Introduction An analysis was carried out of the operating theatre activity at the Role Three Multinational Integrated Medical Unit, located at Sipovo in Bosnia. The overall number of operative procedures, over a two-year period from January 2001 - December 2002, were studied. A total of 409 patients were treated and 443 operations were carried out. The patients ranged in age from 2 – 83 years.

Results 202 operations were performed in 2001 and 241 operations in 2002. Of the total operations, 349 (79%) were performed by the General Surgeon and 91 (21%) performed by the Orthopaedic Surgeon. The majority of patients treated were local civilians, who outnumbered military personnel, by a ratio of 3:1.

347 operations (78%) were of a non-emergency nature and 96 carried out as emergencies (22%). Of the 111 military patients operated on, 63 were from the UK, 25 were Dutch, 16 Canadian and the rest from other countries. The vast majority of orthopaedic procedures performed were of a minor nature, such as incision and drainage, wound debridement and tendon repair. The general surgical procedures consisted largely of elective surgery in the local civilian population.

During my deployment of three months, from November 2002 - January 2003, I carried out 11 operative procedures on 9 patients, 6 of these patients were civilian and 3 military. During the same period, 23 general surgical procedures were performed.

Conclusion My personal experience over 3 months and, a wider analysis over 2 years highlights, the gross under-utilisation of scarce and valuable resource. I feel that the deployment of a General Surgeon with trauma experience could very adequately provide combined surgical cover for the two specialities.