Over 160 Ukrainian doctors now trained to treat war wounds
David Nott and Faculty Trainers Dr Pete Mathew and Dr Ammar Darwish recently returned from delivering two back-to-back surgical HEST courses in Odessa, Ukraine. The team upskilled 74 doctors in a city battered by targeted missiles and heavy shelling.
Standing in solidarity
Continuing our mission of standing shoulder to shoulder with Ukrainian healthcare professionals, David, Dr Ammar Darwish and Dr Pete Mathew returned to Ukraine in August with UOSSM International, this time running two of our surgical training courses in the southern city of Odessa.
Over an exhausting six days, the team delivered a condensed version of our HEST course to 74 healthcare professionals, taking the number of Ukrainians who have received our training this year up to 160.
We deliver our training to those in need of our help, no matter their experience or seniority. During the two courses, the team trained junior doctors, senior consultants, anaesthetists and Ukrainian army officers.
From burr holes to skin grafts
To prepare the group for any trauma injury, our trainers used cutting-edge teaching tools to illustrate a range of techniques such as how to pin and stabilise the pelvis, drill burr holes to relieve cranial pressure, repair heart tears, prepare healthy skin grafts for burn injuries, or how to insert and stitch emergency chest tubes using our prosthetic skin pads (pictured below).
Speaking exclusively to The Telegraph, David said: “I was fairly sure it (the war) would go the same way as Aleppo in Syria. I knew we would see a lot of blast injuries, such as lung trauma, shrapnel wounds and burns."
David was right. Speaking to frontline doctors in Odessa, they are seeing multi-organ injuries for the very first time, such as penetrating damage to the heart and lungs, caused by flying shards of metal. The confidence and skills learned on our courses better prepare doctors for war injuries like these, not commonly presented in standard medical training.
We are incredibly proud of David and our Teaching Faculty as they continue to upskill and support healthcare professionals in Ukraine. "If I was a pessimist, I’d never be able to do what I do”, says David. “You can always make things better for people.”
David's story in The Telegraph
Inspiring the next generation of war doctors
On Friday 21st October, David and a key member of our Training Faculty, Dr Ammar Darwish, met over 100 sixth form students at Whalley Range School in Manchester. The pair shared their experiences as frontline doctors and some of our cutting-edge teaching equipment, such as our war wound model Heston, 3D printed hearts and model blood vessels.
Earlier this year, we received a letter from Waad Fellag, a sixth form student who dreams of becoming a doctor. After reading our Co-Founder’s book, War Doctor, Waad shared: “David Nott showed me the impact he and his team have had on families, especially children. I grew to understand that the simplest and slightest words or actions make a real difference in a person’s life.
Waad asked if we would visit her school to meet the “many bright minds who are passionate about become doctors”, some of which have lived in war-torn countries such as Syria, Libya and Afghanistan.
“A medical degree gives you a passport”
Speaking to over 100 female students, David shared stories from 31 surgical missions and his time treating the wounded following two natural disasters. His first humanitarian mission to Sarajevo in 1993 will always stay with him.
Students listened intently as he reflected on operating in a makeshift hospital, nicknamed ‘The Swiss Cheese’ due to gaping holes in the walls caused by bomb blasts and artillery. Steam escaped the edges his mask as he operated in the freezing cold with no electricity.
David shared: “A Lancet article revealed that 17 million people die every year due to conditions that require surgical treatment. It’s a wonderful thing to have the skills, hands and brain to make people in need better again. A medical degree gives you a passport to help people anywhere in the world.”
Future leaders
Elly Nott, our CEO and Co-Founder, said: “David receives dozens of invitations to speak each year, but Waad’s message, with her desire to inspire her fellow students to become humanitarian doctors, struck a chord with us. Encouraging the next generation of humanitarian doctors, in particular those attending state schools and young women, is an important and valued arm of our work.
I was also pleased to share with students that there are many different ways to lead a humanitarian life. Your contribution may not be medical but is just as valued no matters its form, be that legal, administrative, operational or diplomatic. It was an incredibly uplifting and inspiring afternoon for our team.”
After David’s stories, Faculty Trainer, Dr Ammar Darwish, talked the group through our one-of-a-kind war wound model, Heston. Students gasped as he used Heston to illustrate the damage caused by penetrating head injuries, the benefits of using skin flaps to encourage wound healing, and how to stop severe bleeding in the heart and lungs.
