Major trauma

This chapter provides essential management guidance for medical providers in low-resource environments when surgical services are not readily available. ‘Major trauma’ reviews management of a trauma patient, from initial assessment and medical management, to basic, yet lifesaving, surgical procedures.

Ear, nose, and throat

This chapter covers the essential background and clinical management of ear, nose, and throat conditions as seen in humanitarian settings. It provides essential guidance on disorders of the ear, nose, and throat, including congenital, infectious, neoplastic, or acquired conditions, with special attention to paediatric problems, and guides the reader through clinical diagnosis and management in low-resource humanitarian settings.

Obstetrics

This chapter provides the fundamental principles of care in obstetrics, taking into account important cultural considerations in humanitarian settings. The chapter lays out the general strategies to reduce maternal mortality and morbidity, and provides specific guidance for antenatal care, the medical management of the stages of labour, and postnatal care.

Gastrointestinal illness

This chapter gives an overview of the most important clinical presentations involving the gastrointestinal (GI) tract commonly seen in the field, including hepatitis, cirrhosis, peptic ulcer disease, and GI bleeding, from typical clinical presentation to specific diagnosis and treatment. Recognizing the challenges with diagnosis and management of such conditions in humanitarian settings, this chapter provides doctors who practise in low-resource settings with the guidance to implement more specialized GI medicine

Global impact of antimicrobial resistance

This chapter describes the worrisome trend of resistance development in antibacterial agents with exponential increases in resistance to the most effective classes of antibiotics. Described by the World Health Organization as a major global health security threat, the annual deaths from drug-resistant infection are projected to increase from 700,000 to 10 million by 2050. This chapter outlines the impact of antimicrobial resistance in humanitarian settings and provides practical approaches which can be used by organizations and health providers.

Tuberculosis and HIV in humanitarian contexts

This chapter outlines the fundamentals of tuberculosis (TB) and human immunodeficiency virus (HIV) as seen in humanitarian settings, including disease assessments, approach to diagnosis, treatment, and monitoring. It outlines the epidemiological background and interconnectivity of the two infections, the high burden of both diseases in many humanitarian settings, and the advantages of addressing TB and HIV in a coordinated manner. It provides detailed clinical management guidance including diagnosis, clinical management options, opportunistic infections, treatment monitoring, and prevention.

Neglected tropical diseases

This chapter on neglected tropical diseases (NTDs) provides an overview of the background and main contextual features of NTDs, and includes clear guidance on their clinical recognition and management. Recognizing the prevalence of NTDs in humanitarian settings, with their disproportional effect on the poor, this chapter covers the fundamentals of management of NTDs, and is especially helpful for the provider who may have little prior clinical experience with such conditions. It also includes detailed guidance on recognition and diagnosis of the main NTDs, such as dengue, human African trypanosomiasis, leishmaniasis, leprosy, and schistosomiasis, in settings with very limited diagnostic testing available.

Approach to clinical care in humanitarian contexts

This chapter on the approach to clinical care in humanitarian contexts outlines the fundamentals of providing care in humanitarian settings, including overall guidance on clinical care, key aspects of patient triage, and approaches for paediatrics. It providers important overarching considerations for readers, recognizing the realities and challenges in providing care in the field.

Ultrasound

This chapter outlines how clinical management decisions in humanitarian emergency situations can be greatly enhanced by the utilization of point-of-care ultrasound. The chapter recognizes the advancing technology of point-of care ultrasound and its use in humanitarian missions, and provides guidance on the essential components of clinical ultrasound (image acquisition, image interpretation, and clinical integration).

Laboratory

This chapter outlines how clinical management decisions in humanitarian emergency situations can be greatly enhanced by a well-functioning laboratory. It provides the fundamentals of diagnostic services, including quality assurance and specimen transport, and outlines the basic procedures for the most common tests.