Iraqi Civilians Research Articles

Reconstruction of Nonunion Tibial Fractures in War-Wounded Iraqi Civilians, 2006–2008

To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information. Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan. Sixty-two civilians with nonunion tibial fractures caused by war-related trauma in Iraq; 53 completed follow-up. Amputation and/or reconstruction. Late surgical complications (after the patient's return to Iraq) were analyzed for infection recurrence, bone union, and functional condition (defined using the Short Musculoskeletal Functional Assessment score). Almost three fourths of patients arrived with infected injuries, 9 of whom had amputation as the initial surgery; the rest, and all uninfected patients, had reconstruction. Excluding loss to follow-up, only 4 of 53 (8%) patients who arrived with an infected injury had infection recurrence. Excluding loss to follow-up and amputation, 2 of 14 (14%) patients in the uninfected and 5 of 30 (17%) in the infected injury group did not achieve successful tibial union. Mean Dysfunctional and Bothersome Indices overall were 27.1 and 29.8, respectively, with similar results for all 3 groups (amputations, uninfected, and infected injuries). Our study shows that patients with infected and uninfected injuries surgically treated in Amman achieved similar outcomes. Despite late presentation, our patients had a comparable outcome to other studies dealing with early reconstruction. Reconstruction for the infected group required longer treatment time. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Reconstruction of residual mandibular defects by iliac crest bone graft in war-wounded Iraqi civilians, 2006–2011

Our aim was to assess the long-term results, complications, and factors associated with failure of mandibular reconstructions among wounded Iraqi civilians with mandibular defects. Success was measured by the quality of bony union, and assessed radiographically and by physical examination. Failures were defined as loss of most or all of the bone graft, or inability to control infection. During the 6-year period (2006–2011), 35 Iraqi patients (30 men and 5 women, mean age 33 years, range 15–57) had residual mandibular defects reconstructed by iliac crest bone grafts. The causes were bullets (n=29), blasts (n=3), and shrapnel (n=3). The size of the defect was more than 5cm in 19 cases. Along the mandible the defect was lateral (n=14), central/lateral (n=5), lateral/central/lateral in continuity (n=6), and central in continuity (n=10). The mean time from injury to operation was 548 days (range 45–3814). All but 2 patients had infected lesions on admission. Bony fixation was ensured by locking reconstruction plates (n=27), non-locking reconstruction plates (n=6), and miniplates (n=2). Complications were associated with the reconstruction plate in 2 cases, and donor-site morbidity in 5. After a mean follow-up of 17 months (range 6–54), bony union was achieved in 28 (80%). The quality of the bone was adequate for dental implants in 23 cases (66%). Our results suggest that war-related mandibular defects can be reconstructed with non-vascularised bone grafts by multistage procedures with good results, provided that the soft tissues are in good condition, infection is controlled, and the method of fixation is appropriate. Further studies are needed to assess the role of vascularised free flaps in similar conditions.

Cultural influences on the news

This study explored how cultural context influences news content by comparing American and Swedish news about the Iraq war in 2003. Using a theoretical foundation derived from the works of Hall (1980, 1997) and Hofstede (1979 , 1980, 1991), a theme analysis of television and print news was conducted. The results revealed that the war was portrayed differently in the two countries and that emphasis was placed on different aspects. American media focused on military strategy, interpreted the war from the troops’ perspective, and explained it as the US bringing freedom to the Iraqi people. Swedish media interpreted the war from the international community’s and the suffering Iraqi civilians’ points of view and explained it as a failure of the international community. As hypothesized, American media had comparatively more masculine content while Swedish media had comparatively more feminine content. Findings suggest that culture is an important variable that should be considered when studying news production and coverage.

Jurisdiction over grave breaches of human rights in Iraq committed by PMSCs contracted with the USA: The Nisur square incident

This article examines and analyzes the available legal options to the jurisdiction over grave breaches of human rights suffered by Iraqi civilians at the hands of the personnel of private military and security companies contracted with the U.S. armed forces in Iraq, with reference to the incident of the killing of 17 Iraqi civilians and wounding others in the Nisur Square in Baghdad in 2007 as a result of shooting by Blackwater company personnel. During its direct administration to Iraq as an occupying power the United States have granted to members of its armed forces and contractors immunity from jurisdiction of Iraqi laws. Such immunity helped to some degree, to commit serious violations of human rights against Iraqi civilians and rendered the litigation or prosecution of perpetrators complex, given that the local remedies must be exhausted before searching the possibility of jurisdiction at the international level.

