Abstract
BackgroundThe provision of surgical assistance in conflict is often associated with care for victims of violence. However, there is an increasing appreciation that surgical care is needed for non-traumatic morbidities. In this paper we report on surgical interventions carried out by Médecins sans Frontières in Masisi, North Kivu, Democratic Republic of Congo to contribute to the scarce evidence base on surgical needs in conflict.MethodsWe analysed data on all surgical interventions done at Masisi district hospital between September 2007 and December 2009. Types of interventions are described, and logistic regression used to model associations with violence-related injury.Results2869 operations were performed on 2441 patients. Obstetric emergencies accounted for over half (675, 57%) of all surgical pathology and infections for another quarter (160, 14%). Trauma-related injuries accounted for only one quarter (681, 24%) of all interventions; among these, 363 (13%) were violence-related. Male gender (adjusted odds ratio (AOR) = 20.0, p < 0.001), military status (AOR = 4.1, p < 0.001), and age less than 20 years (AOR = 2.1, p < 0.001) were associated with violence-related injury. Immediate peri-operative mortality was 0.2%.ConclusionsIn this study, most surgical interventions were unrelated to violent trauma and rather reflected the general surgical needs of a low-income tropical country. Programs in conflict zones in low-income countries need to be prepared to treat both the war-wounded and non-trauma related life-threatening surgical needs of the general population. Given the limited surgical workforce in these areas, training of local staff and task shifting is recommended to support broad availability of essential surgical care. Further studies into the surgical needs of the population are warranted, including population-based surveys, to improve program planning and resource allocation and the effectiveness of the humanitarian response.
Highlights
The provision of surgical assistance in conflict is often associated with care for victims of violence
Program audits for Médecins sans Frontières (MSF) operations during 2008 found that only 30% of surgical interventions were due to violence-related injuries; the majority of interventions were for obstetric emergencies and accidental trauma [1]
In this paper we report on surgical interventions carried out by MSF in a zone of active conflict in BioMed Central tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Summary
The provision of surgical assistance in conflict is often associated with care for victims of violence. In this paper we report on surgical interventions carried out by Médecins sans Frontières in Masisi, North Kivu, Democratic Republic of Congo to contribute to the scarce evidence base on surgical needs in conflict. Armed conflict often occurs in low-income countries where fragile health care systems are rapidly overwhelmed during periods of violence and associated population displacement. In such situations, the population becomes even more vulnerable to threats such as poor hygiene, malnutrition, infectious diseases, rape, and poor antenatal care [2]. Program audits for Médecins sans Frontières (MSF) operations during 2008 found that only 30% of surgical interventions were due to violence-related injuries; the majority of interventions were for obstetric emergencies and accidental trauma [1]. In this paper we report on surgical interventions carried out by MSF in a zone of active conflict in BioMed Central tribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
