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
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
Our action in response to the Israel-Gaza war
As a humanitarian organisation delivering surgical training to doctors in regions affected by conflict and catastrophe, we have been devastated by the recent escalation of violence in the Middle East.
We have been in contact with our partners, including Juzoor and Action for Humanity, local faculty of trainers, and those we’ve previously trained, to gather a comprehensive picture of the injuries being encountered and needs of medical professionals on the ground.
Reports reveal that many healthcare facilities are under severe strain. Emergency departments are under immense pressure, with growing numbers of trauma injuries due to shellings, shrapnel or collapsed buildings. Supplies at blood banks and basic medical resources are also running low.
Our action
To support hard-to-reach medical professionals at this time, we:
Turned our world-class surgical training course into a series of short videos that can be watched in their own time. We’ve shared our English and Arabic videos with local doctors across the region.
Shared our videos with local partner medical professional networks, ensuring even more doctors in need can benefit from the resource.
Invited local doctors to our global case study discussion forum to share patient cases and gain advice from peers around the world.
Exploring a bespoke discussion forum for doctors affected by this crisis, where our faculty of trainers and others can offer advice and surgical guidance more personally.
As the emergency unfolds, we will continue to monitor how best to support doctors under pressure until we are able to deliver our surgical training course in person.
Elly Nott, our Co-Founder and CEO, said:
“We are appalled by the violence and loss of life in Israel and Gaza and extend our condolences to all who have lost loved ones.
Following the attacks, many are contending with injuries of vast complexity, scale and intensity.
Healthcare workers should be able to deliver life-saving care to their communities free from the threat of violence and parties should uphold their obligations under international humanitarian law.
Access and protection for humanitarians delivering assistance to those civilians affected is essential.”
This World Humanitarian Day
This World Humanitarian Day, we reflect on our commitment to the humanitarian values that inspire our work - training medical professionals to provide safe, skilled surgical care in countries impacted by conflict and catastrophe.
Our flagship Hostile Environment Surgical Training (HEST) course continues to provide the best in surgical training to those who need it most. Using innovative teaching materials such as our prosthetic hearts, kidneys, arteries and veins, our world-class trauma surgery modules are brought to life by the remarkable, talented training faculty who deliver it. We are so grateful to our team of trainers who give up their time to share knowledge with doctors around the world. We know they also learn as much from them in return.
In addition to training surgeons, we have developed an anaesthesia module, expanding our focus from the surgeon to the wider - any equally important - operating theatre team. As with surgery, conflict presents unique challenges for anaesthetic practice including severe blast injuries, blood loss and resource constraints.
I was inspired to start our Foundation by a single, grainy photograph of David.
In a room in a hospital in Aleppo, lit solely by the steady beam of a projector, he was discussing cases with a group of Syrian doctors at the end of a day of operating. I started thinking how that life-saving training delivered by David in Aleppo, built on decades of frontline experience, could be brought to hundreds, perhaps thousands, more doctors.
David’s unwavering connection with the doctors of northwest Syria goes back a decade and when the devastating earthquake hit southern Türkiye and northwest Syria in February, we immediately started discussing with local partners and colleagues what they were seeing and how we could help. It rapidly became clear that thousands of survivors were left with life-altering injuries in need of surgical treatment and rehabilitative care.
Thanks to expert navigation of local permissions by our partners, we were able to run a joint teaching and operating mission with Action for Humanity in Aqrabat Hospital, Idlib. The Action for Humanity team saw 300 patients in clinic before completing 60 surgeries the following week. Above the operating theatres, we equipped 35 Syrian doctors with the surgical techniques they need to treat complex injuries inflicted by the earthquake or ongoing conflict.
Ninety percent of our training faculty on the mission were Syrian and based in the northwest, therefore able to better understand local health system challenges and teach the course in Arabic.
Sustainability is vitally important to us; we want surgical knowledge to be embedded in communities to the extent that it is self-perpetuating and we are no longer needed. Until it is, we’ll keep returning as long as we are needed, No Matter What.
