title: Surgical support of Operation Sea Signal: adaptability of the 59th Air Transportable Hospital in Cuba.
abstract: OBJECTIVE
  The attempted migration of approximately 50,000 Cubans in the summer of 1994 created a large patient population detained at Guantanamo Bay, Cuba. This study examined the roles and results of the 59th Air Transportable Hospital (ATH) in treating surgical problems within that population during Operation Sea Signal.
  
  
  METHODS
  The surgical case log of the 59th ATH was used to identify all patients operated on at the 59th ATH during the interval of August 1994 to April 1995. These case records and the individual records of the three 59th ATH surgeons were used to determine the types of cases performed, complications, and outcomes.
  
  
  RESULTS
  A total of 333 operations were performed at the 59th ATH in three types of surgery: (1) elective (267); (2) emergency for nonself-inflicted conditions (46); and (3) emergency for self-inflicted conditions (20). The total perioperative complication rate was 2.4% (8/333), and the wound infection rate for clean surgical cases was 0.87% (2/229).
  
  
  CONCLUSIONS
  Elective surgery may be performed in a field environment with acceptable complication and wound infection rates. Humanitarian missions will be faced with considerable pathology from pre-existing conditions within the population cared for. The humanitarian mission may be complicated by political situations that may encourage malingering and self-injurious behavior within the population cared for. The latter events have not been previously encountered in humanitarian missions involving the U.S. military and must be considered by policy makers and mission planners in planning future humanitarian missions.
authors.affiliation: Department of Surgery, David Grant U.S. Air Force Medical Center, Travis Air Force Base, CA 94535, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Pelton
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Buehrer
authors.forename: David L
authors.initials: DL
authors.lastname: Cull
mesh_terms: D003462:Cuba; D004630:Emergencies; D006772:Hospitals, Military; D006775:Hospitals, Packaged; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D016728:Self-Injurious Behavior; D013503:Surgery Department, Hospital; D013530:Surgical Wound Infection / Q000453:epidemiology; D014171:Transients and Migrants; D014187:Transportation of Patients; D014481:United States