Strengthening global surgical capacity through HEST-UK training
Building on the success of our partnership with the Royal College of Surgeons of Edinburgh (RCSEd) in June, where 24 surgeons were equipped with vital skills to save lives and limbs in conflict zones, we joined forces again this December to train an additional 23 surgeons. Our trauma surgery training in the UK (HEST-UK) aligns with RCSEd's broader mission to support global healthcare by equipping professionals to address healthcare needs in low-resource or conflict-affected areas.
Designed for medical professionals working in, or preparing to travel to, conflict and disaster zones, our HEST-UK course brought together participants from around the world. Surgeons traveled from as far as Hong Kong, New Zealand, Australia, Ukraine, and the USA to take part in this transformative week of intensive training.
The course provides comprehensive training in surgical techniques for managing injuries frequently encountered in conflict zones, such as blast and shrapnel wounds, with a dedicated focus on Obstetrics and Gynaecology during the final day. Regardless of their specialty, surgeons gain the skills needed to handle complex trauma cases and significantly improve patient outcomes.
This immersive training integrates real-life trauma case presentations from conflict zones like Syria, teaching models designed specifically for our programmes, and hands-on practice using human cadavers, delivering an unparalleled learning experience.
A Global Effort
The David Nott Foundation and the Royal College of Surgeons of Edinburgh are charitable organisations, and our work is made possible by the generous support of donors and sponsors. We are deeply grateful to The Russell Trust, Essity, BBRAUN, Stryker, and BMA Giving for their invaluable provision of equipment and consumables, which enabled us to deliver this course.
BMA Giving generously granted £10,000 to cover the costs of specimens and equipment for this training. Given the nature of this project, there was significant interest from individuals working with NGOs and other non-profit organizations, where high course fees often present a barrier to accessing training. Thanks to the support of BMA Giving, we were able to reduce fees, ensuring the course was more accessible to a broader range of participants.
Empowering Ukrainian Surgeons to Save Lives
As part of our 2024 localisation efforts in Ukraine, we sponsored three Ukrainian doctors who had previously completed our trauma training courses to attend our Hostile Environment Surgical Training (HEST-UK). This advanced training provided a unique opportunity for them to refine their skills further by practicing on cadavers. They also received dedicated mentorship from our expert faculty, including David Nott, who shared insights drawn from over 30 years of trauma surgery experience in conflict zones.
Upon returning to Ukraine, these doctors joined our growing local Ukrainian faculty to train more surgeons on the ground during this difficult period. Their newly acquired skills were put to immediate use, with reports of life-saving interventions within days of their return.
"Just two days ago, I faced a mass casualty incident involving four patients in one hour. Three of them suffered massive hemorrhages from arterial injuries, fractures, and amputations. I was the only surgeon available. The skills and knowledge I gained through the courses offered by the David Nott Foundation saved their lives and their limbs." - Dr Volodymyr H, Ukrainian General Surgeon
Our most recent training in Ukraine
Equipping medical heroes of South and North Kivu
The Democratic Republic of the Congo (DRC) continues to face a complex and multifaceted crisis that is often overlooked on the global stage, making it one of the world's 'forgotten crises.’ Decades of conflict have left the country with over 8 million internally displaced people. Most of these displacements are driven by violence in eastern provinces like North and South Kivu, where armed groups and intercommunal violence exacerbate instability. The humanitarian needs in the DRC are immense, with over 25 million people requiring assistance. This includes a severe lack of basic services such as food, water, healthcare, and shelter.
The crisis has deep historical roots, shaped by colonial exploitation, political instability, and ongoing conflicts fueled by control over mineral-rich territories. Despite some international efforts, the scale of suffering remains overwhelming and largely unnoticed compared to other global crises.
In the hills of Murhesa, South Kivu, medical professionals gathered at Murhesa Medical Centre for the second time for life-saving training on war surgery and emergency care. Organised by the Friends of the David Nott Foundation in the Democratic Republic of Congo who we funded for teaching tools, this mission was more than just a training course—it was a promise of hope.