Scrubbed Up
Dr Darwish was followed by Scrubbed Up, an outstanding student-led organisation that supports prospective and current medical students, offering guidance on every career step from university applications to exam preparations.
Miss Toyin Bakare, Assistant Head Teacher at Whalley Range School, said: “We are grateful to David Nott, Scrubbed Up and the team for going above and beyond the request made by one of our incredible students, Waad, to visit our school.
It was a demonstration of the power of the written word, which can sow seeds, nurture ideas, and empower others to make a meaningful impact in their spheres of influence.”
What can you do?
We were in awe of each and every student’s enthusiasm, vibrancy and determination to make a difference in the world in their own way. In Waad’s words, “I ask you all – what can you do to help those who need us the most?”
Running London's streets for war doctors
We have been overwhelmed by the determination and generosity of our supporters this running season. Here, we reflect on the achievements and stories of some of our runners in this year’s London Marathon and Royal Parks Half Marathon.
Beth Needham (pictured above), a fourth-year medical student at the University of Liverpool, ran this year’s London Marathon in our name and has raised almost £1000. Beth dreams of becoming an army doctor and was so inspired by David’s story that she decided to get involved in the Friends of David Nott Foundation (FDNF) Society at her University, raising awareness of our mission and vital funds for our surgical training.
“David is such a massive inspiration to me. I’m over the moon to raise some money for the charity he set up.”
“Worth every painful second”
Reflecting on her marathon experience, Beth shared: “It was so, so difficult, but worth every painful second. I was absolutely overwhelmed by the support and encouragement we received on the day and, even though it was one of the hardest things I’ve ever done, I’ve already entered next year’s ballot!
The sheer amount of love, teamwork and pride made for a very emotional finish! I’ll now be wearing my medal for the foreseeable.”
Crossing the finish line together
This weekend, eight supporters ran the Royal Parks Half Marathon with our name on their shirts, raising a fantastic £3000 for our mission. Our Faculty Trainer Dr Ammar Darwish took on the race with his son Mohammad. It was not an easy task for the pair, but Mohammad’s determination pushed them to the finish line.
Dr Darwish shared: “Not sure how, but I just completed the Royal Parks Half Marathon! Having my son Mohammad run next to me constantly calling “come on!” is what no doubt got me through.”
A race to be proud of
Fi Nicholson ran the Royal Parks Half Marathon in an impressive 1 hour 50 minutes – the fastest finishing time of all of our runners this year. Fi has raised an outstanding £1000, which will help us train more doctors serving devastated communities in conflict zones.
“David Nott, to be honest, is an inspiration. I know each penny will go directly to training of surgeons in war-torn areas. If only his work wasn’t needed. I got a shout out from the David Nott Foundation at Westminster. Every shout was a boost," shared Fi.
"Thank you (to all) for the support and friendship, and to the David Nott Foundation for what you do.”
If you’re raising funds for us or would like to share your story, we’d love to hear from you.
Our surgical webinars for frontline doctors are back
On Thursday 30th August, we relaunched our webinar series for doctors. We invite surgeons around the world to share their treatment of complex injuries, some with limited resources in conflict zones. During our webinar, two Ukrainian surgeons shared how they removed shrapnel from a little boy’s heart and treated a woman’s devastating leg injury using skills learned on our Hostile Environment Surgical Training (HEST) course.
Dr Natalia Romanova from Kharkiv Regional Paediatric Hospital joined our HEST course in Ukraine this June. There, she learned how to treat fragment wounds – injuries caused by flying shrapnel – using our human war wound model (pictured below).
Dr Romanova shared: “Unfortunately, we face mine-blast trauma or penetrating wounds constantly (in Ukraine). Every single day.”
Shortly after completing our surgical training course in Kharkiv, Dr Romanova had to put her new skills to the test. A number of children were rushed to hospital after a shelling attack. Metal shards from a cluster munition had penetrated the lung and heart of a 12-year-old boy - fatal injuries without rapid action.
Together, the team performed a thoracotomy and pericardiotomy, opening the chest and heart's sac to find the source of bleeding.
From there, the team removed a blood clot covering a tear in the boy’s heart and blocked the hole with a finger. Carefully and swiftly, they repaired the injury using a piece of the heart's sac, before sewing the torn lung back together. Thanks to their speed and skill, Dr Romanova and her team saved the little boy’s life.
