• J M Ryan, Matthew Fleggson, John Beavis, and Cara Macnab.
• Leonard Cheshire Centre of Conflict Recovery, Academic Division of Surgical Specialties, Royal Free and University College Medical School, 4 Taviton Street, London WC1H OBT, UK. james.ryan@ucl.ac.uk
• J R Soc Med. 2003 Feb 1; 96 (2): 565956-9.

AbstractAfter the 1988-1994 conflict between Armenia and Azerbaijan, fought over the territory of Nagorno-Karabakh, large numbers of people were resettled in camps in southern Azerbaijan. Healthcare in the camps was generally good but there was no access to hospitals. The Leonard Cheshire Centre of Conflict Recovery (LCC) organized a 'fast-track' system of surgical care in the southern camps by securing the help of still-functioning hospitals in the distant capital, Baku. Regular clinics were held in the camps for visiting specialists; and, by arrangement with the Government of Azerbaijan and various non-governmental organizations, treatment was offered to those who fell within strict selection criteria. After a pilot study yielded clear benefits, the scheme was transferred to a local non-governmental organization, which successfully operated an expanded version. The hidden cost of war often includes the neglect of chronic medical conditions that require secondary and tertiary care. The 'fast-track' system illustrates the potential of existing facilities to meet these needs at modest cost, given sufficient support.

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