Doctors’ needs in the West Bank
Over 300 days have passed since Hamas’s invasion of Israel and Israel’s retaliatory attacks on Gaza. Gaza is home to many forcibly displaced Palestinian refugees. The 41 kilometers-long Strip has been under siege since 2006, enduring five major wars, with the retaliation of the October 7th conflict being one of the deadliest in recent history.
In the West Bank, Palestinians live under Israeli military occupation, with Israel controlling essential resources like water and electricity. The intensifying Gaza-Israel war has exacerbated these difficulties. On-the-ground reports reveal that those who live in the West Bank face increasing attacks from Israeli settlers, checkpoints, military raids, increase in settlements, and the detention of Palestinian men, women, and children.
We reached out to Dr Mariam Aweidah, a general surgeon and our Faculty Lead for Palestine, to shed light on doctors’ needs in the West Bank. Mariam lives in Ramallah and travels to Jericho to work, a journey that should take an hour but often stretches to several due to road conditions and checkpoints.
"Every day is different. We always check the news before leaving to see if there are settlers or checkpoints on the roads. As Palestinians, this is part of our daily routine to ensure the roads are somewhat safe for travel." – Mariam Aweidah, Faculty Lead for Palestine.
Mariam works at a peripheral hospital in Jericho, where resources, infrastructure, and specialisations are limited. They frequently need to refer patients to the Palestine Medical Complex in Ramallah to seek the care they need but face significant checkpoint challenges which can prevent patients from passing through, even in ambulances.
Despite being a general surgeon, Mariam sometimes operates on paediatric cases due to the limited capacity at the Palestine Medical Complex in Ramallah. Patients come from across the West Bank, but intensified travel challenges between cities and villages have increased the difficulties for both patients and doctors.
"We don't have intensive trauma training. With more trauma cases and cities isolated from each other, this causes a heavy burden because we aren't all trained for this. We often have numerous gunshot cases, and hospitals can't handle them due to a lack of resources and trained personnel."
Now more than ever, we are committed to training medical professionals in territories that require urgent support such as Palestine. As soon as it is safe to do so, we aim to raise doctors' skills through our training.
"I received training with the David Nott Foundation, which has greatly influenced my ability to manage, stabilise, and save lives quickly”, shared Mariam. “However, not all doctors in Palestine have had this opportunity. I hope to organise another training course to enhance the skills of more medical professionals in the West Bank and in Gaza."
103 surgical life savers in Tripoli, Libya
We’re back from a week in the Libyan city of Tripoli after completing a first-in-our-history mission. We upskilled 103 doctors – the largest number trained on one mission – and trialled our brand-new obstetrics and gynaecology course.
Libya’s history is marked by political turmoil and civil unrest. The uprising against the rule of Gaddafi led to brutal violence against Libyan civilians and instability across the country. Today, 13 years after the ruler’s death, conflict between armed groups continues and Libya’s security remains fragile.
Outside of politics, Libya has been devastated by natural disaster. In September of 2023, heavy rain caused the collapse of two dams, leading to horrific damage and the loss of thousands of lives. Wounds inflicted by violence or natural disasters often require rapid surgical care, with a need to focus on controlling the worst of the damage first.
Surgical toolkit for any crisis
In a bid to empower Libyan doctors with skills to treat wounds caused by war or natural disaster, we partnered with the Libyan Board of Medical Specialties to deliver four surgical training courses in parallel. Over five intense days, our team of expert trainers delivered two trauma surgery courses, two anaesthesia courses and a brand-new obstetrics and gynaecology course.
According to a 2023 UN agency report, a woman dies from pregnancy or childbirth every two minutes. During conflict, women are less likely to seek maternal care and hospitals are under-staffed or under-resourced. That's why our trainers created a bespoke obstetrics and gynaecology course to help doctors better protect mothers and their babies in war and catastrophe.
During the week, we trained 103 doctors. Doctors we’d previously upskilled in Libya also joined our training faculty and led the teaching of a number of our modules for the first time. Dr Aisha Alghamji was one of them.
It really was paralysing
Dr Alghamji shared: “I remember I have a case of a 70-year-old lady. We found there was a huge bleed in her tummy. Most of her blood is – in minutes – almost drained out. It really was paralysing – what to do? She doesn’t have that much time.
"That lack of knowledge paralysed me. She is a living, human being – with dreams, hopes, a whole community. She is part of it. It keeps haunting you, that feeling. What I could do differently?"