“To world leaders and the David Nott Foundation, the Democratic Republic of the Congo urgently needs attention, support, and collaboration in health during this time. Thousands are displaced, facing a security and humanitarian crisis. Training doctors, nurses, midwives, and first-aiders in life-saving skills is more critical than ever.” - Chris Kitumaini, President of the DRC FDNF
A journey into conflict medicine
The training was practical, intense, and tailored to the realities of war-zone healthcare specifically in the DRC. Over a period of 2 days, 4 doctors trained 20 medical professionals from across the region. Participants learned to assess and prioritise life-threatening injuries under pressure, master techniques for suturing wounds, controlling hemorrhages, and managing injuries caused by gunshots and explosions, and perform CPR in resource-limited settings.
The highlight for many was the hands-on neurosurgery workshop, where they practiced emergency craniotomy techniques under the guidance of a skilled neurosurgeon.
Commitment, passion, and motivation
The training concluded with the award of certificates to all participants, symbolising their commitment and the skills acquired during these intensive sessions.
“Driven by the desire to make a positive difference, the David Nott Foundation's support and donation of equipment has helped me organise a training workshop for Congolese doctors to work in resource-limited settings and save millions of lives.”- Chris Kitumaini, President of the DRC FDNF
As the program concluded, we were inspired by the determination and resilience of every individual involved in the organisation of this training, from our Congolese FDNFs to the surgeons they worked with to deliver the training. Their commitment fuels our drive to continue this work. This is why we do what we do, and we won’t stop.
Please note that Friends of the David Nott Foundation (FDNF) operate independently and are not training entities of the David Nott Foundation.
Strengthening trauma response in Northwest Syria
Northwest Syria continues to face escalating hostilities, compounded by regional conflicts that have intensified instability across the area. In October 2024, airstrikes targeting Idlib resulted in numerous casualties, reflecting the ongoing humanitarian crisis. Healthcare facilities, already strained by over a decade of conflict, are now bracing for an increase in trauma cases due to anticipated surges in violence.
Amid this dire backdrop, the World Health Organization (WHO) launched a Trauma Emergency Response and Preparedness (EPREP) plan to strengthen trauma care and emergency preparedness in Northwest Syria. Recognising the David Nott Foundation’s expertise in trauma training, WHO invited us to partner in their efforts to enhance local healthcare capacity. This initiative was generously funded by USAID, whose support has been instrumental in bringing this project to life.
We are honoured to contribute through the delivery of our renowned Hostile Environment Surgical Training (HEST) course, which WHO has identified as a “central pillar” of its trauma response strategy.
From collaboration to local leadership
From November 18 – 22, we delivered a specialised HEST course in Idlib, training 25 Syrian doctors. This marks a milestone in our partnership with WHO and our broader localisation efforts. Notably, this training was entirely led by our Syrian faculty, supported by UK-Syrian faculty members, emphasising the importance of building sustainable, local capacity.
“The new generation of surgeons must learn all of these skills delivered on our courses to save more lives” - Dr Mahmoud Hariri, faculty member
The training focused on equipping participants with critical skills in trauma response, including the management of blast injuries, gunshot wounds, and advanced surgical interventions required in conflict zones. This hands-on course, tailored to address the specific challenges of Northwest Syria, underscored the power of collaboration and the value of empowering local medical professionals to lead in their own communities.
Building resilience amid crises
This mission is part of WHO’s broader plan to enhance the capacity of Northwest Syria’s healthcare system, which prioritises equipping hospitals with essential supplies, creating dedicated triage areas, and improving coordination across trauma networks. Together, we aim to strengthen the region’s ability to respond to mass casualty incidents, ensure communities receive life-saving care during these volatile times, and work towards the sustainable development of the trauma system in Northwest Syria. Building on this foundation, we will continue to contribute to capacity-building efforts in the coming years, with plans to deliver HEST, HEST-A, and HEST-O&G courses early next year.
The devastating events of this past week in Northwest Syria, with fresh waves of airstrikes and escalating violence, have once again underscored the region’s urgent need for enhanced trauma care. We are humbled to have been there just days before, providing Syrian doctors with the life-saving skills they now rely on to manage the growing number of critically injured patients. Our training was not just a response to the immediate need but a long-term investment in the resilience and readiness of Syria’s healthcare system.
