DigiHEST: How we reached 29 countries in two days.
In December, we piloted our first ever Digital Hostile Environment Surgical Training (DigiHEST) course. We transformed an office space, generously provided by Whitby Wood, into an operating theatre and our friends at Redux Content decked the place out as a recording set.
Over the course of a weekend, David Nott was joined by DNF faculty members Ammar Darwish, Rebekka Troller and Pete Mathew to present an ambitious programme of surgical training that was live streamed around the world. Modules covered included abdominal trauma, neurosurgery, maxillofacial surgery, ballistics and more. David was also joined by special guest lecturers Mounir Hakimi (orthopaedics) and Shehan Hettiaratchy (plastics) to form a world-class team of surgical specialists ready to reach out to surgeons in conflict zones and austere environments.
We were joined by up to 100 doctors from around 29 countries over the course the weekend, who were additionally able to pose their questions in real-time to the presenters and ask for advice on cases presenting to them in their localities.
COVID-19 has changed the way that we are able to deliver our training courses in 2020/21. The DigiHEST pilot study is extremely encouraging to our team as it shows that not only can we continue to deliver a high quality training product, but the use of live-streaming technology has implications for the future democratisation of surgical training for the austere environment. Our aim is to get back on the road and delivering face-to-face courses around the world again as soon as possible, but the hard work that has gone into piloting the concept of DigiHEST will inform how we can best deliver training in the future.
Cycling across Europe!
Beginning on 1st September, a group of friends from the USA and the UK, will be taking on the “challenge and opportunity of a lifetime” to raise funds for the David Nott Foundation and STAR, Inc.
Led by Tony Williams and Tom Nero, the team had planned to cycle Route 20, the longest road in the US, starting in Massachusetts on the east coast and finishing in Oregon on the west. However, due to Covid-19 movement restrictions being imposed in various states, the itinerary had to be rearranged and the team are now circum-cycling Italy.
The route will take the team from Milan, anti-clockwise around Italy. The distance is over 2,000 miles with 19 miles of ascent, making it the toughest challenge event taken on for the DNF so far!
The team have set an ambitious target of $250,000 to match the extraordinary scale of this challenge.
As they prepare for “Over 3,000 miles of saddle soreness,” Tony is proud to announce, “With only two months to go till we start our cycle ride, I am very excited that we now have pledges and donations exceeding $157,000 (split almost equally between the US and the UK charities). This is HUGE and a true reflection of the worthy causes we are supporting. A $50,000 challenge gift will match future donations up to that amount.”
We are completely bowled over by their support and cannot wait to update you on their journey across Europe. The team have also set up their own website dedicated to bringing you the latest news on their once-in-a-lifetime trip. Check it out by clicking here.
If you're feeling inspired, please get in touch with your own fundraising challenges - we love to hear from you!
War Doctor Heroes: Meet Dr Marah
Dr Marah, a medical student from Homs, Syria knows that no matter how young a physician is, they should always be updated with the best skills and practices.
The shortage of medical staff, surgical equipment and training programmes are significant barriers to quality healthcare in her region, and these problems are worsened by a poor socioeconomic situation.
After studying medicine for only two years, Marah assisted in a Mastectomy operation on a fifty-year-old woman. Owing to the anaesthetist’s lack of experience, the patient was not under good anaesthesia and experienced a great deal of pain during the procedure. Although Marah was very anxious, she looked after the patient and decided that surgery was what she wanted to do for the rest of her life.
In 2019, we invited Marah to attend our overseas HEST course in Lebanon where she was taught how to perform many complex surgical procedures and was able to build up her confidence. She told us that the training course inspired her to “use every source of power I have to help the patients and that no matter how hard the situation is we should always remember that patients must be our first priority.”
Marah hopes her country finds peace soon and believes that by working together and supporting each other, her people can improve their future. We are confident that Marah will make a brilliant surgeon and we are proud to be supporting her on this journey.
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.
April 2020 Newsletter
Hello and welcome to our latest newsletter.
In this update, we will share our new arrangements in light of COVID-19, bring you the story of a Syrian surgeon and share the superb fundraising efforts of our Somerset supporters.
Thank you, as always, for your continued support and we hope you are keeping well at home.
A Note on COVID-19
Since our last newsletter, COVID-19 has developed into a global pandemic. We understand that this is a significant cause of anxiety for many, so we would first and foremost like to extend our wishes that you and your loved ones are safe and well.
Following the latest government advice, the David Nott Foundation office has closed and our staff are now working from home. The best way to contact us is via email at [email protected]
We have also had to postpone our surgical training courses and are currently developing new ways of reaching surgeons to provide them with training and advice. The pipeline of courses in planning continues to grow with a wide variety of partners to help train surgeons operating in austere conditions across the Middle East and Africa. We’re looking forward to rolling these out as soon as we can.
Spotlight on Dr Ayman
We first met Ayman back in 2013, when David Nott was volunteering in Alzarour Hospital, Aleppo. Whilst treating patients, David was able to teach Ayman and his team a variety of specialised surgical procedures that Ayman was later able to use to save lives.
One patient that Ayman especially remembers was an 11-month-old baby girl. Her father carried her to the hospital after she was wounded in a bomb explosion. She had a severe leg wound and the orthopaedic surgeon wanted to perform an amputation.
Fortunately, Dr Ayman knew there was a chance her leg could be saved. He successfully performed a vein bypass to restore the blood supply and later her leg was externally fixated so that the bone could heal properly.
To Ayman’s immense happiness, the little girl recently started walking.
You can read the full story and hear about our other war doctors here.
Star Fundraisers
Back in February, two small businesses put their heads together and came up with a brilliant fundraising idea – a charity dinner! Based in Chilcompton, Somerset, ‘The Holy Cow’ café and ‘The Pudding Kitchen’ pulled together a delicious four course meal, complete with craft drinks and a tasty dessert selection.
Rachel Middleton, from The Pudding Kitchen, was inspired after her friend sent her a link to David’s Desert Island Discs. After that, she was hooked! We’re thrilled that the team managed to raise over £1,000 for us - enough to train one surgeon on our overseas HEST course.
We love hearing about your creative fundraising efforts, so let us know if you’ve got anything exciting planned.
To the frontline heroes: thank you