Disidencias En La Figuración De La Guerra: Entrevista a Matthew Gutmann (Dissent in the Imagination of War: An Interview with Matthew Gutmann)

In this interview, anthropologist Matthew Gutmann discusses gender violence, especially with respect to antiwar veterans of the Iraq War, and the image they had to face of themselves as invaders and occupiers of a foreign land. The veterans developed a strong allegiance with civilians in Iraq, as they were facing the brunt of the war's terrors.

Suicide bombing: how to prevent death in civilians?

In their Article (Sept 3, p 906),1 Madelyn Hicks and colleagues describe casualties from suicide bombs in Iraq during 2003–10. During the studied period, lethality was significantly higher for Iraqi civilians than for coalition soldiers. Hicks and colleagues speculate that difficult access to adequate hospital treatment for Iraqi civilians could mainly explain this difference in mortality.

Technology-mediated social arrangements to resolve breakdowns in infrastructure during ongoing disruption

When societies experience disruption as caused by natural disasters, various official government agencies, relief organizations, and emergent citizen groups engage in activities that aid in the recovery effort—the process that leads to the resumption of normal life. In war environments however, societal trust can be affected and people may develop distrust of the institutions and associated individuals that provide and resolve breakdowns in infrastructure. This article reports on an ethnographic study of the use of information and communication technologies (ICTs) by citizens experiencing ongoing disruption in a conflict zone. We conducted 90 semistructured interviews with Iraqi civilians who experienced the 2 nd Gulf War beginning in March 2003. We show how citizens used ICTs to continuously resolve breakdowns in infrastructure during ongoing disruption caused by the conflict, by creating new, reliable technology-mediated social arrangements that enabled people to maintain daily routines for travel, education, and obtaining information. We then discuss new ways to think about infrastructure and implications for the disaster relief effort.

Casualties in civilians and coalition soldiers from suicide bombings in Iraq, 2003–10: a descriptive study

Suicide bombs in Iraq are a major public health problem. We aimed to describe documented casualties from suicide bombs in Iraq during 2003-10 in Iraqi civilians and coalition soldiers. In this descriptive study, we analysed and compared suicide bomb casualties in Iraq that were documented in two datasets covering March 20, 2003, to Dec 31, 2010--one reporting coalition-soldier deaths from suicide bombs, the other reporting deaths and injuries of Iraqi civilians from armed violence. We analysed deaths and injuries over time, by bomb subtype and victim demographics. In 2003-10, 1003 documented suicide bomb events caused 19% (42,928 of 225,789) of all Iraqi civilian casualties in our dataset, 26% (30,644 of 117,165) of injured civilians, and 11% (12,284 of 108,624) of civilian deaths. The injured-to-killed ratio for civilians was 2·5 people injured to one person killed from suicide bombs. Suicide bombers on foot caused 43% (5314 of 12,284) of documented suicide bomb deaths. Suicide bombers who used cars caused 40% (12,224 of 30,644) of civilian injuries. Of 3963 demographically identifiable suicide bomb fatalities, 2981 (75%) were men, 428 (11%) were women, and 554 (14%) were children. Children made up a higher proportion of demographically identifiable deaths from suicide bombings than from general armed violence (9%, 3669 of 40,276 deaths; p<0·0001). The injured-to-killed ratio for all suicide bombings was slightly higher for women than it was for men (p=0·02), but the ratio for children was lower than it was for both women (p<0·0001) and men (p=0·0002). 200 coalition soldiers were killed in 79 suicide bomb events during 2003-10. More Iraqi civilians per lethal event were killed than were coalition soldiers (12 vs 3; p=0·004). Suicide bombers in Iraq kill significantly more Iraqi civilians than coalition soldiers. Among civilians, children are more likely to die than adults when injured by suicide bombs. None.