“I was ready"
Before her team presented this case to fellow surgeons, Dr Romanova felt compelled to contact us and share her delight at saving a life against the odds.
It may be unexpected for you to receive this letter. You might not remember me, but it is the (best) way to express my gratitude and it is my duty to do it.
I am a paediatric surgeon from Kharkiv, Ukraine. In June, we attended your magnificent HEST course. My colleagues and I are very grateful to you for all the information and skills we gained within those three days of training.
We were not used to work with such cases in peaceful times, so your professional guidance and knowledge are priceless for us now.
Despite never treating a penetrating wound before, Dr Romanova shared: “I was ready.” The surgery was successful, and the child was later discharged and evacuated from Ukraine.
After Dr Romanova’s team presentation, our Co-Founder, David Nott, said: “Many, many congratulations on such an amazing operation. I was so delighted that you were able to save this child’s life. You have done a brilliant job.”
Surgeons also heard from Dr Ivan Parkhomenko during the webinar, a junior doctor trained by David and other faculty members in Ukraine earlier this year. Dr Parkhomenko described how he’s “starting a little revolution” in his hospital, sharing the skin grafting technique he learned on our course with senior consultants and junior doctors alike.
A global community
We’re committed to continuing to grow our global network of doctors and creating a supportive space for the sharing of surgical knowledge.
If you are a surgeon who would like to receive information about our courses or contribute to one of our webinars, please get in touch.
"The skin is alive - it's all because of you."
“Here – you do it.” These were the words of our Co-Founder David, as he handed a skin grafting instrument to Ivan, a junior doctor in eastern Ukraine attending our surgical training course.
During a Russian shelling, a woman suffered catastrophic leg injuries. Working to repair her wound during a mission in Ukraine, David used the surgery as an opportunity to train local doctors.
He showed them how to perform a skin graft to treat the injury – and that wrapping the graft in fluffy gauze can help with healing. This technique differs to standard wound treatment, which often involves the application of antiseptic spirits and bandages.
David and Ivan have kept in touch since his returned to the UK – a common story for David and our trainers. We are proud to have created a supportive community of war doctors that can ask questions or share cases with us at any time, from anywhere.
When Ivan looked at his patient’s wound in recovery, he was overwhelmed with joy to see that it was healing. During a phone call, he shared with David:
“The skin is alive! It’s all because of you.
I’ve started a little revolution in my hospital. I’ve started to do what you do - using the fluffy gauze for skin grafts. The patient’s granulation (tissue that is an important component of wound healing) is awesome. We haven’t needed to use any antibiotics.
It was one of the best moments of my life doing this operation. I can only say thank you for your knowledge.”
Ivan, a junior doctor facing the horrors of his country’s war, is now armed with a skill that can be used to treat devastating injuries. He plans to teach this technique to his peers – and potentially even senior doctors who typically use other methods.
Although unusual for a junior doctor to teach senior consultants, in war, titles are stripped away. All that matters is the sharing of knowledge and saving of lives.
To carry out the next phase of the patient’s skin graft surgery, David offered his help over Skype. Ivan and his father, a Chief of Surgery based in Kharkiv, will work together with David to rebuild the woman’s leg and remove as many traces of the evidence of war as possible.
Surgery over Skype isn’t new to our Co-Founder. During the historic siege in Aleppo, David guided surgeons online as they reconstructed a man’s shattered jaw. The Syrian surgeons, Dr Assaf and Dr Baydak, successfully carried out the operation and put the man’s face back together again.
The stark similarities between Syrian and Ukrainian conflict do not go unnoticed. As witnessed in Aleppo, healthcare workers in Ukraine are in urgent need of our support. As the war continues to wage on, we are more driven than ever to train doctors and help them prevent needless deaths.
“You have given me new breath in surgery,” shared Ivan. “You were not scared to come here and share knowledge. Thank you.”
More on our training in Ukraine
We’re back from training frontline doctors in two Ukrainian cities
An experienced team of trainers have just returned from delivering two HEST courses in Dnipro and Kharkiv. Here, consultant neurosurgeon and faculty member Pete Mathew shares his experience of teaching frontline doctors in Ukraine and what makes a course successful.
After David volunteered in Ukraine in April, it became clear there was an urgent need to return and deliver our war surgery training course to doctors in the country.
