Medical Support for UN Peace Operations in High-Risk Environments

A UN plane arrives at the airport in Bamako with the bodies of two Chadian peacekeepers killed in an attack on a checkpoint of the United Nations Multidimensional Integrated Stabilization Mission in Mali (MINUSMA) in Tessalit, Mali, October 23, 2013. UN Photo/Marco Dormino)

The UN is increasingly deploying peacekeepers to conflict theaters where there is no political agreement and little or no peace to keep. Such high-risk environments make it harder for the UN to keep its personnel safe, fit, and healthy. While current UN missions have adopted a number of measures to mitigate these dangers, these do not address the systemic challenges facing medical support to UN peace operations.

This paper asks the question: What are the challenges to providing medical support to UN peace operations in high-risk environments? It analyzes five core challenges facing the UN: (1) medical structures, planning, and coordination in UN headquarters; (2) standards of care; (3) coordination in the field; (4) training and capacity building; and (5) resources and capabilities.

On the basis of these challenges, it offers recommendations for making medical support to peace operations in high-risk environments more efficient and effective:

  • The UN Medical Services Division and Medical Support Section should coordinate better and create links with the Office of Military Affairs.
  • Medical support planning should be included in every aspect of mission planning and be tailored to the context.
  • Missions should shift away from Level II hospitals, which are expensive and underutilized, instead exploring alternatives such as mobile medical units with surgical capabilities.
  • Missions should focus on in-mission training, including by improving mentoring of medical personnel.
  • MedEvac and CasEvac procedures should be simplified, decentralized, and made more flexible.
  • The UN should seek pledges of medical equipment and personnel from member states in a more targeted way.