She lost her life.
After 2018 when I attended the course with the Foundation, there is something shifted in my way of thinking. It did that thing for me, that confidence the surgeon needs to do more than their best – to run the extra mile for the patient.
I faced another case similar to it (this lady). I told immediately to me brain – ‘damage control! Damage control!’. I was able to send her home. She is alive, she is a grandmother, she is everything.”
A resilient healthcare system
Dr Moez Zeiton, Consultant Orthopaedic Surgeon and our Faculty Lead for Libya, said: “It is a privilege to have had the opportunity to lead the single most ambitious series of courses for the foundation, training over 100 doctors in a week. It was a huge effort from the foundation’s team and superb faculty to get over the line.
Candidates in Libya travelled from every part of the country with many travelling over 1000km to participate in our surgical training. Their eagerness to learn and share their own experiences was evident and they will now be equipped with the skills needed to deliver high quality care to their patients. "
This marks the beginning of continued training in Libya and a commitment to gifting doctors with extensive trauma skills to handle any challenge.
HELP US FUND MISSIONS IN LIBYA
Two years of war and two years of attacks on healthcare
Two years have passed since Russia's invasion of Ukraine and the scars continue to run deep. As published in the Foreign Policy Centre, our CEO, Elly Nott, shares the realities faced by Ukrainian doctors and the relentless attacks on their healthcare system that continue to persist even after 24 months of war.
Ongoing struggles, relentless weaponisation and devastating attacks on healthcare continue to be perpetrated by Russia. The numbers are staggering with over 1,000 verified attacks on healthcare in Ukraine as confirmed by the World Health Organisation.
"These figures are not just statistics. They represent lives shattered, dreams destroyed, and communities torn apart."
Beyond the numbers, healthcare plays a critical role in upholding societal cohesion and fostering trust between citizens and their government. Despite relentless onslaught, the Ukrainian people have displayed remarkable resilience, refusing to let their national spirit be broken by the brutality of war. But amidst the devastation, there is a glaring absence of justice.
Our work at the David Nott Foundation stands as testament to our commitment to supporting those affected by conflict. As the conflict unfolded in 2022, our Co-Founder, David Nott, conducted a series of intensive training sessions, upskilling 573 Ukrainian doctors over Zoom. In the subsequent years of 2022 and 2023, we expanded our efforts, providing specialised training to 442 surgeons and anaesthetists through 11 comprehensive surgical training courses.
We have forged crucial partnerships with Ukraine's Ministry of Health, the World Health Organisation, and UOSSM. As part of our broader Ukraine program, we've also funded scholarships to further empower healthcare professionals. Specifically, we funded a Ukrainian surgeon and anaesthetist to undergo paediatric trauma surgical training.
As the war wages on, we will continue to support Ukraine's healthcare heroes, ensuring they are equipped with the knowledge and skills needed to save lives and alleviate the suffering caused by the ongoing conflict.
Elly Nott,
Co-Founder
Two Years On: Russia Continues to weaponise and attack healthcare in Ukraine
Our second mission for Palestine's medical workforce
In the ongoing Israel-Gaza conflict, tens of thousands have lost their lives and hundreds of thousands are now displaced. Hundreds of casualties have been reported in the West Bank. Our commitment to supporting affected communities continues and we will do all we can until we reach doctors on the ground.
Despite recent escalation, Palestine has been engulfed by conflict for decades. Recognising a need for upskilled doctors, we first delivered a Hostile Environment Surgical Training (HEST) course in Ramallah in March 2017 and another in 2022 in collaboration with Juzoor. We also taught Palestinian surgeons on our latest UK Train the Trainers course, giving them the skills needed to teach their own peers.
“I love Ramallah. But we don’t have control of our borders,” shared Dr Salwa Najjab, Co-Founder and Chairwoman at Juzoor in 2022.
“We are living in a big prison. Our people should be exposed to the world. We are very happy and thankful to the David Nott Foundation, to come and see what we are doing, to understand our situation and see it in their eyes.”
Following the resounding success of our Hostile Environment Surgical Training (HEST)-UK course for doctors heading to Palestine, we once again joined forces with Palmed to train another group who intend to offer their skills on the frontline.
At Bolton University, we taught six anaesthetists and 31 surgeons from the UK, Germany, Ireland, Denmark, and Norway. The doctors share a common passion for using their hands to help those affected by the aggression on Gaza.