As a small charity, we are able to deliver so much more in terms of training and value for our donors’ money by partnering with other humanitarian organisations like Action for Humanity. Our training partners are diverse in scale and size. We delivered training in Moldova with the World Health Organisation and for Yemeni surgeons with Médecins Sans Frontières. We are excited to collaborate with MedGlobal in the coming months, and in Ukraine, were proud to partner with our friends at UOSSM, a charity initially formed to provide relief and assistance to Syrian civilians affected by the deadly conflict there.
Unfortunately, risks for humanitarians and attacks on healthcare have increased in recent years.
Last week, Physicians for Human Rights reported that 1014 attacks have been perpetrated against Ukraine’s hospitals, health workers, and other medical infrastructure since February 2022. Recent Elrha research also revealed that attacks on Syrian health facilities have deterred people from accessing health services and seeking help when needed.
Every hospital bombed, every healthcare worker killed, denies people vital care and destabilises communities both physically and psychologically. These atrocities are under-reported and we are honoured to support the campaigning efforts of Action for Sama, seeking to raise awareness of and ensure accountability for attacks on healthcare.
We believe in safe, skilled surgical care for all and stand with the communities we serve, No Matter What.
Elly Nott, Co-Founder and CEO
The Rt Hon. The Baroness Boothroyd OM, our beloved Patron
It was with great sadness that we learnt of the passing of our beloved Patron and friend, Baroness Boothroyd.
People like Betty Boothroyd do not come around often. She fought hard to enter Parliament, succeeding in doing so in 1973. She had a distinguished career serving on many select committees and as a whip before making history by becoming the first woman Speaker of the House of Commons. She won respect for her firm but fair application of the rules of the House and admiration for her authority, warmth and wit.
Her presence and unmistakeable star quality elevated any meeting she attended and to have Betty as our Patron was a point of huge pride for all of us. She took a keen interest in our work and would often call David or I, having watched news reports from Syria or Ukraine, and ask what we could do to help. She was with us from the start, when we launched the Foundation in 2016 at the Royal College of Surgeons of England, and she will leave a space quite impossible to fill. We will honour her legacy by striving to be as fearless, and as tireless, as Betty.
A star has gone out in Britain tonight, but the heavens are all the brighter for her presence. For your service to our country, support for our Foundation and friendship to David and I; thank you Betty.
Elly Nott, CEO and Co-Founder
26th February 2023
Merry Christmas from our Chief Executive
The end of the year provides us with a moment to reflect on what has passed and think about the future. It has been a year of many challenges and difficulties, but I am so grateful for the incredible ongoing support we have been so honoured to receive from you all.
I have found joy this year in the time I have spent with the doctors we have had the privilege to train on our courses. Speaking with doctors from Mosul, Iraq, on our HEST in November and from Ethiopia, Palestine, Afghanistan and Syria on our latest STAE course; they provide such inspiration to us as a team.
Thanks to your generosity, we have a full programme of training planned for 2022 and cannot wait to get started. It is our ambition to run six Hostile Environment Surgical Training (HEST) courses and re-start our Obstetric and Neonatal Care specialist courses. We will have two more cohorts of scholars on our scholarship programme and continue to deepen and strengthen the relationships we have built with healthcare workers and partner organisations over the previous six years.
To our DNF community, we wish you a very Happy Christmas and New Year. We truly couldn’t do what we do without you.
New Chief Executive at the David Nott Foundation
It is with great pleasure that we announce Elly Nott, Co-Founder of the David Nott Foundation, has been re-appointed as Chief Executive. Elly shares her thoughts on leading the organisation post-pandemic and her vision for the future.
I am delighted to share that I am returning to the role of Chief Executive of the Foundation. The David Nott Foundation is in my DNA, and it is a privilege to have been given the opportunity to lead the organisation I am so proud to have founded with David.
