Military health outreach on Exercise ASKARI SERPENT: a discussion of clinical and ethical challenges.

Exercise ASKARI SERPENT (Ex AS) is an annual British Army medical exercise that sees the deployment of a medical regiment to rural Kenya. The exercise involves the delivery of health outreach clinics and health education to the civilian population alongside Kenyan governmental and non-governmental organisations. This article includes a post hoc analysis of the ethical and clinical challenges that clinicians faced during Ex AS, applying a four-quadrant approach to ethical decision-making. This article intends to stimulate further debate and discussion on how to best prepare clinicians for clinical challenges and ethical decision-making on future exercises and operations. We conclude that our experiences on Ex AS can provide an insight on how to develop predeployment training for clinicians. Furthermore, the universal nature of the challenges faced on Ex AS can be applied to training for future contingency operations.