Dr Israar Haq, a general surgeon who joined our course shared, "If you have any grain of humanity in your heart, you want to help."
BBC spotlight
BBC-Northwest took notice of our efforts and joined our training. They spoke with experienced surgical trainer, Dr Rebekka Troller, who shared: "The aim is to give the doctors the skills to do damage control, save lives, be the first to respond, and stabilise a patient before they can be transferred."
Our presence at Bolton University also attracted attention from university professors, medical students and doctors. They explored our world-class teaching models and extended a warm welcome to our team in appreciation of our commitment to war doctors.
Our latest course for Palestine reaffirms our unwavering commitment to helping communities facing the horrors of war. We remain steadfast in our mission to empower medical heroes and make a lasting impact on the lives of those in need.
Addressing healthcare challenges in Moldova
In the wake of the escalating conflict in Ukraine, Moldova, a neighbouring country, is grappling with the concern of being somehow drawn into the war. To extend support during these challenging times, the David Nott Foundation, in collaboration with the World Health Organisation, conducted two specialised Hostile Environment Surgical Training-Anaesthesia courses in Moldova.
The refugee influx and healthcare strain
Since Russia's invasion of Ukraine, Moldova has witnessed an influx of over 700,000 refugees seeking peace and safety by passing through its borders. Recognising the strain these precipitates to available healthcare resources, the Foundation has provided ongoing support over four courses since January 2023.
The anaesthesia (HEST-A) courses, conducted from December 11th to 16th, aimed to up skill 25 anaesthetists to better handle healthcare challenges arising from the crisis. The training spanned six days, with the first three days conducted in English and the subsequent three days in Moldovan.
Participants expressed satisfaction with the course structure, emphasising the benefit of discussions and supervised practical activity over a lecture-heavy approach. As the anaesthetists underwent training, they raised concerns about resource availability and hospital capacity in the face of refugee movements. In response, our highly skilled teaching faculty offered valuable advice and information.
Innovative training models
The courses saw three UK-based faculty members delivering in-person sessions, with an additional faculty member, the Foundation’s lead consultant for anaesthesia, delivering a virtual training session on chemical weapons.
The David Nott Foundation's HEST-A course in Moldova not only aimed to enhance the skills of healthcare professionals but also addressed specific challenges posed by the Ukraine crisis. By fostering collaboration with WHO and adapting the course content to local needs, the Foundation continues its mission of providing essential medical training in conflict zones to save lives and alleviate human suffering.
“There is nothing more heart-warming, more fulfilling, than seeing the impact of our work through the stories of those we teach. To see that connection brought to life is truly a testament to our mission.” - Hannah Graham-Brown, Programmes Officer at The David Nott Foundation
End of Year Reflection from our CEO
At the David Nott Foundation, we strive for a world where access to safe, skilled surgical care is a reality for all.
In areas affected by conflict and catastrophe, every day doctors are striving to provide care to communities contending with the horrors of war. From Ukraine to Syria, Palestine to Sudan; health systems are under strain and sometimes under attack.
With our small staff team of eight, we deliver training that exceeds what might be expected of an organisation of our size. This year, we are immensely proud to have trained 433 surgeons and anaesthetists from Moldova, Yemen, Ukraine, northwest Syria and the UK. That means we’ve trained 1,589 doctors since 2015, expanding our global network of surgical life savers.
Responsive. Open-hearted. Committed. It inspires all we do.
As 2023 draws to a close, we want to express our heartfelt thanks to each and every one of you who has been a part of the David Nott Foundation journey. This year presented unimaginable challenges, from earthquakes to conflicts, yet your unwavering support allowed us to train 433 surgeons and anaesthetists across the world.
In the face of adversity, our commitment to providing access to safe, skilled surgical care remains stronger than ever. With your generosity, we've made a real impact in communities facing crises. Here's to a future filled with continued growth, empowerment, and positive change. Thank you for being a vital part of our mission.
Wishing you a compassionate and hopeful New Year!
With gratitude, Elly Nott
CEO and Co-Founder
Doctors rapidly trained to treat trauma injuries in Gaza
During a remarkable four-day Hostile Environment Surgical Training (HEST) course, surgeons and anaesthetists from the UK, Germany, Sweden, Norway and Qatar gathered in Bolton to learn how to treat trauma injuries in the Gaza Strip.
