Another successful STAE course
This month, we were honoured to train 14 doctors from Afghanistan, Syria, Palestine and Ethiopia on our latest Surgical Training for Austere Environments (STAE) course. Over five days, the group participated in bespoke surgical workshops, specifically designed for treating traumatic – and often unique – injuries caused by war and catastrophe.
Starting the week off in Brighton and Sussex Medical School, the participants practiced an extensive range of cardiothoracic procedures, such as fast and efficient thoracotomies (gaining access to the chest), heart repairs and how best to manage injuries to the lungs.
Aided by videos taken by our Co-Founder, David Nott, during overseas missions, the group also learned how to repair blood vessels – a vital skill for managing severe blood loss.
Equipped for every emergency
As the week progressed, every doctor was exposed to a different but equally vital field of medicine, from plastic surgery to orthopaedic trauma. This is key, as we know war and catastrophe can present patients with often varied and complex injuries.
In conflict for example, it is not uncommon for junior doctors to be the only healthcare workers left in hospitals. This means they need to step into a number of roles, from cardiothoracic surgeon one day to paediatric specialist the next.
New obstetric simulators
On the last day of training, the participants completed a range of obstetrics workshops in the beautiful new facilities of the Royal College of Obstetricians and Gynaecologists in London. Using our new simulators (pictured below), the group refined their C-section techniques and learned how to address emergency scenarios, such as breech births or neonatal resuscitation.
Listening and learning
We were honoured to be joined by doctors from Palestine, Syria, Afghanistan and Ethiopia, and each country is recovering from - or still facing – conflict. To ensure we continue to deliver the highest quality training and meet the needs of our doctors, we listen to participants’ experiences of their home countries.
Dr Naseebah Nayef left Syria in 2013. She shared with us: “(During the war) I treated Syrian protestors in my private practice. Post-that, my house was bombed, and I had to flee with my three children from Syria. I am so very, very grateful for being a part of this course.”
Merry Christmas from our Chief Executive
The end of the year provides us with a moment to reflect on what has passed and think about the future. It has been a year of many challenges and difficulties, but I am so grateful for the incredible ongoing support we have been so honoured to receive from you all.
I have found joy this year in the time I have spent with the doctors we have had the privilege to train on our courses. Speaking with doctors from Mosul, Iraq, on our HEST in November and from Ethiopia, Palestine, Afghanistan and Syria on our latest STAE course; they provide such inspiration to us as a team.
Thanks to your generosity, we have a full programme of training planned for 2022 and cannot wait to get started. It is our ambition to run six Hostile Environment Surgical Training (HEST) courses and re-start our Obstetric and Neonatal Care specialist courses. We will have two more cohorts of scholars on our scholarship programme and continue to deepen and strengthen the relationships we have built with healthcare workers and partner organisations over the previous six years.
To our DNF community, we wish you a very Happy Christmas and New Year. We truly couldn’t do what we do without you.
Meet war doctor trainer, Dr Una Walsh
Dr Una Walsh, General Surgeon and Major Trauma Fellow at St Mary’s Hospital London, is the newest member of our faculty. Here, Dr Walsh shares her experience of our latest course in Iraq, where she was responsible for teaching abdominal and paediatric trauma.
Joining the Foundation
I first met Professor Nott in 2016, when I worked as his Registrar at Chelsea and Westminster Hospital. Since then, I am privileged to call him my mentor. It quickly became very clear to me that our thoughts were aligned on global health and inequalities, and I was keen to get involved and help in whatever way I could.
I was quite junior at the time - a 3rd year Registrar - but I knew if I continued my training, stuck with it and pushed hard, I could use the skills and operative knowledge I gained to join the Foundation and further their aims abroad.
This required a considered rethink on my career path and after discussion with Professor Nott and deanery tutors, I made the decision to switch training from breast to colorectal surgery and create a path towards emergency and trauma surgery. This also laid the groundwork for a humanitarian-focused career. I have since completed general surgery training, joined the Foundation’s faculty and currently work as a Major Trauma Fellow alongside Professor Nott at St Mary’s Hospital London.
A pull to help those in need
My first experience of humanitarian work was with Sir Magdi Yacoub’s charity, Chain of Hope, based at the Brompton in London. Through a chain of volunteer surgeons and medical doctors, Chain of Hope identifies children with congenital heart disease in urgent need of surgery not available in their own country and arranges transfer to centres in high-income countries that sponsor their surgery. They also have an active training programme, whereby teams fly out to operate or train local teams across the developing world. My role is to travel to low- and middle-income countries and provide aeromedical escort for children to sponsor centres for life saving heart surgery.
On behalf of the charity, I have retrieved children from Zambia, Haiti, Sierra Leone, and the Ivory Coast. This work is extremely rewarding working with a fantastic charity, plus I have a very lovely collage of pictures of the children I have helped, recovered after surgery. This work has also given me a wealth of experience in mission planning and the nuances of humanitarian work including navigating many and varied world airports with understandably terrified mothers and often babies in tow.
Whilst, heart-warming work it feels like a very small drop in the ocean - that's what drew me towards global health as an entity. The ability to help more than just single individuals.
At the David Nott Foundation, if you train one surgeon, the knowledge is shared with many more in local communities helping hundreds - that ethos resonates really strongly with me.
Cutting-edge teaching technologies
The latest HEST course in Erbil, Iraq, was my first course as a Faculty Trainer. It was a really lovely introduction to working with the Foundation. I led the abdominal and paediatric sections of the course. This involved both lectures and skills training.
All the training equipment, funded by our supporters, is superb. We were able to provide near-to-life simulated training through the use of purpose-made and anatomically correct tissue, including bowel arteries and veins, hearts, kidneys, windpipes and even skulls. The hearts and kidneys were my particular favourites, truly amazing and life-like.
Then Heston – the anatomical model! It’s just the cherry on top. You can demonstrate the exact movements you’d make in surgery. For example, how to mobilise the colon to get to the kidney, or more importantly the major vessels which can often represent the most challenging of traumatic injuries.
Heston also has little magnetic buttons that keep the organs in the correct anatomical positions, which allows you to simulate exactly how you would move and access body parts. It’s a tremendously clever part of his design.
Humbling stories
Most of the surgeons I trained came from Mosul, so many had experiences of the war to liberate their city from Islamic state (IS) invasion.
I admired so much the strength and courage they showed - and listening to their stories was humbling.
When Dr Troller (another faculty member) was teaching a procedure called a resuscitative thoracotomy, one of the surgeons commented during the war that they'd done ten - and only one survived. This could be down to the catastrophic injuries caused by war, making procedures like this even more challenging.
After completing the course, they were equipped with helpful strategies, giving them confidence that future outcomes will be different for patients. This is the real-world value of this innovative course.
They were a very talented, welcoming and hard-working group of individuals and I’m really looking forward to training many more like them.