Meeting the Need for Reconstructive Surgery in Palestine (2025-2026)

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 shown 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 devastated healthcare infrastructure. This reconstructive need is best met by a multidisciplinary team of plastic and reconstructive surgeons alongside physical/occupational therapists, skilled nurses and a wide range of healthcare providers, all 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 and seek gainful employment to provide support for their families. Such surgeries require specific training and equipment, and patients often require repeated interventions over an extended duration. Thus, there is need for a coordinated approach built on strong multi-organizational partnerships.

Project Description

Building on the work of a previous team, this project will create and refine an actionable needs assessment and forward-thinking blueprint for meeting the reconstructive surgery need in Palestine following the ongoing active conflict. In addition to the quantitative and medical approach, the project will also employ a documentary and qualitative approach to study how reconstructive care is being delivered, and the impact it is having on patients and providers.

In 2025-2026, team members will 1) refine the blueprint with improved estimates of need and more granular data; 2) conduct a reconstructive surgery capability assessment within Palestine; and 3) document and characterize how the reconstructive need is currently being met.

To meet these goals, team members will:

1. Build on the team’s existing computational mathematical modeling approach to include the most recent casualty and injury data pulled from multiple sources (e.g., local government agencies/health ministries, news reports and interviews the team conducts with medical personnel). Team members will layer on novel data from surveys they are running in Palestine to help characterize what portion of the injuries will require reconstructive surgery and what type of surgery they will require.
2. Deploy the reconstructive surgery capability assessment tool currently being developed by the 2024-2025 team. This capacity assessment, specifically tailored for reconstructive surgery, will be conducted at an institutional level, including all operating hospitals (both permanent and temporary) within the region.
3. Conduct surveys to characterize the types and volume of reconstructive surgery being provided in the region, adjustments surgeons are making to accommodate the circumstances, and patient outcomes. Team members will benchmark these findings against existing literature on reconstructive surgery in low-resource and/or conflict settings for quantitative comparisons and analysis, as well as diving into individual patient, surgeon and other healthcare provider vignettes for a qualitative and documentary approach. This goal will be a combination of quantitative surveys alongside documentary style storytelling and qualitative research. 

Anticipated Outputs

Refined models to predict reconstructive surgery need; evaluation of current reconstructive surgery capacity in the region; new data regarding injury burden and operative outcomes; academic publications; conference presentations

Student Opportunities

Ideally, this project team will include 4 graduate students and 12 undergraduate students with experience or interest in data science, population models, public health and healthcare infrastructure, global health, care delivery and capacity building in low-resource settings, and/or the study of Palestine and the surrounding region through historical, cultural and/or societal lenses. Medical students and surgical residents interested in reconstructive surgery or global medicine are encouraged to apply.

The team will begin working as a single group in order to coordinate timeline and objectives for each project aim. They will then split into three subteams based on interest and experience.

Team members will interface directly local Palestinian institutions, aid agencies and global partners, learning how to collaborate on a project with multiple stakeholders and build cross-institutional relationships. They will participate in creating sophisticated models and assessments, interview aid agencies and providers, and build blueprints for meeting a goal. Students will also have the opportunity to write articles for publication and/or present their work at conferences.

One student, likely from the Department of Surgery or Duke Global Health Institute, will be selected as project manager.

Timing

Summer 2025 – Summer 2026

• Summer 2025 (optional): Students from 2024-2025 team submit findings and write-ups to academic journals
• Fall 2025: Develop protocols and interview local, regional and global partners; refine models with new data; develop methodology for and begin conducting reconstructive surgery capability assessment; develop surveys to assess reconstructive surgery techniques and outcomes
• Spring 2026: Analyze data from ongoing surveys; create initial write-ups of findings; formalize literature reviews for publication and dissemination of work; continue engagement with partners to share findings and generate buy-in for updated blueprint
• Summer 2026 (optional): Submit findings and write-ups to conferences and academic journals

Crediting

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Meeting the Need for Reconstructive Surgery in Palestine (2024-2025)