Organised in two weeks in collaboration with Palmed, 42 doctors headed for the Middle East were trained to treat complex trauma injuries incurred in the Israel-Gaza conflict. This course not only marks a significant step towards preparing medical professionals for future missions in Palestine but also reflects a shared commitment to saving lives in conflict zones.
"Thank you to the David Nott Foundation. Without them, this training would not have been possible. Together, we are organising this course to assist the people in the Gaza Strip once it is safe and travel becomes feasible. The response from numerous doctors expressing their desire to help has been overwhelming, and we are hopeful to conduct a second course in the coming weeks." - Riyadh Al Masharqa, Plastic surgeon, PalMed
Addressing urgent medical needs in Gaza
The course was organised in response to the pressing humanitarian crisis in Gaza, Palestine. According to on-the-ground partners, medical professionals are stretched to their limits and hospitals are overwhelmed.
The group included specialists in orthopaedic surgery, cardiothoracic surgery, obstetrics and gynaecology, paediatric anaesthesia, and general surgery. Some brought valuable, first-hand experience from regions affected by conflict, like Afghanistan and Syria, while others joined to grow their understanding of how to treat war wounds before heading on mission.
"I'm excited about expanding my skill set beyond obstetrics and gynaecology to acquire new capabilities that will benefit mothers and their infants in Gaza and the West Bank. I recognize the desperate need for assistance in this region. This course is unique as it combines obstetrics and gynaecology with trauma care. This training aims to address complex challenges comprehensively and I look forward to it.” - Dr Iman Al Mabhooh, Obstetrician and Gynaecologist
A troop of volunteers
For the very first time, 11 FDNF volunteers from our Friends of The David Nott Foundation (FDNF) and Trainees of The David Nott Foundation (TDNF) societies volunteered to help arrange and assist during the course. This joint effort meant it could be organised at lightning speed, rapidly creating a network of well-trained war doctors.
“Given not only the humanitarian crisis in Gaza but with the targeting of healthcare workers in particular it's never been more important to strengthen our healthcare colleagues and equip them with the skills to do their incredibly difficult jobs and to support them through a very precarious situation.” - Nadia, FDNF Manchester President
Our surgical HEST and anaesthesia courses were held simultaneously, demonstrating our commitment to enhancing the skills of all those striving to preserve life in the operating theatre.
"What has been great about this course is meeting people that have experienced things in the field. From the anaesthetics point of view, it's been helpful to learn how they deal with limited resources and supplies, and we have been using airway mannequins and practicing with video scopes."- Dr Douglas Philpott, Anaesthetist
We’re committed
As war continues to rage, we are working on a second surgical training course with the goal of upskilling even more frontline medical professionals. We won’t stop empowering doctors with the knowledge needed to save lives and limbs against the odds.
Our latest training in Palestine
Funding paediatric trauma training for two Ukrainian surgeons
In the wake of ongoing conflict, we have taken a significant step in supporting Ukrainian doctors. To further strengthen Ukraine’s medical workforce, we sponsored two doctors, paediatric surgeon Dr Dim Ershov and anaesthetist Dr Olga Panasiuk, to attend the Paediatric Advanced Cadaveric Trauma Surgery (PACTS) course for surgeons.
After the war erupted, Dr Ershov, and Dr Panasiuk were recruited as surgeons for the Ukrainian army. The two doctors previously met our Co-Founder, Professor David Nott, during one of our surgical training courses in the country. Since March 2022, we have trained over 400 surgeons during 12 surgical training courses in cities such as Odesa, Kyiv, Dnipro, Poltava, Lviv and Zhytomyr.
Deepening our impact
In a bid to strengthen our support for medical professionals in war and catastrophe, we’ve expanded our offering beyond our flagship Hostile Environment Surgical Training (HEST) course. We worked with leading anaesthetists to develop an anaesthesia course and will be developing a nursing course next year, with the goal of saving even more lives inside and outside the operating theatre.
We also provide scholarships for frontline doctors in need of additional training. Dr Ershov and Dr Panasiuk were funded by us to attend the PACTS course in Newcastle.
The course, led by Dr Suren Arul, a paediatric surgeon who previously served in the military, is a two-day intensive program that blends surgical procedures with anaesthetics and nursing. The course incorporates realistic scenarios, including intensive role-playing at six different tables with various surgical cases, simulating the pressured experienced in war zones.