Find out more about our work in Syria
Apply for our new Medical Inventory and Procurement Officer role
The David Nott Foundation is a UK charity dedicated to training surgeons in conflict zones and austere environments, giving them the skills needed to save more lives. We do this by delivering our Hostile Environment Surgical Training (HEST) courses in territories affected by conflict, such as Palestine, Iraq, Syria, Yemen, Somaliland and Ukraine. Since 2016, our faculty of trainers have upskilled over 2,007 doctors in 17 countries.
Job title: Medical Inventory and Procurement Officer
Summary: This role is an essential part of the success of the programmes delivery here at the Foundation. The Medical Inventory and Procurement Officer will be responsible for managing our global training and logistics HQ where the David Nott Foundations surgical training equipment and other is kept. This space will be owned by you.
Accountability: Initially this role will managed by and accountable to the Programmes Manager with some support provided to the Head of Operations.
Responsibilities:
Responsibilities include, but are not limited to the following
Inventory management
- Maintain and manage inventory records for all items in a clean and tidy store.
- Ensure safety and security of access into the store at all times.
- Conduct regular stock checks and audits to ensure appropriate accuracy of inventory records.
- Monitor stock levels and reorder items as needed to prevent shortages and to ensure we can deliver training at reasonably short notice if required.
- Communicate stock and inventory issues to management.
Procurement
- Source and purchase the small and single use items through our list of current suppliers.
- Develop and maintain relationships with current and future suppliers and vendors.
- Ensure all procurement activities comply with the organisation’s policies, procedures and environmental and sustainability ambitions.
- Research and obtain quotes and negotiate prices for new stock items to ensure cost effective purchases.
Support training and events
- Work with the Programmes Team to understand upcoming trips and what kit will be required for these training courses, as well as support with packing the kit ready for travel.
- Work directly with heads of Faculty and Director of Product in the training section to better understand equipment needed for training.
- Work with the Communications and Engagement and Fundraising teams to ensure that there is kit and supplies for fundraising events, TDNF and FDNF conferences, meetings and other training events.
Development
- Devise ways to optimise inventory management.
- Work with Programmes Team to understand and anticipate needs for upcoming courses.
- Work with Faculty and others to understand new equipment that will further support the success of our training offerings.
Wider support
- Across the charity we all pitch in to help different teams and areas of This may mean you attend and support with the delivery of other teams’ activities and events. From time to time, you may also work with another team for a fixed period of time or collaborate on a project to ensure we deliver on our mission for safe and skilled surgical care for all. We think this is a good way to gain experience in different areas of the organisation and enhance your professional skills. Willingness to occasionally travel where we work is required.
- There is also a requirement that this role will manage aspects of the day-to-day running of the office in support of the Head of Operations, this will include procurement of office supplies, stationary and other things that support the smooth running of the office.
Person Specifications:
Communication
- Ability to communicate effectively with people at various levels of their careers.
- Ability to develop and maintain relationships with suppliers and manufacturers.
- Ability to communicate effectively about medical inventory needs and developments.
Initiative and Problem-solving
- Identifies problems and suggests potential solutions.
- Proactive in seeking feedback and enhancing processes.
Developing Self and Others
- Creates and commits to personal development plans to address strengths and weaknesses, using feedback to strengthen plan.
Role Specific Knowledge and Skills
- Essential – Medical background, as this role requires understanding and identification of a wide range of medical equipment and instruments.
- Essential – Good working knowledge of Microsoft.
- Essential – Adhere to all policies set pit in the charity’s staff.
- Essential – Capable of adapting quickly to new systems and interfaces.
- Essential – Ability to communicate effectively with those in the team and others.
- Desirable – Data management and forecasting.
Role specific Experience and Qualifications
- Essential – Experience of working with medical inventory and stock as a clerk or officer.
- Essential – Medical Background, experience working with clinicians.
- Desirable – Experience of using inventory management.
The role holder must have the right to live and work in the UK, and they must not have any
restrictions on their international travel through dual nationality or an entry ban in any country
within which the Foundation might, in future, operate.
Salary: £32000-£35000, depending on skills, attributes, and experience, plus an annual personal development fund of £2000 and membership of a workplace pension scheme.
Contract Length: Permanent, with an initial probationary period of three months.
Application Details: To apply, please send a copy of your CV and a cover letter (no longer than 2 pages) stating why you want this opportunity and detailing how you meet the person specification above. Please send all applications to [email protected] quoting ‘Medical Inventory and Procurement Officer’ in the subject line.
