title: Anesthesia Provision in Disasters and Armed Conflicts.
abstract: OBJECTIVE
  Disasters and armed conflicts are characterized by high numbers of trauma cases, and occur mainly in developing countries where the healthcare response is already impaired, resulting in an inadequate response. Aside of the trauma cases, other surgical health conditions are also still present and require urgent care. Surgical care needs are different from context to context and depend on local means and capabilities.
  
  
  RESULTS
  Doctors without Borders (MSF) has proven that even in precarious situations, safe administration of anesthesia is possible, and the "do no harm" principle can and must be upheld. Anesthesia providers need to recognize the difficulties linked to these contexts.
  
  
  CONCLUSIONS
  Local, spinal and general intravenous (mainly with Ketamine) anesthetics seem to be the most widely accepted. Inhalation anesthesia has constraints; regional is underused and epidural is not recommended. Standard operative procedures should be in place, and an informed consent from the patient must be granted.
authors.affiliation: Surgical Care Unit - Operational Centre Brussels, Médecins Sans Frontières - Doctors Without Borders, Rue de l'Arbre Bénit 46, 1050 Brussels, Belgium.
authors.forename: Miguel
authors.initials: M
authors.lastname: Trelles Centurion
authors.affiliation: Operational Research Unit - Operational Centre Brussels, Médecins Sans Frontières - Doctors Without Borders, Rue de l'Arbre Bénit 46, 1050 Brussels, Belgium.
authors.forename: Rafael
authors.initials: R
authors.lastname: Van Den Bergh
authors.affiliation: Emergency Unit - Operational Centre Brussels, Médecins Sans Frontières - Doctors Without Borders, Rue de l'Arbre Bénit 46, 1050 Brussels, Belgium.
authors.forename: Henry
authors.initials: H
authors.lastname: Gray
keywords: Anesthesia; Armed conflict; Disasters; Ketamine; Precarious settings; Surgery