"They kept us on our toes"
After their two days of training, we met up with Dr Ershov and Dr Panasiuk to ask about their experiences. “Teamwork in the training program put us in a more realistic situation.” shared Dr Panasiuk. “The models were very interesting, very realistic. They kept us on our toes - as we would be during real surgery.”
"We extend our heartfelt appreciation to the David Nott Foundation for their unwavering support. As Ukrainians, we wish to express our deepest thanks to David and the entire foundation for their tireless efforts. Through multiple courses, they have saved lives and limbs, standing as champions for Ukraine and democratic freedom. PACTS will equip us with the skills to be more effective. Without their support, we would undoubtedly be prone to making several mistakes."- Drs Ershov and Panasiuk
Protecting Ukraine's children
“Undoubtedly, Dim and Olga can now return to Ukraine equipped with the skills and knowledge to perform life-saving procedures and surgeries, said Dr Suren. "Their participation in the PACTS course, sponsored by the Foundation, has undoubtedly elevated their capabilities, allowing them to make a significant impact in their homeland."
As conflict in Ukraine persists, we will continue to provide training and support to doctors in need. Thanks to a new wealth of knowledge, Dr Dim Ershov and Dr Olga Panasiuk will give more of Ukraine's children hope for the future.
MedGlobal Conference 2023: Building resilience amidst disaster
We’re back from Chicago, after two days at MedGlobal’s Annual Conference 2023. The conference brought together medical professionals, humanitarian aid coordinators, volunteers and students to discuss how we build resilience, protect mental health and utilise the power of artificial intelligence in conflict and disaster.
“We are not immune from conflict and disaster anywhere in the world. Ecuador, Ukraine, Gaza, Yemen, Sudan. Our mission is to ensure the lives of those going through challenge are better.” - Dr Zaher Sahloul, Co-Founder and President of MedGlobal
As conflict and disaster continues to stain our world, humanitarian organisations play a key role in helping communities survive and rebuild, whether by supplying basic resources such as shelter, food, water or clothing, or in the case of our Foundation, empowering doctors with life-saving surgical knowledge.
Despite the importance of humanitarian support, it is critical that communities are empowered to restore and rebuild their own lives - and have the tools to do so.
Local empowerment
Our Co-Founder and CEO Elly Nott spoke on the conference’s opening panel, alongside panellists Dr Omar Lateef, Chief Executive of RUSH University Medical Centre in Chicago, Sarah Eyring, Direction of Operations at the Stirling Foundation, and Sharon Eubank, Director of Humanitarian Services at Latter-Day Saint Charities. The group discussed how we can help communities become more resilient.
Elly shared: “What’s needed is a unified effort and giving locally-led organisations the space to flourish. They are closest to the need and what their communities require.”
For communities to rebuild, four things are vital:
- Humanitarian funding needs to be long-term, not just one to two-year funding cycles
- More funding must reach locally-led organisations, not as sub-contractors, but leaders of their own restoration
- Governance must be front and centre of all efforts
- Our healthcare workers must be better protected
Healthcare is a human right
Speaking about protection, Elly shared: “Healthcare is under attack wherever we look. We’ve seen it in over 900 verified attacks in Syria. The mental health effects on our healthcare workers are immense.”
In addition to advocating for the protection of our doctors, programmes like our Train the Trainers course hand the power to surgeons and anaesthetists in conflict and catastrophe, giving them knowledge and skills they can share with their colleagues. Sharing forms bonds and will help clinical teams make quick, effective decisions together, despite surrounding in chaos.
“Mental health gets better when you believe in what you’re doing. Local empowerment will build improved mental health. If you feel valued, invested in, connected as a team and part of change – mental health will get better.” – Dr Omar Lateef
Lifetime Achievement Award
Outside of relationship building and discussion during panels, our Co-Founder Professor David Nott was honoured with a Lifetime Achievement Award for his contribution to humanitarian surgery on the frontline. He received a standing ovation from approximately 400 gala attendees, after sharing stories from his time in Aleppo.
"I was operating on a little girl. All of a sudden, we were told to evacuate as the hospital was about to be bombed. I looked at the anaesthetist, and said I wasn't leaving. They didn't leave either. Together, we operated on the little girl - and no bomb came. She survived."
We thank MedGlobal for their generosity and invitation. Together, we will continue to serve, support and empower communities in need.