Suicide attacks—the rationale and consequences

The use of suicide bombers as a military and political strategy has a long history. At present, most suicide attacks happen in Iraq, Afghanistan, and Pakistan. In The Lancet, Madelyn Hicks and colleagues 1 Hicks MH-R Dardagan H Bagnall PM Spagat M Sloboda JA Casualties in civilians and coalition soldiers from suicide bombings in Iraq, 2003–10: a descriptive study. Lancet. 2011; 378: 906-914 Summary Full Text Full Text PDF PubMed Scopus (46) Google Scholar present findings from their study of military and civilian suicide bomb casualties in Iraq, drawing on the extensive but incomplete Iraq Body Count database. For the period between March, 2003, and December, 2010, their database contained information for 1003 suicide attacks on Iraqi targets, which resulted in an estimated 12 284 deaths—79 suicide attacks on coalition forces caused about 200 deaths. Casualties in civilians and coalition soldiers from suicide bombings in Iraq, 2003–10: a descriptive studySuicide bombers in Iraq kill significantly more Iraqi civilians than coalition soldiers. Among civilians, children are more likely to die than adults when injured by suicide bombs. Full-Text PDF

Phantom Empire: A Feminist Reflection Ten Years After 9/11

On May 1, 2011, close to ten years after Al Qaeda suicide bombers had used jet airplanes to demolish three targets in the eastern United States - most unforgettably blowing the World Trade Center twin towers up in smoke - the United States, having at last managed through its intelligence sources to locate the Pakistani hill refuge where Osama bin Laden had been hiding, secretly dispatched its Navy SEAL team to go there and shoot dead. There are many both tragic and farcical things might remark on about this momentous yet peculiarly anticlimactic event. On the tragic side of course are the hundreds of thousands of Iraqi and Afghani civilian and young U.S. military lives lost, displaced, or permanently maimed, and trillions of dollars of US. public resources squandered, on the murderous path to hunting down Al Qaeda and its leader. Representing the farcical, have U.S. mass cultures schizophrenic response to the announcement that we got him - the hysterical football cheers for Our Side and frat boy street celebrations quickly followed by pious quotations from Proverbs and Facebook posts about doing as Jesus would and forgiving our enemies (Sullivan 2011). And for combined elements of both tragedy and farce, consider the deliberate timing and staging of bin Ladens execution as a racialized and gendered propaganda tactic in the lead-up to the 2012 presidential election and the certification of Barack Obama as a Real (honorary white Christian) Man, whose valor in exterminating the Islamist foe will go down as unassailable. But I prefer to focus on another, less noticed sequel to the US. security apparatus's Top Assassination. Within two weeks, a strange follow-up episode occurred when the government of Pakistan made the gesture of returning to the United States the tail of the damaged stealth helicopter that the navy had used to perform the commando operation. Mainstream U.S. media reported this act in the light of strained US.-Pakistani relations following the killing. Pakistan faced tremendous criticism in the U.S. Congress for, if not deliberately harboring terrorists, then its leaders' apparent ignorance of bin Ladens whereabouts all those years and not doing enough to show support for the U.S.-led War on Terror while receiving billions in U.S. military and economic aid. Internally, President Asif Ali Zardari came under strong attack for abetting the violation of Pakistani sovereignty by, as the Washington Post put it, not having been of the raid in advance (as if being informed of U.S. unilateral action would be any less indicative of imperial fiat). But I propose shift our vantage point to look more closely at what this Return of the Tail signifies, both materially and symbolically, with regard to U.S. positioning in the world and the shape of masculinist militarism ten years after 9/1 1. In so doing, may find that, in ways newly configuring the fall of the twin towers ten years ago, this piece of tail returns as a kind of fetish embodying the decline of American empire in the twenty-first century. In the immediate aftermath of the terrorist attacks in September 2001, I imagined a new geopolitical scenario arising in the smoke clouds through the symbolism of phantom twin towers: the American imperial colossus confronting Al Qaeda and its jihadist partners and counterparts across the globe (Petchesky 2002). My point was to counter the prevailing Manichean Good versus Evil narrative that resounded at the time - certainly among the U.S. right wing and George W. Bush administration but also, in a kind of reverse fashion, among certain elements of the Left; a narrative of either righteous defenders of the Homeland and Christian values versus crazy jihadist terrorists; or, alternatively, resistant anti-imperialists (the chickens coming home to roost) versus arrogant Western oil interests. Rather than opposites, I argued, these two adversaries mirrored each other like fratricidal twins in their capitalist wealth, nationalist imperialist ambitions, manipulation of religion, staunch militarism, masculinism (even if, in the U. …

