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
Welcoming our new CEO
Having founded the charity in 2015 and led it as CEO for nine years, Elly Nott has stepped down as Chief Executive to take up an alternative role in the leadership of the organisation.
As Elly embarks on her new role, the charity warmly welcomes Dr James Gough as its leader. James is a former military and aid doctor, having served with the British Army and international aid groups in Afghanistan, Egypt, Indonesia and Bangladesh.
Beyond the field of medicine, James has served with the UK Foreign and Commonwealth Office and founded both the virtual reality enterprise One Shot Immersive and a UK charity promoting and protecting the wellness of those who serve the Crown.
Dr James Gough MBBCh, newly appointed CEO of the David Nott Foundation, said:
“It is the privilege of my professional life to have the opportunity to serve the beneficiaries of the David Nott Foundation as Chief Executive. At a time of immense human suffering around the world, the dedication of our donors, our volunteers and our people is both humbling and critically important.”
Graham Hodgkin, Chair of Trustees of the David Nott Foundation, said:
“The David Nott Foundation continues to develop its position as providing the gold standard of conflict surgical training. The Foundation is known and respected among humanitarian organisations, government ministries and policymakers and trusted by healthcare workers. Crucially, our training saves lives and makes access to safe, skilled surgical care a reality for more people in conflict and catastrophe-affected regions.
Alongside Co-Founders David and Elly Nott, and my fellow Trustees, we are delighted to welcome James as our new CEO and have every faith in his ability to deliver our vision and mission to our stakeholders. He will have our unwavering support as he takes on his new role as CEO of this remarkable and special organisation.”
Since our birth in 2015, our global faculty of trainers have upskilled over 2000 doctors in countries tarred by war and disaster, such as Yemen, Syria, Iraq, Ukraine and Palestine. Under James's leadership, we look forward to further deepening our impact across the globe.
SUPPORT OUR MISSIONS
Our new Betty Boothroyd Scholarship Fund
We are delighted to announce the launch of our new Scholarship Fund in memory of our late Patron and beloved friend, The Rt Hon. The Baroness Boothroyd OM. The fund invites applications from medical professionals living, working or volunteering in conflict zones, including surgeons, clinicians and nurses, who wish to further their surgical training.
Our Patron
Betty became our Patron in 2016, when the conflict in Syria was at its most intense. Areas of the country were besieged, civilian infrastructure targeted and the passage of humanitarian aid restricted. Betty would often call our Co-Founders to express her concern at what was happening and ask what the Foundation could do to help.
In conflict, surgeons need a particular set of skills and decision-making strategies to be able to respond effectively to the waves of devastating injuries they encounter daily. The work of training doctors began in Misrata, Libya, moved on to Aleppo, Syria, and we have since then trained 1,825 surgeons and anaesthetists in conflict setting including Iraq, Cameroon, Palestine, Ukraine and many more.
From the very beginning of her journey with us, Betty remained deeply passionate about our training of frontline doctors working relentless hours. In honour of Betty’s commitment to our mission, we are proud to launch the Betty Boothroyd Scholarship Fund.
What’s the funding criteria?
Whether you’re a Sudanese nurse interested in a Masters in Trauma Management, a Palestinian doctor wishing to complete a paediatrics course, or a humanitarian surgeon interested in joining one of our HEST-UK courses, we may be able to support you with funding.
Guidelines
1. Applications are open to any surgical team members who wish to further their medical training or education (e.g. surgeon, anaesthetist or surgical nurse)
2. The training that applicants are seeking funding for can be held anywhere in the world
3. Applicants must meet one of three criteria below:
- Living and/or working in a conflict or catastrophe zone
- Your country of origin is a territory that has experienced conflict or catastrophe, however you currently reside in another country
- You are a humanitarian surgeon who travels to, and volunteers in, conflict and catastrophe zones
“Thanks to Betty’s generosity to our Foundation, she will continue to make a difference to doctors striving to heal their wounded communities for decades to come.” - Elly Nott, Co-Founder
Contact us to apply
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.