French forward Surgical Team in Ivory Coast Deployment (Operation Licorne): The place of Medical Support to the Population in ten years of Military Surgical Activity

Aims: To quantify and review qualitatively the activity of the military general and orthopedic surgeons deployed throughout Ivorian territory between 2002 and 2012 in French FST (NATO role 2). To confront the epidemiology of the surgical pathologies, the human resources, the logistic capacities and to analyze how Medical Support to the Population (MSP) is achieved in a secluded location in Africa. Patients and methods: Between 2002 and 2012, all the patients (military personal and local nationals) operated in the different FST deployed in the Ivory Coast were eligible and included in the study. The surgical activity was analyzed and broken down into surgical specialties, war wounds (WW), non war related trauma emergencies (NWTE), non trauma emergencies (NTE) and elective surgery (ES). Demographics (age, sex, status), the circumstances of healthcare management, the wounded organs, the type of surgical procedure as well as surgical specialties were described. Results: Over this period, surgeons operated on 2559 patients and realized 2816 surgical procedures. ES accounted for 71,7 % of the surgical activity, NTE 18,6 %, NWTE 8,3 %, WW 1,4 %. MSP represented 91,1 % of the global surgical activity. The visceral surgery represented 41,3 % of the activity, soft tissues 23,1 %, orthopedic 18,8 %, gynecology 8,5 %, urology 5,2 %, head and neck 2,8 %, thoracic 0,2 % and vascular surgery 0,1 %. Conclusion: Over ten years of deployment on the territory, 90 % of the French FST activity was dedicated to MSP covering a large range of surgical specialties for the benefit of the Ivorian people. MSP requires specific skills beyond the original surgical specialty of military surgeons to fulfill the needs of local populations.