When Conflict Closes the Operating Room: The Impact of War on Elective Surgeries

ABSTRACT Protracted conflict in Bukavu, South Kivu, DR Congo, has repeatedly disrupted elective surgical care, leaving patients with nonemergency conditions at high risk of morbidity, disability, and long‐term suffering. Drawing on local facility data and health system studies from eastern DRC, this perspective argues that elective surgery is not optional but essential to health equity in conflict settings. Despite 14.6% of surgical admissions in DRC being elective (even under MSF‑supported operations), elective case provisioning in Bukavu is severely constrained by systemic breakdowns, supply disruptions, workforce shortages, and poor data. Surgery postponement yields progressive morbidity: hernias become strangulated, fibroids induce chronic anemia, and delayed cholecystectomies escalate into emergency cholecystitis. Current humanitarian and national health responses focus on trauma, infectious disease, and obstetric emergencies, marginalizing elective care. To realign priorities, this paper recommends integrating elective surgical planning into crisis preparedness, strengthening local surgical workforce, operationalising mobile surgical teams, and capturing perioperative delay data to inform resource allocation. Restoring elective services in Bukavu operating rooms is both ethically imperative and clinically urgent.