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Orthopaedic and Plastic Reconstructive Surgery for War Victims: The Italian Co-Operation Experience in the Ethiopian-Eritrean Conflict

Orthopaedic and reconstructive surgery for war wounds is different from the type of surgery performed for civilian injuries. Furthermore, in developing countries, additional problems often arise from the lack of an integrated approach (which includes preand post-operative treatment and preand post-operative rehabilitation) to the war wounds and related complications. From the outbreak of the Ethiopian-Eritrean conflict, the Italian Co-operation supported this complex emergency situation by sending to the site, a surgical team consisting of an orthopaedic surgeon, a maxillo-facial and plastic surgeon, an anaesthesist specialist, a ward nurse, a scrub nurse, and a physiotherapist. The emergency surgical team, in collaboration with the local Eritrean staff, was based at the Asmara Halibet Hospital (Eritrea) from April to December 1999. The presentation reports the results obtained during this period, and focuses on the methodological approach selected to improve the quality of the treatment of patients, and to best manage the situation in an emergency setting. 650 patients were treated according to the ICRC guidelines. The safest and cheapest peripheral anaesthesia procedures were performed in 60% of cases. On-the-job training on the integrated treatment of persons with war injuries with the resident staff was carried out daily. The integrated approach towards war wounds and the prevention of complications using the existing resources were the main objectives of the rapid response, and confirmed the efficacy of the intervention.