Global health, global surgery and mass casualties. I. Rationale for integrated mass casualty centres

Tariq Khan, Leonidas Quintana, Sergio Aguilera, Roxanna Garcia, Haitham Shoman, Luke Caddell, Rifat Latifi, Kee B. Park, Patricia Garcia, Robert Dempsey, Jeffrey V. Rosenfeld, Corey Scurlock, Nigel Crisp, Lubna Samad, Montray Smith, Laura Lippa, Rashid Jooma, Russell J. Andrews*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


It has been well-documented recently that 5 billion people globally lack surgical care. Also well-documented is the need to improve mass casualty disaster response. Many of the United Nations (UN) Sustainable Development Goals (SDGs) for 2030 - healthcare and economic milestones - require significant improvement in global surgical care, particularly in low-income and middle-income countries. Trauma/stroke centres evolved in high-income countries with evidence that 24/7/365 surgical and critical care markedly improved morbidity and mortality for trauma and stroke and for cardiovascular events, difficult childbirth, acute abdomen. Duplication of emergency services, especially civilian and military, often results in suboptimal, expensive care. By combining all healthcare resources within the ongoing healthcare system, more efficient care for both individual emergencies and mass casualty situations can be achieved. We describe progress in establishing mass casualty centres in Chile and Pakistan. In both locations, planning among the stakeholders (primarily civilian and military) indicates the feasibility of such integrated surgical and emergency care. We also review other programmes and initiatives to provide integrated mass casualty disaster response. Integrated mass casualty centres are a feasible means to improve both day-to-day surgical care and mass casualty disaster response. The humanitarian aspect of mass casualty disasters facilitates integration among stakeholders - from local healthcare systems to military resources to international healthcare organisations. The benefits of mass casualty centres - both healthcare and economic - can facilitate achieving the 2030 UN SDGs.

Original languageEnglish (US)
Article numbere001943
JournalBMJ Global Health
Issue number6
StatePublished - Dec 22 2019


  • health economics
  • health policy
  • injury
  • surgery
  • traumatology

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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