We decided it was best to send a small but experienced team, consisting of David, myself and Ammar Darwish. The three of us have worked in a number of war zones over the past decade – and Ammar and I have been part of the Foundation’s teaching faculty for years.
Reaching as many doctors as possible
To have a bigger impact, we decided to deliver two courses in Ukraine. We held one three-day course in Dnipro and another in Kharkiv – two cities that have faced significant attacks over the past few weeks.
To enter the country and support us on our mission, we worked with UOSSM International. Together, we travelled from Poland and made our way to our first training destination – what appeared to be a teaching facility in Dnipro.
On the walls, there were pictures of students happy and smiling, a stark difference to Ukraine’s present reality.
Training overseas is always a leap into the unknown. We never quite know where the teaching location will be. We don’t always know what sort of doctors will arrive. But it always comes together.
Once we got our bearings, we set our equipment up before the doctors arrived – from Heston our war wound model to David’s comprehensive training videos on a projector. Heston is an excellent teaching aid for describing injuries or techniques.
Making an impact in Dnipro
In Dnipro we had over 30 attendees of varying seniority and specialties - junior doctors, consultants, emergency doctors and an anaesthetist. We had a fantastic Ukrainian translator with us, which was amazing. Different doctors arrived on different days, which is quite normal in an emergency, resource-poor setting. They need to return to treating patients on the frontline.
Sometimes it can take a little time to gain the trust of attendees. We need to prove our worth – which is absolutely understandable.
Creating a community
Some of the surgeries are quite simple, but the hurdle is finding the confidence to do them under challenging, high-stress circumstances. We want doctors to feel empowered - sometimes all that’s needed is confidence. We want doctors to feel inspired to learn and try the techniques they’ve seen on our course.
We hear from those we train that we offer a morale boost, but perhaps more importantly we provide a forum for surgeons with different levels of experience to have discussions and raise questions – a safe space for doctors to debate views.
Speaking with the doctors we met in Dnipro, it was clear they were resigned to the inevitability of returning to the frontline after our course ended. They are solemnly grinding away. Some of the very junior doctors were more anxious about returning to work.
The road to Kharkiv
After three days, we packed up and travelled up to Kharkiv to deliver our second course. The group – 28 doctors - were very happy to see us.
Back-to-back courses can be very tiring, but we are always happy to do it. It’s always very tempting to do two in a row, to reach more people.
There was a marked change in behaviour from the beginning to the end of our courses. Being an effective teacher requires getting your message across with enthusiasm. If you don’t feel drained after a course, or you don’t see excitement in your audience, you haven’t given it everything.
You also need to be able to adapt to the needs of your attendees. It’s important to be flexible and go off-script – to deliver the course in a way that best suits those in front of you.
Standing in solidarity
When training in active war zones like Ukraine, an experienced team, support from the Foundation and partners like UOSSM International are important.
I hope our training has boosted Ukrainian doctors. As long as this war wages on, we will continue to offer whatever support we can.
Surgery on the frontline in Ukraine: David Nott in conversation with Bridget Kendall
We are delighted to announce that The BEARR Trust is hosting an event with our Co-Founder David, to discuss his work providing emergency surgical care and training local doctors in Ukraine.
David will be in conversation with award-winning journalist and BEARR patron, Bridget Kendall, to share his stories of working in crisis and catastrophe zones for over 25 years - including the delivery of two HEST courses in Ukraine. The online event will take place at 18:30 BST on Monday 27 June via Zoom.
About Bridget Kendall
Bridget Kendall worked for the BBC for over 30 years, specialising in Soviet and Russian affairs after graduating from Oxford and Harvard universities. From 1989 to 1995, Bridget was the BBC’s Moscow correspondent, covering the final years of the USSR and the first years of post-Soviet Russia.
As the BBC’s Diplomatic correspondent from 1998 to 2016, she covered conflicts in Chechnya, Georgia, Tajikistan and Ukraine, among others, and in 2001 and 2006 she conducted two interviews with Vladimir Putin, both broadcast live to the world from inside the Kremlin.
In 2016, Bridget was elected Master of Peterhouse Cambridge. She is also a patron of The BEARR Trust.
Register to attend this special event today
Messums Gallery raises £17,000 to help us train doctors in Ukraine
When the war in Ukraine unfolded, Johnny Messum and fellow colleagues at Messums Gallery decided to offer their help by raising funds for charities working in the field. They auctioned a selection of beautiful works and raised an outstanding £17,000 for our cause, helping us upskill local doctors and prepare them for war injuries.
