Friends of David Nott Foundation Conference - leaders of tomorrow
This month, we held our third Friends of David Nott Foundation (FDNF) conference, hosted this year by our FDNF at the University of Cambridge in the Clinical School of Medicine. This event brought together 45 dedicated FDNF members from universities across the UK, including Dundee, Leicester, Nottingham, Manchester, Glasgow,Cork, Bristol, and Cardiff, alongside international attendees from the Czech Republic.
Our Friends of David Nott Foundation societies are made up of medical students who wish to embark on a humanitarian career. By bringing them together for teaching and connection with our trainers, our goal is to nourish the next generation of humanitarian surgeons.
The conference featured four specialised workshops led by our faculty members, focusing on vascular surgery, orthopaedics, paediatrics, and general trauma. These sessions provided students with hands-on surgical experience and insights into the challenging yet rewarding field of humanitarian medicine.
Faculty trainer Dr Mahmoud Hariri, a surgeon who met our Co-Founder David Nott in underground hospitals in Syria, led our final lecture. He shared his experiences from Syria and the difficulties of being a surgeon under unimaginable pressure.
“One of the hospitals I worked in was in a cave in a mountain. There are many hospitals like this in Syria. Some are underground or in a gym. Most of our lives at that time (during the siege), were underground."
"Being a war surgeon is not a funny thing, it is difficult. I have experienced soldiers placing bets on what they could hit each day.” - Dr Mahmoud Hariri, faculty trainer
Our Co-Founder Elly Nott opened the event with an inspiring address, expressing her excitement for this annual gathering and highlighting the critical role it plays in fostering the next generation of humanitarian healthcare professionals.
"Our FDNF conference is a highlight of my year. It’s a joy to meet the next generation of humanitarians and see how enthusiastic they are to use their skills to make the world a better place.” Elly Nott, Co-Founder
Through our FDNFs, students contribute significantly to our work by raising awareness, fundraising for missions, and volunteering on our Hostile Environment Surgical Training (HEST) courses offered in the UK.
They are the future of this world, and now more than ever, we need people who want to help and make a difference.
This conference not only reinforced the commitment of current FDNFs but also inspired new additions to engage deeply our mission in helping to ensure safe surgical skills are available to all.
More on FDNF's
“If this training can work in Gaza, it can work anywhere else.”
Dr Israar Ul-Haq joined our HEST-UK (Hostile Environment Surgical Training-UK) course in Bolton to improve his trauma surgery skills before entering the heart of Palestine’s crisis – the Gaza Strip.
Dr Israar Ul-Haq is a doctor with a primary focus on urgent and pre-hospital care. Volunteering his expertise, Dr Ul-Haq joined two separate missions to Gaza, serving in Khan Younis and Deir al Balah.
“As I entered Gaza I felt a mix of emotions—eager to employ the skills I learned from HEST and help those in need, yet wary of the drones I can hear as soon as I entered.”
With minimal resources and an overwhelming patient load, ranging from 500 to 1000 individuals daily according to Dr Ul-Haq, the medical staff faced immense challenges. The injuries they treated ranged from blast injuries and crush wounds, to traumatic amputations and fatal head injuries, or gun shot and sniper wounds. Techniques learned during the HEST course, such as medical triage or procedures for getting access to the chest quickly, such as thoracotomies, were immediately put into action.
It impacted every aspect of my work in Gaza
Dr Ul-Haq shared: “The course impacted every aspect of my work in Gaza, such as understanding the local environment and the types of injuries we encountered. Whether it was performing chest drains, managing blast injuries, conducting debridement, or treating burns, the training equipped me with the necessary skills I needed.
The lectures on burns were very useful, they directly influenced our treatment protocols. Techniques like thoracotomy and bleeding control learned during the course became standard procedures in our daily practice. The emphasis on conducting primary and secondary surveys, along with fast scanning helped us to quickly assess and address critical issues in a high-pressure setting."
