War Doctor Heroes: Meet Dr Ahmed
Since 2015, Yemen has been devastated by a civil war which has left 80% of the population in need of urgent humanitarian aid. Dr Ahmed has been on the frontlines of this conflict since he qualified as a surgeon, and performs life-saving trauma operations on a daily basis.
Despite medical shortages posing an enormous obstacle to healthcare, Ahmed and his colleagues do everything they can to treat their patients, against the odds. He told us: “It is our responsibility to help the patients affected by this war, so we must keep learning to improve our skills."
Earlier this year, we were able to offer Dr Ahmed a place on our overseas HEST course in Yemen. Here, he learnt how to perform a thoracotomy, alongside other vascular interventions that he has since used many times to treat war wounds.
One patient that he treated recently was an eight-year-old girl who came to his hospital with a severe foot wound and a fractured tibia and fibula. The standard treatment in other hospitals would have been an amputation, but Dr Ahmed knew her foot could be saved.
Using the skills learnt on the HEST course, Dr Ahmed and his team externally fixated her leg in order to heal the bone and then successfully performed a cross leg flap to cover the foot wound.
Thanks to Ahmed's quick thinking, the little girl recently started walking again.
Surgeons like Dr Ahmed lie at the heart of everything that the Foundation seeks to achieve. To help us train more surgeons like him, please consider donating today.
May 2020 Newsletter
Hello and welcome to our latest newsletter.
In this update, we share our new webinar series, introduce you to our latest War Doctor Hero and keep you in the loop with David's media appearances.
Thank you, as always, for your continued support and we hope you are keeping well at home.
Taking our Training Online
To do what we can for our surgeons, we have launched a fortnightly webinar series led by David Nott and our faculty. During these sessions, we invite medics from low-resource settings to present their surgical cases to each other and to our training faculty so that they can share experience and advice.
We’ve also launched a COVID-specific webinar series which aims to provide any information, support and advice that we can to surgeons, particularly around how to look after their own safety when operating on COVID-positive or unknown patients.
One surgeon who has benefitted from these webinars is Dr Lucien, who we trained on a UK course back in 2018. Lucien said: “With advice from David and others from across the world on this webinar, I hope we can improve protection for our surgical teams and continue to provide surgery for those that absolutely need it.”
We plan for these webinars to endure beyond this pandemic as an excellent way of supporting surgeons and keeping in touch with them.
Spotlight on Dr Binod
In this latest instalment of our #wardoctorheroes series, we're proud to introduce Dr Binod from Nepal.
Binod serves the rural, mountainous district of Dolakha, the epicenter of the 2015 Nepal Earthquake.
His patients have to travel for hours along bumpy, winding roads to reach the hospital, where a lack of resources can often present another obstacle to surgical treatment.
In 2018, we were able to offer Binod a scholarship to attend our UK-based STAE course, where he learnt how to manage orthopaedic and vascular injuries in low-resource settings.
The day after Binod returned from the UK, a child came to his hospital with a broken leg after falling from a height. Her left femur was completely crushed.
Using the skills learnt on the STAE course, Binod was able to repair the blood vessels, externally fixate the bone, and perform a skin graft to save her leg.
David in the News
David recently penned an editorial in The Lancet, in which he discussed the urgent need to coordinate a global response to COVID-19 and protect the world's most vulnerable populations.
David wrote that "in fragile settings, there is no massive infrastructure like the NHS. There are few ventilators - eg, South Sudan has four ventilators per 11 million people, Chad has three per 5 million people, and in northern Syria there is one ventilator for every 36,000 people." In order to prevent this pandemic from ravaging war-torn countries and refugee communities, David argues that governments must unite to coordinate a world-wide response. You can read the full article here.
If you would like to hear more about his experience treating COVID-19 patients on the NHS 'front-lines', then you can also hear him speak to NPR's Terry Gross in the US about the psychological similarities between this pandemic and operating in war zones. Click here to listen to the broadcast.
Missed out on David's talks last year?
If you missed out on David's speaking events or if you're just in need of some inspiration during lockdown, then this might just be the stay home ticket you need. You can watch a snippet of his talk with BBC's Sarah Montague here, or to watch the full video, click here.
Taking our Training Online
To do what we can for our surgeons, we have launched a fortnightly webinar series led by David Nott and our faculty. During these sessions, we invite medics from low-resource settings to present their surgical cases to each other and to our training faculty so that they can share experience and advice.
We’ve also launched a COVID-specific webinar series which aims to provide any information, support and advice that we can to surgeons, particularly around how to look after their own safety when operating on COVID-positive or unknown patients. David has brought on UK-based intensivists and anaesthetists to help with this and we are pleased to have opened it up to medics beyond our list of surgeons.