After Russian invasion, artists at Messums Gallery and the art-collecting community were keen to find a way of offering support to the people of Ukraine. This led to Messums Gallery holding their first ever auction, raising funds for our Foundation and Hope and Homes, a charity dedicated to protecting families torn apart by war.
Artists donated exceptional works of art (a selection below) to an online auction that closed on the 2nd May. The auction led to a generous donation of £17,000 to the David Nott Foundation, and the same figure to Hope and Homes.
Johnny Messum, Founder of Messums Gallery, said:
“It is so difficult to know, beyond the immediate instinct to want to help, how best to assist Ukraine. Our way was to find personal connections to charities doing brilliant work in the field.
The David Nott Foundation was immediately identifiable as a charity representing a clear and direct course of action in the face of great human tragedy. We particularly admired the Foundation’s work because it is so enabling of others.”
Rebecca McLoughlin, Head of Donor Relations at the David Nott Foundation, said:
“We are overwhelmed by the incredible generosity of Messums Gallery and their artists.
These funds have helped us physically reach and surgically train doctors within war-torn regions of Ukraine, giving them the vital skills needed to treat traumatic wounds and save lives.”
Find out about our latest mission to Ukraine
From underground hospitals in Syria to training in Gaziantep
For the first time, we delivered two surgical training courses over a four-week period in different countries. Our latest course was for Syrian doctors in the Turkish city of Gaziantep, some of whom had worked together in hospitals in Aleppo between 2011 and 2016.
After a memorable course at Edna Adan Hospital in Somaliland, we partnered with Syria Relief to train 26 healthcare professionals in Gaziantep.
A Turkish city near the border with Syria, Gaziantep is home to a number of doctors who know the destruction of war all too well. Many were forcibly displaced from Syria by conflict and some had operated with David in underground hospitals when eastern Aleppo faced military bombardment and siege.
Unbreakable bonds
When the Syrian government, with Russian air support, began targeting medical workers and healthcare facilities, doctors started treating patients in secret hospitals with extremely limited resources. David travelled to Aleppo to help the doctors manage complex injuries and save lives. His sharing of surgical knowledge often led to life-long bonds with those he taught.
Dr Mahmoud Hariri from Aleppo shares: “I first met David in 2013. He came to us in Aleppo, and we learned many things. We learned to be multi-tasking surgeons. I can now do surgery on the kidney, heart, vessels. This is the notion of the multi-tasking doctor. A lot of lives have been saved.”
Dr Hariri and 25 others joined our Gaziantep course with the help of our Course Director Dr Ammar Darwish and the Syrian Board of Medical Specialties (SBOMS), an organisation dedicated to helping Syrian medics work as specialised doctors in northern regions of Syria.
Trainees becoming trainers
The course was taught by accomplished Faculty - some who had learned from David in Syria or during a previous HEST course - and were now excellent surgical teachers.
Helping trainees become trainers is what we are here for. We want to empower doctors within countries affected by conflict and catastrophe to be surgical and health system leaders, serving their own communities.
The group learned how to manage and treat complex war wounds, such as blast injuries, gaping holes in the body, or deep burns. They also learned what to prioritise when faced with multiple wounds, the majority of which they will never have seen during standard medical training.
New skills in practice
Others on the course had also worked with David in conflict. Dr Ehab Baydak, a maxillofacial surgeon from Idlib, Syria, saved a man’s life with David’s help over skype. Since then, Dr Baydak has put his skills to practice in his community.
“During the siege of Aleppo, I was working in an underground hospital and received a patient whose face was severely injured from a bombing. We hadn’t seen this type of injury before and didn’t know how to deal with this,” Dr Baydak shares.
“Due to the siege, we couldn’t transfer patients outside of the city. Dr Murhaf Assaf and I contacted David who talked us through how to do the operation over Skype.
After the Syrian regime took control of Aleppo, I moved back to Idlib to be with my family. There, I came across the same injury, and I was able to do the surgical procedure alone – all because of my experience with David.”
Our courses teach healthcare professionals how to perform procedures just like this – operations that David has undertaken in war zones over 30 years of voluntary humanitarian work. We were honoured to contribute to the surgical education of 26 doctors in Gaziantep, giving them the skills needed to save lives and limbs against the odds.