility is flexible enough to expand into a hybrid level 2+ with augmentation of modules based on changes in mission requirements and variation in medical aspects.

Highlights

An essential element of United Nation’s peacekeeping operations (UN PKOs) is provision of health services in support of mission personnel in areas of operations [1]
Need for a modified level 2 medical treatment facility The literature on medical aspects of expanded and more robust post-Cold War UN PKOs suggests the need for field medical treatment support capable of moving itself, while retaining the ability to deliver varied medical care at different levels
The level 2 facility arguably is the center of gravity for medical support for UN PKOs

Summary

Introduction

An essential element of United Nation’s peacekeeping operations (UN PKOs) is provision of health services in support of mission personnel in areas of operations [1]. Need for a modified level 2 medical treatment facility The literature on medical aspects of expanded and more robust post-Cold War UN PKOs suggests the need for field medical treatment support capable of moving itself, while retaining the ability to deliver varied medical care at different levels.

Results

Conclusion