Since the fall of the Assad regime in December 2024, Syria's borders have opened, and in April, our team of Faculty surgeons ran our first ever Hostile Environment Surgical Training in Aleppo.
Against a backdrop of destruction and severe shortages of even the most basic medical supplies, 24 surgeons travelled from Raqqa, Tartus, Idlib, Homs, Hama, Damascus and Al Suwayda to attend the course.
The surgeons – whose specialities included neuro, vascular, urology, orthopaedic, maxillofacial and general surgery - spent five days training with the Foundation’s Faculty members in the first HEST® training of this kind in Syria.
DNF partnered with Action for Humanity, UOSSM, the Syrian Ministry of Health and Aleppo University School of Medicine to run the course, which featured Heston® and other state of the art prosthetic training equipment. The training was delivered by our local Syrian Faculty in Arabic, and supported by UK Faculty leads Dr Ammar Darwish, Dr Pippa Letchworth, Dr Saladin Sawan and Dr Mahmoud Hariri.
Consultant Surgeons in Gynaecological Oncology Dr Pippa Letchworth and Dr Saladin Sawan ventured to Idlib during the HEST® course, where they spent 3 days and performed 10 operations on gynaecological cancer patients. The hospital was supported by SAMS.
Dr Sawan explained: "In addition to delivering this treatment to patients, we focused on enhancing knowledge decision making and surgical skill capabilities of doctors in Idlib with 4 consultants and about 13 residents."
Syrians have been through unimaginable hardship since the conflict began in 2011, and even since the fall of the regime, the situation has been dire.
Dr Mohammad Jazaely, a general surgeon from Damascus Hospital, Al-Mujthid, said: “The hardest experience I went through was on our liberation day on 8th December. There were many injuries, and we had to work with limited resources. In the span of 48 hours, we carried out around 40 laparotomies. Eventually, we ran out of resources. So, we had to make do with what we had.”
For Dr Jazaely, his commitment is unhindered despite the incredibly difficult conditions.
“I love working here, because at the end of the day, this is my country, and these are my people. For this reason, I must give everything I can, and I stayed here in the country."
Hospitals are dilapidated, dirty and crowded, with constant power cuts. There are very few anaesthetists in the country and there is a shortage of all surgical specialisms. Health care workers are exhausted, and morale is low. But Dr Jazaely explained the impact of the course.
"This is the first time we've had this kind of training in Syria, honestly. They're very high-level trainings. The reason is that the trainers are specialists in this field. They've worked hands-on in war zones across different regions."
Medical professionals are also facing a huge number of injuries as a result of landmines. Dr Mohammed Al-Sednawi, General Surgeon from Damascus said: “The most difficult situation we were working on was the landmine injury, because it affects a lot of civilian people, who weren’t involved in the war. So, they come to the emergency sector and they go to the operating room, where there were no resources, such as sutures, and a lot of decrease of resources and suction tubes — a lot of suffering in our operating room.”
Dr Abu Mohammadain, a urologist from Aleppo, worked with our Co-Founder David Nott over a decade ago when they worked together during his first visit to Syria in 2013, and again in 2014. "It was truly a major opportunity for us as surgeons. We didn’t have much experience with war injuries, disaster injuries, or trauma cases. And, thanks to God, the results of that direct engagement with Dr David were outstanding. It helped us save lives, improve patients' outcomes, and reduce disabilities caused by war injuries."
During this time, our Co-Founder was working alongside our Faculty member, Dr Mahmoud Hariri in Aleppo hospitals, risking their lives to save others. It was a seminal moment for him to run this course.
Dr Hariri said:
“This is a historical moment. This is the first course run in Aleppo. This is the first course that has been done for them - the first time seeing such type of demonstration, simulation, practical course rather than just theoretical information. I believe that such course should be run many times, until feeling that most of the surgeons have some experience in trauma cases in this country.”
Our Medical Director, Dr Ammar Darwish, was invited to join the panel on Humanitarian Surgery at the ASGBI (Association of Surgeons of Great Britain and Ireland) Annual Congress, and to lead two half-day training sessions as part of the Pre-Congress Training Village.
Ammar delivered training to 30 participants over the two courses, who were able to learn more about how to deal with major trauma, both blunt and penetrating injuries, that are common in patients on the frontline.
These two training sessions focused on Cardiothoracic and Abdominal Trauma, and mirror closely what we teach in our HEST® course, through a lecture, presentation of real-life cases seen by our faculty and an opportunity to get hands-on practical experience making use of the prosthetic organs and Heston® to build skills, knowledge, confidence and proficiency.
These types of training sessions allow doctors in training to gain some insight into the world of humanitarian surgery and continues to shine a light on the training needs of those doctors living and working on the frontline.
