Trauma care in Morocco: Observations and opportunities from an American Association for the Surgery of Trauma (AAST) delegation visit

Authors

• Kristy Lynn Hawley, University of Colorado School of Medicine, Aurora, Colorado, USA.
• Mary E. Fallat, School of Medicine, University of Louisville, Louisville, Kentucky, USA.
• Stephanie Bonne, Advocate Health - MidwestFollow
• Katherine Kelley, Kelley Acute Care Surgery, Philadelphia, USA.
• Ajai K. Malhotra, The University of Vermont, Burlington, Vermont, USA.
• Amy Murphy, TriHealth, Cincinnati, Ohio, USA.
• Michelle Papathanas, TriHealth, Cincinnati, Ohio, USA.
• Anne Rizzo, The Guthrie Clinic, Sayre, Pennsylvania, USA.
• David H. Livingston, University of Colorado School of Medicine, Aurora, Colorado, USA.

Recommended Citation

Hawley KL, Fallat ME, Bonne S, et al. Trauma care in Morocco: observations and opportunities from an American Association for the Surgery of Trauma (AAST) delegation visit. Trauma Surg Acute Care Open. 2026;11(2):e002219. Published 2026 Jun 9. doi:10.1136/tsaco-2025-002219

Abstract

Purpose: Trauma is a leading cause of morbidity and mortality in the Kingdom of Morocco, where rapid socioeconomic development and the 2023 Al Haouz earthquake intensified demands on the health system. The American Association for the Surgery of Trauma was invited to visit the country to assess trauma care capacity and identify opportunities for system strengthening.

Methods: A multidisciplinary delegation visited Morocco in November 2024. Meetings were held with the Ministry of Health in Rabat, and the delegation visited the Université Mohammed V de Rabat, Al Ghassani Hospital in Fes, and Mohammed VI University Hospital in Marrakech. Site visits and structured discussions with clinicians, administrators, and policymakers occurred. Findings were organized using a trauma prevention framework.

Results: Primary prevention challenges included road traffic injuries as the leading cause of injury death, inequities between urban and rural populations, and cultural barriers to blood and organ donation. Secondary prevention gaps centered on prehospital care, which is minimally equipped and relies on the French SAMU model of providing medical care in the field ("stay-and-play" model), fragmented trauma governance without a national authority, variation in hospital infrastructure, and absence of a trauma registry. Tertiary prevention weaknesses included workforce shortages, limited trauma-specific education, scarce rehabilitation and mental health services, and insufficient pediatric capacity. The 2023 earthquake highlighted both resilience-through central coordination and rapid mobilization of care to an exceedingly rural site-and a valuable opportunity to build on this foundation by formalizing a national trauma system response to enhance consistency and equity of care delivery.

Conclusions: Morocco is at a pivotal moment in trauma system development. Addressing challenges across prevention levels offers opportunities to reduce preventable mortality and disability, improve equity, and strengthen preparedness. Lessons learned may inform national policy and provide insights for other low- and middle-income countries.

Document Type

Editorial

PubMed ID

42299323