The Role Of Neurosurgery In Global Health Integrating Mass Casuality Disaster Response

Disasters – both natural and man-made mass casualty events – result in hundreds of thousands of deaths each year. Despite programs such as the World Health Organization Emergency Medical Teams and the International Council of Nurses Core Competencies in Disaster Nursing and multi-institution graduate courses, basic medical/surgical care still does not reach a disaster site for days to a week or more, too late for those who need emergency care. We propose expanding the well-established trauma/stroke center model to address mass casualty disaster response. This model integrates all aspects of care: (1) temporally, from prevention programs to pre-hospital care to acute hospital care (surgical and intensive care) to rehabilitation; (2) interdisciplinary, from community health workers to emergency responders to hospital-based physicians and surgeons; (3) technologically, from resilient equipment to telemedicine to drones and robots to smartphone apps; and (4) socioeconomically, from public to private to military medical resources. An integrated network of mass casualty response centers affords economies of scale, coordination, and reduction of duplication that make cost-effective universal healthcare for both disasters and daily care a practical goal. The humanitarian response to mass casualty disasters can catalyze the integration of healthcare resources to improve not only disaster response but also day-to-day healthcare – essential to meet the healthcare-related United Nations Sustainable Development Goals for 2030.