Iraq and the case for Australian war crimes trials

This article presents the case for Australian war crimes trials, following Australian participation in the invasion of Iraq and the subsequent deaths of as many as a million Iraqi civilians. It focuses on jus in bello (war crimes) rather than jus ad bellum (just war). The article sets out the argument and rationale that Australian war crimes trials are needed. Having established the necessity, the article identifies two of the principal alleged atrocities for which Australian officials should be held criminally accountable. It details Australian military support for the use of cluster bombs against civilians during the 2003 invasion, and senior Australian military commanders’ responsibility for planning and carrying out multiple purported war crimes during the attack on Fallujah in late 2004. The article recognises that, in order for Australian officials to be prosecuted under the International Criminal Court (ICC), all domestic remedies must be first exhausted. It therefore specifically addresses which Australian laws can be used, with particular emphasis on anti-terrorist legislation passed in 2002 under the Howard Government and the introduction into Australia’s domestic federal criminal legislation offences equivalent to the ICC Statute offences of genocide, crimes against humanity and war crimes. These provide the most applicable legal tools for prosecuting senior Australian officials for war crimes in Iraq.

Multidrug-Resistant Chronic Osteomyelitis Complicating War Injury in Iraqi Civilians

War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission. In the Médecins Sans Frontières Reconstructive Surgery Project in Amman, Jordan, we retrospectively reviewed baseline demographics and results of initial intraoperative surgical cultures among Iraqi civilians with suspected osteomyelitis. One hundred thirty-seven patients (90% male; median age, 35 years [interquartile range {IQR}, 28-46]; median time since initial injury, 19 months [IQR, 10-35]) were admitted with suspected chronic osteomyelitis after war-related injury. One hundred seven patients had a positive intraoperative culture. Before arrival, patients had undergone a median of 4 (IQR, 2-6) surgical procedures in Iraq. Fifty-nine (55%) of 107 patients with confirmed osteomyelitis had a multidrug-resistant (MDR) organism isolated at admission: cefepime-resistant Enterobacteriaceae (n = 40), methicillin-resistant Staphylococcus aureus (n = 16), and MDR Acinetobacter baumannii (n = 3). An association of borderline significance existed between a history of more than two prior surgical procedures in Iraq and an MDR isolate at program entry (multivariate: odds ratio, 5.3; 95% confidence interval, 0.9-30.6; p = 0.064). Health care actors, including Iraqi health facilities and humanitarian medical organizations, must be aware of the link between chronic war injury and antimicrobial drug resistance in this region and should be prepared for the management challenges involved with the treatment of chronic drug-resistant osteomyelitis.

Violent Deaths of Iraqi Civilians, 2003–2008: Analysis by Perpetrator, Weapon, Time, and Location

Armed violence is a major public health and humanitarian problem in Iraq. In this descriptive statistical analysis we aimed to describe for the first time Iraqi civilian deaths caused by perpetrators of armed violence during the first 5 years of the Iraq war: over time; by weapon used; by region (governorate); and by victim demographics. We analyzed the Iraq Body Count database of 92,614 Iraqi civilian direct deaths from armed violence occurring from March 20, 2003 through March 19, 2008, of which Unknown perpetrators caused 74% of deaths (n = 68,396), Coalition forces 12% (n = 11,516), and Anti-Coalition forces 11% (n = 9,954). We analyzed the subset of 60,481 civilian deaths from 14,196 short-duration events of lethal violence to link individual civilian deaths to events involving perpetrators and their methods. One-third of civilian violent death was from extrajudicial executions by Unknown perpetrators; quadratic regression shows these deaths progressively and disproportionately increased as deaths from other forms of violence increased across Iraq's governorates. The highest average number of civilians killed per event in which a civilian died were in Unknown perpetrator suicide bombings targeting civilians (19 per lethal event) and Coalition aerial bombings (17 per lethal event). In temporal analysis, numbers of civilian deaths from Coalition air attacks, and woman and child deaths from Coalition forces, peaked during the invasion. We applied a Woman and Child "Dirty War Index" (DWI), measuring the proportion of women and children among civilian deaths of known demographic status, to the 22,066 civilian victims identified as men, women, or children to indicate relatively indiscriminate perpetrator effects. DWI findings suggest the most indiscriminate effects on women and children were from Unknown perpetrators using mortar fire (DWI = 79) and nonsuicide vehicle bombs (DWI = 54) and from Coalition air attacks (DWI = 69). Coalition forces had higher Woman and Child DWIs than Anti-Coalition forces, with no evidence of decrease over 2003-2008, for all weapons combined and for small arms gunfire, specifically. Most Iraqi civilian violent deaths during 2003-2008 of the Iraq war were inflicted by Unknown perpetrators, primarily through extrajudicial executions that disproportionately increased in regions with greater numbers of violent deaths. Unknown perpetrators using suicide bombs, vehicle bombs, and mortars had highly lethal and indiscriminate effects on the Iraqi civilians they targeted. Deaths caused by Coalition forces of Iraqi civilians, women, and children peaked during the invasion period, with relatively indiscriminate effects from aerial weapons. Please see later in the article for the Editors' Summary.