These online sessions have been very well received by the doctors. Lucien Wasingya, who we trained on a UK-based course back in 2018, said: "With advice from David and others from across the world on this webinar, I hope we can improve protection for our surgical teams and continue to provide surgery for those that absolutely need it."
We plan for these webinars to endure beyond this pandemic as an excellent way of supporting surgeons and keeping in touch with them.
War Doctor Heroes: Meet Dr Binod
We are proud to introduce Dr Binod Dangal in the latest instalment of our War Doctor Heroes series, which celebrates our global network of surgeons.
Binod grew up in Sindhupalchok, a remote, mountainous village in Nepal. Thanks to the support of a volunteer teacher from Italy, Binod was inspired to study medicine and, after training abroad, he now serves the community in the Dolakha region.
Nepal often suffers from earthquakes and landslides, and the difficult geographical terrain creates a barrier for Nepalese people seeking healthcare, particularly in the rural regions. Binod's patients sometimes have to travel for hours along bumpy, winding roads to reach the hospital, where a lack of resources often presents another obstacle to surgical treatment.
In 2018, the David Nott Foundation was able to offer Dr Binod a full scholarship to our UK-based STAE course. During this specialised training course, Binod was taught the proper management of orthopaedic and vascular injuries in low-resource settings, skills that he was able to put to use almost immediately.
Indeed, the day after he returned to Nepal, a nine-year-old child was brought to his hospital with a broken leg. She had fallen from a height and her left femur was completely crushed. Using the skills learnt on the STAE course, Binod was able to repair the blood vessels, externally fixate the bone, and perform a skin graft to repair her leg.
“With patience, teamwork and the right skills, it is even possible to manage complex trauma cases in low resource settings."
Doctors like Binod are at the heart of everything the Foundation seeks to achieve. With your support, we can train even more surgeons, helping them to serve the communities that need them most.
The Lancet: The COVID-19 response for vulnerable people affected by conflict
David Nott writes for The Lancet:
Next year I will have worked full time in the UK's National Health Service (NHS) for 40 years. I seem to be a survivor not only from the political rollercoaster that various governments have enacted on the NHS, but also from volunteering my surgical skills in places affected by conflict and natural disasters for the past 25 years. The experiences of the patients I have served whose lives have been impacted by war, injustice, and inhumanity during this time have given me insight into what life is really about. Every person on this planet has a right to live and survive by whatever means possible. Having seen the adverse health impacts of conflict and humanitarian disaster on patients, I understand the mass movement of unprotected people from war to places of relative calm.
Many of the estimated 70·8 million forcibly displaced people worldwide live in insanitary and inhospitable conditions, sometimes up to six families living in one tent in a 3 m area. At a time when so many people are living under lockdown because of the coronavirus disease 2019 (COVID-19) pandemic, it is important to highlight the dreadful conditions that displaced people endure, which I have personally witnessed in refugee camps throughout the world. Apart from difficult living conditions in these camps, many people share one latrine and washing facilities and hundreds queue for food every day. People tolerate such conditions because they want to live. They have been forced to live this way by inhumane acts in conflict and authoritarianism.
Many people in high-income countries might think that these humanitarian problems happen to other people far away and have little to do with them. At the start of this year with the first reports of a new virus in China, some people watched with casual nonchalance. Even when Joseph Wu and colleagues reported in late January that COVID-19 was going to become a global pandemic requiring substantial preparation, this warning received insufficient attention. Too many of us were lulled into a false sense of security by shrugging politicians. Looking back now, it is hard to understand from a scientific and epidemiological standpoint that there seemed to be no one with sufficient leverage to wave that red flag very early on.
Read the full article here.
War Doctor Heroes: Meet Dr Koma
We are delighted to feature Dr Koma Akim, a general surgeon from South Sudan, as our latest War Doctor Hero.
South Sudan is the world's youngest sovereign state, having gained its independence from Sudan in 2011.
Since December 2013, the country has been embroiled in a civil war that has resulted in the displacement of more than 4 million people, and contributed to the endemic poverty that affects 80% of the population. Conflict between nomadic people, particularly over the issues of cattle and grazing rights, has compounded the violence, yet health resources and medical professionals remain scarce.
Dr Akim is one of only a handful of general surgeons in the country, and regularly deals with gunshot and arrow wounds as a result of cattle rustling. Those who make it to his hospital are often in a very bad way, suffering from internal bleeding and broken bones. Without any advanced orthopaedic instruments, Koma must often treat these fractures non-operatively, even though his patients would benefit from external fixators or skeletal traction.
Alongside his work in the district hospital, Dr Akim has also undertaken humanitarian missions in Ganyiel, in the Unity State of South Sudan. Koma recalled performing an emergency C-section for a retained second twin in the midst of the fighting here. In spite of the high maternal mortality associated with this complication, Dr Akim was miraculously able to save the lives of both the mother and her two babies.
