Background

The war in Palestine has decimated an already burdened health care system and simultaneously increased the surgical medical need. In the current acute phase of conflict, this burgeoning set of surgical needs are focused on life-saving measures, such as trauma surgery for penetrating wounds, amputations of severe extremity injuries and wound management to prevent sepsis.

Experience from prior conflicts has taught us that after the acute phase, a significant reconstructive surgical need emerges that is often overlooked by international aid agencies and difficult to service by a decimated healthcare infrastructure. This reconstructive need is best met by plastic and reconstructive surgeons, who are trained to cover injuries ranging from bone and soft-tissue reconstructions of the hand, lower extremity, and craniofacial areas, as well as burn care, scar release, and comprehensive wound management. 

These reconstructive surgical interventions are not lifesaving, but they are life-restoring; they improve quality of life and allow patients to re-enter society, not merely socially, but also to seek gainful employment and provide support for their families. 

Meeting these reconstructive surgical needs requires specific training and equipment, and they often require repeated interventions over an extended duration. As such, the contribution of generic healthcare resources and isolated mission trips are unlikely to be an effective or sustainable way to address the need.

Project Description

This project team will create an actionable needs assessment and forward-thinking blueprint for meeting the reconstructive surgery need in Palestine following the ongoing active conflict. 

Team members will model the anticipated volume in each category of reconstructive surgery, identifying what is necessary to deliver care in a resource-strapped environment (e.g., personnel skill sets, medical equipment, pharmaceuticals, infrastructure, post-operative care) and what is already in place at a global and regional level (e.g., external aid organizations and/or existing infrastructure). Then, they will develop a plan for where and how targeted efforts could make the largest impact towards meeting unmet reconstructive surgical needs.

To meet this goal, team members will:

1. Utilize computational mathematical modeling to forecast the reconstructive surgical need, incorporating casualty and injury data from the ongoing conflict pulled from multiple sources (local government agencies/health ministries, news reports, interviews), as well as prior studies on the burden of disease and injury in conflict zones.
2. Map the steps and resources to meet the surgical care need by digesting and distilling existing medical literature and interviewing providers with experience delivering care in limited-resource and conflict settings to understand care extending from the pre-operative to post-operative window.
3. Inventory existing structures, organizations and initiatives that are positioned to meet reconstructive needs in the region (e.g., WHO, UNRWA, Palestinian American Medical Association, Doctors Without Borders, The Palestine Red Crescent Society, local government offices, professional societies) through interviews with groups to document what they are able to provide (e.g., personnel, education, supplies) and in what quantity and category. 
4. Develop a blueprint for meeting unmet needs in each category, including estimating costs and resources required based on discussions with aid agencies, medical providers, financial reports, cost-impact studies related to surgical aid, and training and capacity building.

Anticipated Outputs

Blueprint for meeting reconstructive surgery needs in Palestine; informal network of organizations, providers and agencies; needs assessment; publications; conference presentations

Student Opportunities

Ideally, this project team will include 4-5 graduate/professional students and 6-7 undergraduate students interested in global health and medicine, healthcare infrastructure, data science and modeling, care delivery, capacity building and reconstructive surgery as well as the history and culture of Palestine.

Team members will practice a range of research and professional skills. They will interface directly with aid agencies and providers, learning not only how to interview, but how to collaborate on a project with multiple stakeholders, seek buy-in and build cross-institutional relationships. They will learn to execute sophisticated modeling, sensitivity analyses, comprehensive needs assessments and build blueprints/strategies for meeting a goal. Students will also have the chance to do deep dives into the region and will gain invaluable skills researching global healthcare delivery, capacity building and international development.

Timing

Fall 2024 – Spring 2025

• Fall 2024: Break into subteams and identify timeline and objectives for each group; complete data collections, including literature reviews and interviews with agencies, providers and organizations; analyze data
• Spring 2025: Summarize subteam findings and aggregate data; submit findings to relevant journals; develop blueprints for addressing needs in conjunction with stakeholders

Crediting

Academic credit available for fall and spring semesters