Soldier Photography of Detainee Abuse in Iraq: Digital Technology, Human Rights and the Death of Baha Mousa

Digital media technologies provide new opportunities for the recording and publicising of human rights violations. In recent years, soldier photography during military conflicts has become one of the most controversial sources of images of abuse, especially in relation to the visual representation of detainees. The backdrop to this article is the death of Baha Mousa, an Iraqi civilian who died while in detention on a British Army military base in Basra in southern Iraq in 2003. A soldier’s video footage of Mr Mousa’s treatment in the detention facility has helped to generate a range of cultural, political and legal effects, not least an ongoing official Inquiry into the causes of his death. But while new media technologies, such as mobile camera-phones, can provide an expanded visual record of human suffering and death in war zones, this article argues that this brings dangers as well as possibilities. More generally, it raises questions about how human rights practitioners should respond to the increasing visualisation of witnessing.

Voices of Dissent in the Iraq War: Moving from Deviance to Legitimacy?

Using indexing theory as a framework, this content analysis of 2003–2007 Time coverage explores the range of dissenting voices of the war in news dialogue. Findings show that war criticism remained constant throughout the years and was largely targeted toward the Bush administration. While most dissent originated from official sources, American and Iraqi civilians did have space to voice their dissatisfaction. Journalists themselves became increasingly vocal in their condemnation of the war. These results suggest that clashes between public opinion and official perspectives have implications in news coverage and promotion of debate about current affairs.

When Values and Attributions Collide: Liberals’ and Conservatives’ Values Motivate Attributions for Alleged Misdeeds

Conservatives tend to make dispositional whereas liberals make situational attributions for social problems and alleged misconduct (the "ideo-attribution effect"). Three studies demonstrated a reversal of the ideo-attribution effect. Conservatives made stronger situational attributions than liberals for the behavior of Marines accused of killing Iraqi civilians (Studies 1 and 2) and police officers accused of wrongly killing a cougar running loose in a Chicago neighborhood (Study 3). Reversals of the ideo-attribution effect occurred because conservative values were more consistent with excusing the Marines' and police officers' behavior, whereas liberal values were more consistent with blaming the Marines and police officers. These results suggest that the ideo-attribution effect-and attributions more generally-are shaped by whether people's attributional conclusions are consistent or inconsistent with their salient values.

Is anyone watching? War, cinema and bearing witness

War-on-terror-themed fictional films, particularly those focused on the war in Iraq, have largely failed at the box office and have been subjected to stinging criticism by right-wing political commentators and film reviewers. Critics on the political right have been upset by a perceived lack of patriotism in the films, often arguing that they are dangerous incitements to new acts of violence. However, unlike many earlier war films, including those made about the conflict in Vietnam, directors of films about the war on terror are quite self-consciously making political films that question United States (US) policy and practice, that focus on the effects of war on US service personnel and civilians in Iraq and Afghanistan and that, significantly, attempt to rehabilitate Arabs, Muslims and Islam from decades of Hollywood demonization. Moreover, the films are being made and released into a media environment in which quality news reporting has declined even as the intensity of feeling about ‘otherness’ has sha...

Jus in bello a operace Irácká svoboda

War is a constant feature of human affairs and a permanent topic of ethical debates. Moral reasoning about war and peace known as just war theory has its roots in Christian ethics and is connected to positive international law. The theory is doubly critical - it serves as a tool for evaluating the justice of a state's decision to go to war, as well as its conduct in particular warfare. The article uses the latter part of just war theory as an analytical tool for answering the question whether the allied conduct during the Operation Iraqi Freedom in 2003 met the criteria of justice in war (jus in bello). Two main principles of jus in bello are discrimination and proportionality. These moral categories aim at reducing the damage and destruction incurred in war. The Operation Iraqi Freedom was conducted with awareness of the importance of these principles, because the U.S. Army used new weapon technologies, mainly precision-guided missiles, that reduced the casualties among Iraqi civilians.