These experiences motivated Koma to learn more and enhance his skill set, so that he could continue to alleviate the suffering of ordinary people in his country.
In 2019, Dr Akim attended our London based Surgical Training for the Austere Environment course (STAE). On this training programme, he learnt how to properly expose blood vessels and said “being able to practise it means I have the confidence to do it in a real situation. If I can do it, I can teach it.” This skills-sharing is a vital part of what we as a Foundation hope to achieve. By training one doctor on our course, we give them the knowledge and skills needed to teach countless more.
It is Koma's ambition to become a role model for the next generation of South Sudanese doctors. He hopes to inspire more to become surgeons in order to better serve the people of war torn South Sudan and told us that "my skills and theirs will be more needed here, in South Sudan, than anywhere else in the world."
To help us train more surgeons like Koma, you can make a donation here.
Yemen HEST January 2020
The DNF team, in partnership with MSF Spain, recently returned from our latest mission to Yemen which brought in 31 surgeons from across the country for a specialised five-day training course. Since 2015, Yemen has been the stage of one of the world's worst humanitarian catastrophes. Hundreds of thousands of Yemeni citizens have already lost their lives, and as the fighting continues, many more are in need of urgent medical treatment and supplies. At the front-lines of this conflict are the surgeons and medics who face the challenge of saving lives without losing their own, all the while limited by a lack of resources and insufficient training.
Our Hostile Environment Surgical Training course (HEST) was designed to confront this problem. Over the course of five days, our Faculty, comprising David Nott, Ammar Darwish, Pippa Letchworth, Pete Mathew and Rebekka Troller instructed surgeons on a wide range of trauma topics. By equipping these medics with the necessary knowledge, confidence and skills that they need to treat patients, we can improve the medical outcome for countless people.
The regions where HEST is taught often rule out cadaveric teaching, so the Foundation’s whole body simulator, Heston, was employed for training. This state of the art, bespoke simulator mimics the look and feel of real human flesh and features the full range of organs, blood vessels and key anatomies needed for facilitating learning.
Supporting Heston, we also deployed our neonatal models and our new VR learning experience, which simulates a mass casualty event. This immersive experience focuses on the triage of ten patients using International Committee of the Red Cross categories: serious wounds, second priority, superficial wounds and severe wounds.
To date, the Foundation has trained 803 medics across 28 courses, benefiting an estimated 1.7 million patients. Through this global network of war doctors, we can raise the standard of medical care worldwide and continue to save more lives and limbs. To help us train even more surgeons, you can donate here.
December 2019 Newsletter
In this Christmas newsletter we celebrate you, our wonderful supporters. Thanks to your kindness and generosity, this year we have been able to deliver nine specialised training courses in eight countries, training 127 medics from all across the world.
The doctors we train share their knowledge with colleagues, expanding our global network of skills sharing and improving patient outcomes in some of the world's most surgically austere environments.
Without your help, our work would simply not be possible. So, in this festive season, we want to thank you for everything that you do to support us.
We wish you a very merry Christmas and look forward to the new year ahead.
Our Impact Report has Landed!
We're delighted to share with you our first Impact Report. This report celebrates all that we have achieved as a Foundation since we started in 2015.
To read about how your donation has made a difference to the lives of countless patients, and to learn more about the surgeons we train, take a look at our Impact Report today!
Thank You from our Doctors
You may remember Dr Lucien from Uganda, who attended our specialised Surgical Training for Austere Environments (STAE) course in April.
Recently, Lucien travelled to London again for a conference and we were delighted to be able to see him. Presenting David with a beautiful wood carving, Lucien thanked the Foundation, saying: "Thank you for the training. I am so proud to be among the trainees".
Star Supporter: Bis Culley
Since 2016, Bis Culley has been working hard to curate our beautiful range of greetings cards. Contacting illustrators, liaising with donors and arranging all the postage and packaging, Bis is truly one of our standout supporters.
From these cards alone, Bis has raised over £11,000 for the David Nott Foundation, enough to train eleven surgeons on our overseas HEST course. Alongside this, Bis has also run several fundraising events for us and even applied for a grant on our behalf.
If you haven't had the chance to buy your Christmas cards yet, please do take a look at all the designs we have on offer. The deadline for ordering is Wednesday 18th December, so don't miss out! 100% of the profits will go towards training war doctors and saving lives.
Our Impact Report has Landed!
We are delighted to share with you our first ever Impact Report. Thanks to your continued support and generosity, we are proud that the Foundation has trained a total of 772 doctors across 27 courses, improving the patient outcomes for the medical victims of conflict all across the world.
Click on the link below to learn more about the surgeons we train and how they're impacting their communities.
With many thanks to Andrew Rees at Westco Communications and Paul Gray-Nicholson at Fusion Paper for so generously supporting the production of our Annual Report and Impact Report.