Application deadline: Midnight 24 November 2024
A milestone mission in Ukraine
In October, we partnered with the World Health Organization (WHO), UOSSM, and the Ukrainian Ministry of Health to deliver our frontline surgical courses in Ukraine. Thanks to the support of our partners, we were able to train 71 medical professionals from across the country, including the frontlines, who travelled to Kyiv to gain essential trauma care skills. These newly acquired skills will be crucial as they return to their hospitals and provide care in some of the most difficult conditions imaginable.
Since the onset of the war, we have remained steadfast in our commitment to support Ukraine’s medical community. Our mission has been clear: to empower medical professionals who face the realities of war injuries every day. To date, we have trained a total of 666 healthcare workers across Ukraine and built a dedicated team of Ukrainian instructors who, this October, successfully led the Hostile Environment Surgical Training (HEST) course. This October mission was a milestone, as it included an adaptation of the courses tailored to Ukraine’s needs, extending our usual three-day Hostile Environment Surgical Training-Anaesthesia (HEST-A) course to five days, allowing us to deliver even more course content.
Empowering Frontline Nurses and Strengthening Local Healthcare
This mission to Ukraine marked many milestones for us, one being the pilot of our Hostile Environment Surgical Training (HEST) course specifically designed for nurses. In this pilot course, we trained 15 nurses, equipping them with vital trauma care skills. Just as importantly, this course offered us an opportunity to learn from the participants themselves. As they shared their insights, experiences, and specific challenges they face on the ground, we were able to gain a deeper understanding of how we can adapt and enhance our training to best meet their needs in conflict settings.
Nurses are at the heart of frontline healthcare, providing continuous care in some of the most intense and difficult environments. Their bravery and commitment are essential not only in treating patients but also in strengthening healthcare systems in conflict zones. We firmly believe that building resilient healthcare systems requires empowering and supporting nurses.
In addition to training, we are committed to localisation in Ukraine. We do this in a number of ways, including the local employment of key programmatic team members, building relationships with local suppliers and ensuring our strategy is fully in line with that of the Ministry of Health and affiliated bodies. This approach ensures that our training sessions are adapted to locally available resources, we support the local economy, and we deliver a sustainable product for the future of Ukraine.
Our team’s dedication has been unwavering. They travelled long hours, often overnight, and took shelter alongside Ukrainians as they navigated the challenges of delivering these courses amidst ongoing conflict. This commitment was evident in every moment of training.
“As my first deployment with the Foundation, seeing the dedication and resilience of the Ukrainian surgeons, anaesthetists and nurses, who both delivered and attended the courses, palpably highlighted the importance of DNF’s role in providing not only training, but also solidarity.” – Hetty Cane, DNF Programmes Officer
The Power of Partnerships
Our work would not be possible without the strength and commitment of our partners. With critical funding from the WHO, logistical support from UOSSM, and guidance from the Ukrainian Ministry of Health, we have been able to deliver life-saving training in Ukraine. These partnerships are central to our mission, enabling us to empower frontline medical professionals and make a lasting impact on healthcare in conflict zones. Together, we are building a future where medical teams are equipped, resilient, and ready to save lives when it matters most.
“This mission was a huge step towards our goal of localising our HEST courses in Ukraine. It was a mission of firsts. It was a privilege to collaborate with UOSSM, headed up by Ahmed Aldbis and Muhammad Zaydiye, who, with their team, worked with us to enable these courses. We're indebted to the Ukrainian Ministry of Health, WHO-Ukraine and Bogomolets National Medical University for partnering with us.” - Nick Cartwright, DNF Head of Operations
Find out more about our work in Ukraine
Stars align at Almeida Theatre to support our mission
On Sunday 13th October, the Almeida Theatre welcomed an audience to a special event, ‘Doctor Theatre’. The evening featured a line-up of some of the world’s greatest actors, Peter Capaldi, Judi Dench, Lindsay Duncan, Stephen Fry, Ian McKellen, Simon Russell Beale and Imelda Staunton. During the course of the evening each actor took to the stage to interview or to be interviewed by one another. They discussed life on stage, on screen and in the real world. It was at times hilariously funny and, in other moments, deeply moving. In a special moment, Judi Dench and Ian McKellen spoke to each other as old friends, almost as if the audience were not there. The final conversation was with Judi Dench and David Nott. For the audience, simply to witness their connection and mutual admiration was wonderful.