Is anyone watching? War, cinema and bearing witness

War-on-terror-themed fictional films, particularly those focused on the war in Iraq, have largely failed at the box office and have been subjected to stinging criticism by right-wing political commentators and film reviewers. Critics on the political right have been upset by a perceived lack of patriotism in the films, often arguing that they are dangerous incitements to new acts of violence. However, unlike many earlier war films, including those made about the conflict in Vietnam, directors of films about the war on terror are quite self-consciously making political films that question United States (US) policy and practice, that focus on the effects of war on US service personnel and civilians in Iraq and Afghanistan and that, significantly, attempt to rehabilitate Arabs, Muslims and Islam from decades of Hollywood demonization. Moreover, the films are being made and released into a media environment in which quality news reporting has declined even as the intensity of feeling about ‘otherness’ has sharpened. This article argues that war on terror film directors are themselves bearing witness to the tragedy of war and thereby inviting film audiences to see the effects of war.

A Descriptive Analysis of Patients Admitted to the Intensive Care Unit of the 10th Combat Support Hospital Deployed in Ibn Sina, Baghdad, Iraq, From October 19, 2005, to October 19, 2006

Although a review of the 1-month experience of a British intensive care unit (ICU) deployed in 2003 to Iraq outlining its care of 47 patients exists, a descriptive study outlining patient characteristics, workload, and outcomes of an ICU during a long-term deployment to Operation Iraqi Freedom is lacking in the medical literature. Between October 19, 2005, and October 19, 2006, the 10th Combat Support Hospital (CSH) deployed in an ICU to Ibn Sina Hospital in Baghdad, Iraq. Staff prospectively collected patient admission data from November 1, 2005, to August 31, 2006, in handwritten logbooks. This information included nationality (United States/Iraqi/other), military versus civilian, mechanism of injury or nontrauma admission diagnosis, ICU length of stay (LOS), and outcome. These data were retrospectively reviewed for the purpose of reporting the experience of the 10th CSH ICU during its deployment. The 10th CSH ICU admitted 875 patients during the study period. This represented 27% of all hospital admissions (n = 3289). Categories of patients admitted to the ICU included United States military, US contractor, Iraqi military, Iraqi civilian, non-US contractor, coalition military personnel, and security internee. Three patients were unable to be classified due to missing information. The most common patient category of admission was Iraqi civilian (n = 472, 53.9%). Noncoalition (Iraqi civilian, Iraqi military, non-US contractors, and other noncoalition military) admissions made up 76.9% (n = 673) of all admissions. US military (n = 165) and US contractors (n = 31) made up 22.4% of all ICU admissions. Trauma-related admissions were the most common diagnoses (n = 730, 83.4%). Other admission diagnostic categories included medical (n = 125, 14.3%) and postoperative (n = 5, 0.6%) patients. A total of 15 patients (1.7%) were unable to be categorized based on diagnosis due to missing information. The most common medical diagnosis requiring ICU admission was related to cardiovascular disease (n = 51, 40.8%). Seven of the admissions to the ICU were pediatric patients (0.8%). US military personnel traumatically injured suffered significantly more explosion injuries and burns than their Iraqi military and other noncoalition military counterparts. The ICU LOS was significantly shorter in US military and US contractor patients compared to all other groups, likely a result of expeditious air evacuation to a higher level of care. This air evacuation of US personnel combined with the fact that Iraqi patients were transferred to local civilian hospitals prior to the completion of intensive care stay limited follow-up. Despite a lack of meaningful follow-up, the observed ICU all-cause mortality was 5.0% (n = 44). The primary mission of a US military ICU deployed in support of combat operations is the care of its injured troops. However, the 10th CSH deployed in an urban region of Iraq in a mature theater of operations and its ICU more commonly cared for non-US patients during combat medical operations. These patients included pediatric patients as well as admissions for nontrauma illnesses. This mission was accomplished by nurses and physicians faced with unique challenges and resulted in an acceptable ICU mortality rate.