Maintaining baseline, corrective surgical care during asymmetrical warfare: a case study of a humanitarian mission in the safe zone of a neighboring country.

The current insurgency warfare in Iraq is of an unconventional or asymmetrical nature. The deteriorating security has resulted in problems recovering and maintaining essential health services. Before the 2003 war, Iraq was considered a developed country with the capacity to routinely perform baseline medical and surgical care. These procedures now are performed irregularly, if at all. Due to the unconventional warfare, traditional Military Medical Civilian Assistance Programs (MEDCAPs) and civilian humanitarian missions, which routinely are mobilized post-conflict, are unable to function. In December 2005, an international medical mission conducted by the Operation Smile International Chapter in neighboring Jordan employed civilian physicians and nurses to provide surgery and post-operative care for Iraqi children with newly diagnosed cleft lip and palates and the complications that had occurred from previous surgical repair. Seventy-one children, their families, and a team of Iraqi physicians were safely transported to Jordan and returned to Iraq across the Iraqi western province war zone. Although complications may occur during transport, treatment within a safe zone is a solution for providing services in an insecure environment.