The evening was filled with ‘peek behind the curtain’ moments; anecdotes of life on stage, the secrets of making blockbuster hits, and of course some personal revelations. The actors also brought some prized mementos to auction at the end of the evening, including a prop from the “Harry Potter” films (from Imelda Staunton), a personally illustrated “Doctor Who” script (from Peter Capaldi), a prosthetic heart the Foundation uses to teach surgeons lifesaving skills, and a painting by done by Judi Dench herself. The auction was conducted brilliantly by the evening’s emcee, Stephen Fry, who played a major role in making the sum raised on the auction alone £19,500.
In addition to this once in a lifetime line-up of actors providing the audience with a thoroughly entertaining and moving evening, the event generated an incredible £61,000 for our work. We are indebted to the Almeida Theatre, the supporters who attended and to the Theatre Friends of the David Nott Foundation who organised the event. We would like to say a special thanks to Joyce Nettles, without whom the evening would not have been possible. Her tireless dedication to the Foundation, not just this year but in years gone by, is truly remarkable. On behalf of the 2077 doctors we’ve trained worldwide since 2015, thank you.
Should you wish to watch the event, we will soon have a recording available to view for a small donation. Please watch this space or contact [email protected] for more information.
If you’d like to contribute to the total, donate by Dec 31
October 7th: A catalyst for unrelenting crisis and the fight to save lives
October 7th is a day that remains seared into our collective memory—a day marked by unimaginable loss, fear, and suffering. The death toll continues to rise, and for every life lost, there are countless more left injured and grieving. The ripple effects of this violence are spreading far beyond that single day, reaching into every corner of the region. As the violence escalates across Gaza, the West Bank, Lebanon, Yemen, and Israel, the humanitarian needs grow more urgent with each passing hour.
We have not forgotten the victims—the hostages, the dead, the wounded, and the families in mourning. Like many in the humanitarian and development community, we’ve been overwhelmed by the surge in requests for assistance. Over the past year, we have adapted to meet this growing need. We know the skills, knowledge, and expertise we provide will save lives. This year alone, we’ve trained 55 surgeons and 18 anaesthetists in the UK and Kuwait to prepare them for operating in Gaza. Our founder, David Nott, and Head Surgeon, Ammar Darwish, have both traveled to Gaza on missions with MAP and MSF, bearing witness to the daily horrors Palestinians face. In addition to direct medical support, we’ve created teaching videos in English and Arabic to assist doctors in real-time on the ground.
“Seeing Gaza reminds me of the vital importance of our foundation’s work. Training doctors, operating on patients in war zones, bearing witness to doctors’ needs on the ground, I’m more driven than ever to help the charity grow so we can reach even more people in need.”
We hear a lot about the death tolls of Oct 7th and the violence since. But for every death there are countless injuries. Many of these will be life-changing and require highly specialist input that is simply not available. This is the case across the region, as the violence begins to spread beyond Gaza and Israel, into the West Bank, Lebanon and Yemen.
"The number of injured in Gaza has now surpassed 70,000. The complexity of these injuries means that these patients will require extensive medical care—surgeries, physiotherapy, and immense resources to reconstruct their lives. This is a humanitarian crisis of unimaginable proportions."
As the violence spreads like a global contagion, the need for medical aid is growing by the day, and we remain committed to doing everything we can to provide support.
James Gough,
CEO
Our most recent work for Palestine
Addressing the crisis in healthcare
As conflicts continue to devastate civilian lives across the globe, healthcare systems in war zones face unprecedented challenges. In the past decade alone, over 180,000 civilians have been killed in armed conflicts worldwide, with regions like Syria experiencing a mass exodus of healthcare workers—over 70% have fled due to violence. In Ukraine, recent reports indicate that over 17 million people require humanitarian assistance, with healthcare facilities frequently targeted and damaged, leading to significant shortages of medical supplies and personnel. In Palestine, the situation is even more dire, with access to healthcare severely restricted due to ongoing violence. Reports show that over 50% of medical facilities in Gaza are non-functional or operating at reduced capacity due to conflict, significantly affecting patient care.
