title: A literature review of medical aspects of post-cold war UN peacekeeping operations: trends, lessons learnt, courses of action and recommendations.
abstract: OBJECTIVE
  Post-Cold War United Nations Peace Keeping Operations (UN PKOs) have been increasingly involved in dangerous areas with ill-defined boundaries, harsh and remote geographies, simmering internecine armed conflict and disregard on the part of some local parties for peacekeepers' security and role. In the interest of 'force protection' and optimising operations, a key component of UN PKOs is healthcare and medical treatment. The expectation is that UN PKO medical support will conform to the general intent and structure of UN PKOs. To do so requires effective policies and planning informed by a review of medical aspects crucial to UN PKOs. The intent of this article is to report on a review of principal medical aspects practical to post-Cold War UN PKOs.
  
  
  METHODS
  This review was assembled through a comprehensive, grounded, systematic iterative inquiry of open-source articles.
  
  
  RESULTS
  This inquiry revealed that the principal medical aspects in post-Cold War UN missions were the following: (1) the changed nature of UN PKOs, (2) new challenges in terms of proximity and distance to medical care, (3) expanded need for preventive medicine and disease contagion prevention and (4) increased propensity for psychological morbidity and need for intervention.
  
  
  CONCLUSIONS
  Post Cold War, the dramatically changed nature of UN PKOs has resulted in new challenges mainly in terms of medical logistics, preventive medicine and psychiatry. The changed nature of post-Cold War UN PKOs altered the character of medical support most notably regarding (1) a need for emphasis on immediate response proximate to medical events and rapid transport over long distances and traversing barriers to higher levels of care, (2) proactive contagion and hazard identification and prevention and (3) interventions designed to reduce psychological morbidity. Recommendations are offered about possible courses of action in terms of addressing trends found in identified medical aspects of PKOs.
authors.forename: Ralph Jay
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D006285:Health Planning; D006297:Health Services Accessibility; D006801:Humans; D007391:International Cooperation; D001523:Mental Disorders / Q000628:therapy; D008887:Military Medicine / Q000639:trends*; D008889:Military Personnel; D011315:Preventive Medicine / Q000379:methods; D014480:United Nations
keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT