The Observer: In Aleppo’s destroyed hospitals the dead lie with the living
David writes for The Observer
I don’t think that in all my years of doing this I’ve ever seen such dreadful pictures of injuries, of people lying on the floor of an emergency room, the dead mixed with the living.
One colleague, who I speak to all the time, was in despair, sending me all these photographs, and saying: “David, you have to do something to help us.” But what can I do?
The message out of eastern Aleppo is that there are no hospitals functioning at all. They have all been repeatedly attacked in the past few days. Some were able to evacuate, but one was totally and utterly destroyed by rockets and bombs. I heard that two doctors were killed and 16 other staff injured and I am afraid that one of the dead may be a brilliant surgeon, who would be a particularly serious loss.
There is another hospital that we haven’t even had a message from. So, I suspect they are out of action, but we know nothing about the staff or the conditions there.
The Aleppo hospitals have been re-opened so many times, underground or at new locations, but between the bombing and the siege I don’t know if it will be possible to resurrect them this time. There is so much equipment that you need in order to operate and there is no sterilisation and no monitoring machines for anaesthetics. Even if the hospitals saved some machines they can’t run them because the generators have been destroyed or are out of fuel.
The taking out of every hospital and medical facility that gives hope and help to civilians is not a coincidence. The medics have such fantastic morale that you would not imagine them giving up, but I have an awful suspicion that this is the endgame.
Read the full article here.
Skype Blog: The first ever known surgery over Skype with Dr. David Nott
Skype was developed in 2003 to help people stay together, no matter where in the world they happen to be. Since launch, we’ve discovered many weird, wonderful and original ways that people use video calling. From pet sitting to interior design. From working out to personal stylist advice—people really do use Skype in the most creative ways.
Recently, we came across the The David Nott Foundation, a UK-based charity which gives surgeons and medical professionals the skills they need to provide relief and assistance in conflict and natural disaster zones around the world.
Founded by Dr. David Nott and his wife Elly, The David Nott Foundation’s main focus is to improve the standards and practice of humanitarian surgery in conflict and catastrophe areas around the world. Both are passionate about helping those less fortunate than themselves and their efforts in treating victims in areas of catastrophe goes from strength to strength. We caught up with Dr. Nott, “the Indiana Jones of Surgery”, and found out how Skype features in their mission to help surgeons develop their skills for warzones—and how he and his wife started volunteering their time:
“I started in Sarajevo in 1993. I watched a film called The Killing Fields with my Dad and I had a fascination about different places and helping people. The film was about a friendship between a journalist and a local interpreter in Cambodia during the civil war but essentially about people helping each other. And then something sparked in my head, that I’d like to do something like that myself. When I became a consultant, the first thing I did was to volunteer my services to Médecins Sans Frontières in Sarajevo. I should have only stayed for a couple of weeks but I ended up staying for three months.”
Dr. Nott tells us how technology and Skype came into the picture. “In 2007, I believe I was the first person ever to receive details of how to perform surgery via text messages in the Congo. This was when a friend of mine texted me the procedure of how to take off somebody’s shoulder and arm. This was in the Congo, in the middle of a jungle, without any help or anything!”
And then after surgery by text message, came the first ever known surgery performed over a Skype video call.
Surgeons in Aleppo sent me a picture of a man whose jaw had been blown off by a fragment in a bomb blast. They asked me what they thought they could do. I took the pictures around to several of my colleagues to get their opinions on what they thought was the right thing to do to fix it. The doctors in Aleppo had never done this sort of operation; they’d never mobilized a myocutaneous flap (which is a muscle and tissue flap that rotates into the neck). They’d never mobilized a muscle before either, so that’s where Skype came in. They had a phone attached to a selfie stick so I could view everything. The operation started at about 8 in the morning and went on until 4 in the afternoon. It was very complicated but it worked 100%. Using Skype was fantastic because it allowed me to see what they were doing in real time. I was telling them which bit to cut, which bit not to cut—I directed them all the way through, from the moment they picked up the knife to the moment they put in the stitches.”
Read the full article here.
Philanthropy Age: ‘You carry on because you’re saving somebody else’s life’
British surgeon David Nott has spent two decades operating on thousands of people in war zones, making life and death decisions under fire. Now he hopes to pass his hard-earned skills on to a small army of frontline volunteers
There’s a simple reason why I keep going back: I feel sorry for those who are caught up in conflict. Everyone needs access to healthcare, and I try to be the person to provide it. I first volunteered in the besieged city of Sarajevo, Bosnia, in 1993 after seeing TV coverage of the conflict. What happened to me there changed my life. I’ve worked in conflict and catastrophe zones ever since: from Liberia and Darfur, to Haiti, Syria and Yemen.
In places wracked by war or natural disaster, there are few surgical provisions. There are limited blood supplies, few drugs and no diagnostic aids to speak of, so you rely on your medical skill. Yet, in war, most of the senior surgeons will have fled and it is the junior medics who are left behind. They may know basic surgical techniques, but they are faced with the most difficult wounds imaginable, from gunshots, snipers, IEDs and mines.
I take part in up to three missions a year with organisations such as Syria Relief, Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC). I go for three weeks at most if it is a really hot war zone; six weeks if the frontline is further away. If there are no casualties from the night before, my day starts around 7am, with a security briefing at 7.30am. I take an hour to visit patients and from 9am there are either new patients to see in the clinic or, if there are casualties in the emergency room, I begin operating. I can be doing that all day and sometimes all night. At my longest stretch, I operated for 22 hours. You forget the time, although you’re absolutely worn out. You carry on because you’re saving somebody else’s life – and then somebody else and somebody else. You sleep where and when you can.
In quieter periods, I teach. In Syria, for example, there are lots of junior surgeons who are not particularly well trained. They accompany me in the operating room and we do the surgery together. I show them first, and then they pick up the knife, scissors and forceps. Speed and accuracy are very important. I teach techniques to limit blood loss, and quick procedures. You get very engrossed in surgery – even though you are in a war zone, your mind is utterly focused on the job at hand.
Read the full article here.
David Nott receives Special Recognition at Pride of Britain Awards 2016
Every year for the past 23 years, David has taken several months’ unpaid leave from his NHS job in London to work as a volunteer for aid agencies including Médecins Sans Frontières, the Red Cross and Syria Relief.
The world’s most experienced conflict surgeon has operated with makeshift instruments, by torchlight and in constant fear for his own life.
He refused to stop operating when IS fanatics burst into his theatre in Syria and even when ordered to leave a hospital in the Gaza Strip which was due to be targeted by an air strike.
David, 59, recalls: “Everyone was leaving. But I knew I couldn’t possibly leave this little girl alone. I said to the Red Cross anaesthetist with me, ‘Do you want to go?’ He said, ‘No, I’ll stay with you’. So we stayed together, both believing that all three of us would die.
“But I carried on with the operation and as the minutes ticked by, I tried not to panic.
“I was expecting the worst, but I kept on operating.
“We were supposed to be blown up, and I was thinking, ‘If it happens, I’ve done a lot with my life really’.
“If our time was up, I just wanted to be there to hold the little girl’s hand.”
He has carried out lifesaving operations on victims of conflict and catastrophe in countries ranging from Bosnia and Afghanistan to Liberia, Haiti, the Central African Republic, Gaza and Nepal.
In Aleppo in Syria, he worked in a makeshift hospital saving lives as barrel bombs rained down.
The carnage affected him more than any other conflict, and it took him months to readjust after returning home from the visits.
“It’s such a tragedy I can’t find the words,” David says.
His humanitarian work began in 1993. He flew to Bosnia after seeing the conflict on the news.
“I’d seen a man on TV crying as he searched for his daughter among the rubble after a bomb blast in Sarajevo,” David says. “I made a snap decision. I was overwhelmed by the necessity to help.”
The married father of one was awarded the OBE in 2012 for his work in war zones, which he fits in around surgical roles at three London hospitals.
He is also a qualified pilot and has served with the Royal Auxiliary Air Force as a volunteer surgeon, holding the rank of wing commander.
David has also raised hundreds of thousands of pounds for charitable causes and has set up the David Nott Foundation, a charity training surgeons to carry on his work in war zones and natural disaster areas. “It’s the legacy I am trying to leave,” he says. “To be a war surgeon is a fine art, knowing the right thing to do for a patient with what’s available. If you do too much, that patient will die as surely as if you do too little.”
David’s dedication to saving lives is simply extraordinary. We are all horrified by the humanitarian disaster in Syria, but he has risked his own life to make a difference there. His reserves of compassion and courage are boundless.PRIDE OF BRITAIN JUDGES
Read more here.