2023 Global Health Engagement and Humanitarian Surgery Presentations

Rathnayaka M K D Gunasingha, MD1; Allyn Auslander, PhD2; Sarah Wright, MD1; Margaret Shields, BA3; Michaela Scanlon, BA, BS3; Tamara Worlton, MD1; Carolyn Gosztyla, MD1; 1Walter Reed National Military Medical Center; 2Operation Smile; 3Uniformed Services University of the Health Sciences

Objective: A major mission of the US Navy hospital ships is humanitarian assistance and disaster response. These missions are also intended to improve surgical preparedness for combat response. Over the last two decades, the United States Navy Ship (USNS) Comfort and Mercy have participated in recurrent missions such as Continuing Promise and Pacific Partnership. Non-governmental organizations (NGOs), such as Operation Smile, have been included in mission planning and execution to expand the resources of the hospital ship and provide additional opportunities for partnership that extend beyond military relationships. This study aims to characterize the role that Operation Smile has played in recent military global health engagements (GHE) and highlight the mutually beneficial role they can play as a mission partner.

Methods: Available surgical case logs from 2006 to 2019 USNS Mercy and Comfort missions and documentation from Operation Smile were reviewed. The program year, location, and volume of cases, especially for plastic surgery and oral and maxillofacial surgery (OMFS), were collected. Additional records were reviewed to characterize each organizations perceived benefits of this collaborative relationship for delivery of surgical care.

Results: Operation Smile participated in 2006-2010 and in 2015 USNS missions on the Mercy and Comfort and the USS Kearsage, an amphibious assault ship. Operation Smile completed 782 surgeries over 14 visits to partner countries on board the hospital ships. US Navy plastic and OMFS surgeons completed 634 surgeries over 44 visits to partner countries. In 2008 in the Philippines, Operation Smile added three times the number of patients the US Navy operated on. In 2008, the USS Kearsage carried out 2 Operation Smile programs and operated on 74 patients.

Conclusion: Operation Smile has increased operative case volume and may have improved military readiness for multiple disciplines on board the ship. The missions on the USS Kearsage improved forward surgical team (FST) readiness by providing additional exposure for complex airway management and perioperative care. This increased patient volume helps US Navy surgical and ancillary staff prepare for military support of combat and disaster related craniofacial trauma. Operation Smile's perceived benefits from this relationship include predictable resources and ancillary support as well as increased provider support, specifically for anesthesia, nursing, and pediatrics.