Patients that stay with us
“One patient's case is stuck in my head. He presented with a shrapnel injury to his back, which had penetrated his thorax. While we stabilised him initially, signs of Beck's triad (low blood pressure, distended neck veins, and distant or muffled heart sounds) alerted us to a possible cardiac tamponade (a serious condition where fluid builds up around the heart) - I had learned to identify this issue through fast scanning during the course. We rushed him to the operating theatre. Employing techniques like the clamp shell procedure, we successfully removed the bleeding around his heart, stabilising him.”
“We had a four-year-old brought into the hospital with a pneumothorax, severe head injuries, and burns. We immediately admitted the child to the ICU. We performed a chest drain to treat the pneumothorax and employing rapid sequence induction (a method to quickly administer anaesthesia and secure the airway) to stabilise the child's condition. We debrided the wounds at the back and used fluid therapy to manage shock and maintain stability.”
Our course is not just about building medical skills, it's about cultivating problem-solving abilities in the most challenging of circumstances. In environments where resources, staffing, and traumas are at their peak, the course empowers doctors to think laterally and use whatever limited resources they have. From using different pain management drugs to conducting fast scans to evaluate a patient's condition rapidly, every aspect of the training is geared towards equipping doctors with the tools they need to save lives, no matter where they are.
“Upon arrival, another patient had no bleeding or shrapnel injuries, but vitals would not stabilise. drawing on what we learned from the HEST course, we identified a left-sided pneumothorax. Despite initial stabilization efforts, the patient's vital signs remained unstable,” shared Dr Ul-Haq. “I often used the fast-scanning technique taught in the course. ; I detected an additional right-sided pneumothorax. Without hesitation, I proceeded to insert a chest tube, a procedure ingrained in our training. Had we delayed any longer, the outcome could have been disastrous.”
“Gaza is facing unimaginable suffering, and HEST was incredibly helpful there. If it can work in Gaza, it can work anywhere else too.”
READ MORE ABOUT OUR WORK FOR PALESTINE
The anaesthetist in a war zone
It takes a team to save a life in a war zone. Recognising the vital need for anaesthetists in conflict, we developed a bespoke anaesthesia course, to prepare anaesthetists for working in war hospitals. One of our experienced trainers, Dr Hussein Nagi, recently taught anaesthetists from Kuwait who are heading to Palestine.
Managing pain in different ways
“Treatment and anaesthesia do not end in the operative theatre. In a war zone, you could have a whole ward of people with post-operative pain, for example after amputations. Anaesthetists must do what they can with what they have to continue their care," shared Dr Nagi in Kuwait.
"A colleague once shared that a boy was screaming in the night with phantom limb pain after getting an amputation, he was shouting ‘my toe is hurting’. His toes were not there.
They found a stock of epidural kits in their hospital (for maternal care) and gave it to him through a catheter – the boy was almost pain free. You can resolve severe pain, by nerve blocking, with a range of drugs. You just need to be able to adapt to your environment.”
Our course teachers share tips and tricks just like this, with the goal of making anaesthetists adaptable to the challenges of a conflict-affected environment.
The science behind war
A trainee from Kuwait, during our latest HEST-A course in the Middle East, shared: “The trainers were combining their war experience with theoretical teaching, which added a lot to the course – showing us what to expect.
There were three main sessions that I learned the most from. Damage control, the ballistics science behind bullets and bombs, and the chemical weapons session. They’re not taught during medical training so knowing more about them, how to deal with these situations, understanding the science to then anticipate what we may meet in A and E, was the highlight of the course.”
Triage is critical
“It was an impressive course. The most interesting part for me was the triage, and making decisions using the information we have learned over years in studies, but applying it to a conflict zone.
"You have to adjust and accommodate to different situations, especially areas where you don’t have all the resources."
Gaza today urgently needs resources, food, water, equipment and man power. From what we hear from doctors on the ground, medical resources are much needed. It is very desperate.”
We have trained over 80 surgeons and anaesthetist in the UK and Kuwait who have, or intend to, volunteer their skills in Palestine's frontline hospitals. We will continue to upskill doctors in support of the people of Gaza.