In response we are equipping healthcare workers with the skills they need to save lives in these volatile environments. Our flagship Hostile Environment Surgical Training (HEST) program provides essential training to doctors, preparing them to handle trauma injuries common in conflict zones, including gunshot wounds and blast injuries. Given that the majority of injuries in modern warfare are caused by explosive devices, this specialised training has never been more critical.
Bridging the skills gap in conflict medicine
Conflict medicine involves the diagnosis, treatment, and management of injuries resulting from armed conflict, encompassing a range of trauma-related conditions. It requires a unique set of skills that go beyond conventional medical practices. In areas like Sudan, and Somaliland where many doctors lack the necessary training to manage complex war injuries, our work is vital.
The Foundation has trained over 2,000 doctors in 17 countries, offering practical skills in triage, emergency procedures, and trauma care. However, the scarcity of surgeons with specialised knowledge in conflict-related trauma exacerbates the situation, as studies indicate that 90% of healthcare workers in these zones feel inadequately prepared to handle such injuries.
Impacting lives in conflict zones
Our trained doctors are now saving lives in some of the most dangerous regions, including Yemen, where half of the healthcare facilities are non-functional. They are not only addressing immediate trauma but also providing long-term care, helping communities recover from the devastating impacts of war.
Through ongoing training programmes, we continue to build a global network of conflict medicine experts who are making a significant difference in conflict zones.
World Humanitarian Day
On World Humanitarian Day, we perhaps allow ourselves a few more minutes to think about others. Perhaps those we often find it hard to think about or to imagine. To remind ourselves that humans, wherever they are, deserve the basic access to freedom, to peace, to equity and to love that many of us enjoy. To have to make a special day each year is both a tribute, and a damning indictment of humankind. On most measures, it has been a relentless and notably horrific few years for humanity.
Moving from the private sector as I have and beginning my first few weeks as CEO of the David Nott Foundation, I have been struck by the unfortunate parallels in the language used. I did not expect to be talking about a “growth market”, but that is indeed what humanitarianism is experiencing.
For the past 12 years, the number of displaced people has increased every year. The number of refugees has tripled in a decade. In 2023, 1 in 69 of us on the planet were forced to leave our homes – 117.3 million people. More specifically to our line of work, conflict related fatalities are also on the rise. The annual number of deaths in conflict since we began our work almost a decade ago has risen by 92% to almost 250,000 this year.
Many of those deaths will be what we call ‘Survivable Deaths’. It is these deaths our teams work tirelessly to prevent by training doctors with the skills they need in conflict and catastrophe.
You can imagine that if we saw these kinds of numbers on a business forecast in a different context, it would be a reason to celebrate. But we are in the business of alleviating suffering. The more suffering there is, the more of a strain and demand it puts on the sector as a whole to meet the vital needs of those we must continuously work to serve.
In a conversation with a Ukrainian diplomat some months ago, I heard her talk of war as “a branding exercise”. She explained to me that Ukraine was not just competing with other wars for international attention and resources, but also with Donald Trump, Taylor Swift and the Climate Crisis. Her point was clear. To win the war, you need to win the media and the requisite public support. It is for this reason that today I believe we should think deeply, not just about the horrors we are seeing on our newsfeed, but to the horrors we are not. With conflicts and catastrophe raging all over the world in Haiti, DRC, the West African Sahel, Afghanistan and Myanmar, to name just a few, we can perhaps be forgiven for feeling overwhelmed and somewhat fatigued. One of our explicit responsibilities at the David Nott Foundation is to think every day about these ‘forgotten conflicts’ and lesser-known catastrophes. Thanks to the incredible generosity of our donors, we are able to consider them in our planning and delivery of vital surgical and medical training. However, the increasing need is so vast, that we and other non-profit organisations worldwide need to think very seriously about how we scale – another regrettable business term that is a sign of our times. Scaling requires funding, partners, innovation, knowledge and an appetite for risk. Many of us do not consider ourselves as direct contributors to humanitarian work, but with the skills and requirements I describe, perhaps today is the day to re-consider. To be more explicit, we certainly wish to hear from you at the David Nott Foundation.
With gratitude, James Gough
CEO