I was training surgeons on chest trauma and abdominal trauma and I gave a talk about training surgeons in conflict zones and the work of the DNF which had a huge positive impact on the audience who where surgeons and trainees from the UK and overseas.
Betty Boothroyd Scholarship Award
The 2025 Betty Boothroyd Scholarship has been awarded to Dr Munzer Al Khalil, among the most renowned and respected health system leaders from Syria. Dr Al Khalil founded the Idlib Health Directorate and Alamal Hospital for Orthopaedic Surgery in 2013 and conducts research on improving health systems and governance and aid effectiveness in conflict-affected and fragile areas.
Together with DNF Senior Adviser and Co-Founder Elly Nott, Dr Al Khalil is establishing DNF Research which will publish cutting-edge insights from health systems in the MENA region, with an initial emphasis on Syria.There are many lessons to be drawn from the humanitarian and development responses, both local and international, to the conflict in Syria.
With Dr Al Khalil’s unparalleled knowledge and the Foundation’s extensive experience in the country, DNF Research will publish blogs, commentaries and original research in peer-reviewed journals to advance understanding of health and conflict dynamics and provide lessons for other fragile states.Baroness Betty Boothroyd OM was the Founding Patron of the David Nott Foundation.
Passionate about our mission and particularly engaged by our response to the humanitarian crisis in Syria, her impact continues through her generous legacy to the Foundation and scholarship which bears her name.
We’re often moved by messages from readers of War Doctor – David’s written account of over 25 years of volunteering surgical skills on the frontline. But sometimes, a story comes along that reminds us exactly why we do what we do, and resonates so deeply that it feels important to share.
Anastasiia, our inspiring Ukrainian supporter, shares how War Doctor changed her perspective on conflict, deepened her empathy for others, and helped her find purpose in uncertainty.
"This book… I don’t know, it’s something special, something that came into my hands at the right time and in the right place. I’ve read many books in my life, and I’ve never been interested in surgery or war stories. But when war came to my home, and I had to leave everything I was used to and everything I held dear, I finally decided to read this book – one that had come to me long ago and quite by accident. I just bought it in a supermarket in Ukraine when my mom and I were planning to attend a first aid course at the very beginning of the war. I had no idea what this book was really about.
At first, it was hard to read because I’m quite a sensitive person, and reading about injuries or surgeries was difficult – I’d start to physically feel pain. A neighbour even joked that sometimes my face looked like it had “subtitles” for the book – “Caution: I’m in shock.” It probably took a month before I could really get into it – I just couldn’t read it sometimes, even though I was curious.
Then one day, I got stuck at an airport for 12 hours after my last visit to my family, and knowing I had no way out, I opened the book I had brought with me – and it suddenly became so engaging and easy to read that I read almost half of it that night.
That’s how my journey with David Nott’s story began. Everything – from his bravery, dedication, and honesty, to the incredible resilience of his wife – deeply moved me.
When I got temporary shelter in Austria, I found myself surrounded by many other refugees, including Syrians. We’re learning the language together now, and before this, I knew nothing about their history or the horrors they had lived through. When we were all sharing our stories, some of them said they walked here on foot – and I was shocked. After reading this book, I began learning about many other armed conflicts I had only ever vaguely heard of, reduced to the phrase “there’s a war going on somewhere over there” – and that was it. I couldn’t empathize, and I couldn’t help.
When I finished the book, I sat in silence for a while, just thinking that I also want to be useful to people who’ve gone through things like this. I have to admit, I’ve faced many challenges in Austria. One of the hardest is that people don’t understand and don’t even want to try to understand that I’m here not because this was the dream of my life, but because circumstances forced me. I wasn’t prepared for this, and that’s why I don’t speak German. A lack of knowledge and an unwillingness to know what others have been through makes us cruel – and that’s what happened to many people here. Even though I’ve been living here for over a year, I still sometimes cry out of frustration, because my home and the future I wanted – a peaceful youth, my dreams – were stolen from me.
But before this, looking at my Syrian classmates, I too was cruel in my own ignorance. I didn’t want to know their stories, and I wasn’t interested – even though I myself had lived through war, and should have had more compassion for others who had suffered the same.
In the end, I just want to say this book gave me hope – both in my personal situation and, together with everything I’ve been through.
"War Doctor made me realise that no matter what happens, even one person, if they have good intentions and a strong will, can change the world."
Stories of people like Martin Luther King and Mahatma Gandhi always felt distant – in far-off places with different rules and ways of life. But this story felt like it was here, close to my heart in every way.
This is how this book turned my world and my detached way of living into a desire to be part of those who live to help others. I’m still looking for the field where I can do that – but I know for sure that I don’t want to stand aside anymore."
"The book opened my eyes, heart and became a direction – helped me make a choice in life. It shaped what I want to do and how to relate to the horrors around me.”
David’s Book War Doctor is available below.