Qualitative perspectives (on incoming medical teams during conflict) from surgeons in the Middle East and North Africa

Marks, Isobel H, Kanya, Lucy, Singh, Darshita, Saleh, Raoof, Friebel, Rocco and Hargest, Rachel ORCID: https://orcid.org/0000-0001-9830-3832 2025. Qualitative perspectives (on incoming medical teams during conflict) from surgeons in the Middle East and North Africa. British Journal of Surgery 112 (Supple) , xv35-xv40. 10.1093/bjs/znaf209

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Abstract

Background The international community has, for many years, offered support and medical services at times of conflict, crisis, or disaster, but their ability to do so effectively has come under increasing scrutiny in recent years. The aim of this study was to examine the perceptions of local surgeons to incoming medical teams and international non-governmental organizations (iNGOs) during times of conflict. Non-resident diaspora surgeons who returned during conflict were analysed as a subgroup. Methods A cross-sectional study using qualitative methods was performed. Study participants were in-country-based medically qualified personnel performing surgery during conflicts in the Middle East and North Africa, who had worked in these settings before the onset or escalation of conflict. Participants were identified through a pre-interview questionnaire distributed via the Royal College of Surgeons of England and other targeted networks. A structured guide was used to conduct in-depth interviews with 21 surgeons from eight countries and a thematic analysis was undertaken. Results Local surgeons generally had positive working relationships with incoming medical teams, but not universally. Some experienced frustration with inexperienced incoming surgeons and others were limited in interaction due to the nature of the conflict. A need for coordination, timely intervention, and less ‘playing the hero’ was noted in relation to iNGOs. Diaspora surgeons often played a significant role in supporting local surgeons clinically and via equipment procurement and training. Conclusion Incoming medical teams travelling to conflict areas should be experts in their field and work collaboratively with local surgeons. Increased communication and collaboration between iNGOs and local surgeons is necessary to reduce duplication of effort and improve services.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: https://academic.oup.com/pages/standard-publication-reuse-rights, Start Date: 2025-12-01
Publisher:	Oxford University Press
ISSN:	0007-1323
Date of Acceptance:	2 September 2025
Last Modified:	22 Dec 2025 13:00
URI:	https://orca.cardiff.ac.uk/id/eprint/183416

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