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7 Principles of delivery of surgical care from a military facility to a local population; lessons learnt from deployed surgical care in Gao
  1. Maj Grosset Antoine
  1. Orthopaedic, Trauma and Limb Reconstructive Surgery department; Percy Military Teaching Hospital, Clamart, France; French Military Health Service


Medical aid to the population stems from a long French tradition of caring for native populations. It has evolved through the various deployments in modern conflicts and is now based on well-defined principles. It is diplomatically important, as it allows the acceptance of the Force by the population. It is governed by military and strategic, legal but also ethical rules.

The experience of the surgical assistance offered at the operational base in Gao has highlighted the limits that each surgeon has had to impose on himself to ensure the sustainability of this care.

It was necessary to consider the local environment, to learn and adapt to socio-cultural norms, and to assess the needs of the population. Very costly in terms of human and material resources, it was necessary to define the care that could be offered.

Confronted by a very large request for care, and the virtual absence of local health structures, not everything can be done, nor should it be done.

Throughout his mandate, the military surgeon must consider the operational mission which takes precedence, and the humanitarian side. The principle of beneficence is at the heart of the medical reflection.

The transmission of knowledge is essential for sustainability. The basic principles are taught to junior surgeons during specific theoretical courses, and practical training alongside an experienced surgeon.

The main idea is that this surgical aid should be beneficial to the greatest number and be sustainable, without compromising the operational mission or giving false hope to the local population.

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