The impact of asymmetric warfare on the methods of response by healthcare providers working in conflict: Approaching a new model of intervention

The emerging trends of asymmetric and urban warfare and their impact on the burden of disease and health needs in conflict affected areas are at the forefront of today's healthcare debate. Recent events have shown the greatest challenge to implementing emergency and trauma care intervention is the inadequacy in the health system in which it is set. Health systems and health care providers are often the first victims challenged by the blending of civilians and combatants and the rising need to provide and adjust treatment capacity for prolonged periods of time. This research aimed to address the need for a new model for the provision of life-saving emergency and trauma care services in the context of asymmetric warfare. Using consensus-based evidence, it identified two main components as foundation of the model. First, a conceptual 5-step framework to introduce the concept of the Trauma Stabilization Point (TSP) and support the decision to implement or not such services. Second, the application of the Haddon matrix to facilitate the understanding of the main strategies to adopt and the key activities to perform before, during and after the implementation of TSPs in conflict settings. Recognizing lack of empirical data on the benefit of such intervention, the two main components add a needed structure for future standardization, to the decision-making process, and to the identification and future dissemination of best practices. A very important step to support emergency and trauma care planning and implementation efforts for the benefit of populations in conflict.