We have exciting plans for the future. We want to increase the number of surgical training courses we run globally and deepen our relationships with the selected countries within which we work. We also want to develop a bespoke obstetrics and neonatal course, to help doctors and midwives in conflict-affected states and austere environments better support expectant mothers and their babies.
At the heart of our mission is our determination to empower local healthcare workers in the places we operate and learn as much from them as they learn for us. Building strong relationships enables us to gather the most accurate picture of what they need during times of crisis - and ensure we deliver.
It’s an honour to serve them.
Elly Nott Leads DNF's Celebration of International Women's Day 2021
To mark International Women's Day 2021, David Nott Foundation Co-Founder Elly Nott writes:
This International Women’s Day I will be thinking about Mariam, Aiya, Aesha and Farida.
Mariam lives in Palestine, Aiya and Aesha in Libya and Farida in Syria but I have had the honour to meet them all at courses run by the David Nott Foundation (DNF), the charity I Co-Founded in 2015.
The DNF has a simple mission; to equip doctors with the skills they need to save more lives in areas affected by conflict and natural disaster. In these places, resources are often scarce, and medical education and training disrupted. We believe everyone deserves access to high-quality care, from highly-trained professionals, no matter where they live. Our impact resonates long after our team has left because the knowledge and techniques we teach are shared and go on to improve the lives of whole communities for years to come.
It remains a fact that whilst women form 70% of workers in the health and social sector[1] worldwide, they are underrepresented in surgery, particularly at the most senior levels. Worldwide statistics are difficult to obtain but in the UK women made up 13.2% of consultant surgeons in England in 2020, according the to the Royal College of Surgeons of England (RCS).[2]
Knowing the sort of statistics that exist, we as an organisation are eager to encourage the participation of women in all our courses and particularly to apply for our scholarship programme which, pre-COVID, brought doctors from around the world for a weeks’ intensive training in partnership with the RCS. We were also proud to have a 50-50 male-female teaching Faculty on our last mission abroad, to Yemen in 2020.
Our courses are a two-way process. We share knowledge; knowledge that is the product of decades’ experience in areas affected by conflict and catastrophe, and invite discussion. Our Faculty never stop learning and return from every course energised by the doctors they meet, ready to adapt future teaching to be as relevant and applicable as it can be.
I first met Farida during specialist obstetric and neonatal resuscitation training we held in collaboration with Hand in Hand for Aid and Development in Gaziantep in September 2018. Of the participants, 90% were women and I remember watching as they debated with the faculty throughout lectures and on into the coffee breaks. Aiya and Aesha attended the course we ran in Misrata, Libya, in March 2018, Aesha driving some 1000km from Sabha, in the south of the country, to attend. We encouraged them to apply for scholarships and after some major efforts to secure their visas, we welcomed them to the UK for further training. I shall never forget the knock on our door at home and answering it to see Aiya holding up two bags of gifts she had brought for my young daughters.
Mariam, I first met in Ramallah in March 2017. It was a memorable first meeting as that afternoon there was a boiler explosion in the venue we held the teaching. The lights went out, alarms sounded and all around there was chaos but in the darkness an arm linked in mine and guided me through to safety. It was Mariam, with whom I remain in touch and continue to follow her progress and commitment to her career as a surgeon.
We #ChooseToChallenge the under-representation of women in surgery and we #ChooseToChallenge the preconception of what a humanitarian surgeon looks like.
[1] https://apps.who.int/iris/bitstream/handle/10665/311314/WHO-HIS-HWF-Gender-WP1-2019.1-eng.pdf
[2] https://www.rcseng.ac.uk/careers-in-surgery/women-in-surgery/statistics/
Elly & David Nott featured in Foreign Policy’s Global Thinkers 2016 list
Since the Syrian civil war erupted, the Assad regime has killed almost 700 medical personnel—and thousands more have fled. In Syria, “health care is seen as a weapon,” Welsh surgeon David Nott told the Independent. “You take out one doctor, you take out 10,000 people he or she can no longer care for.” Over the past four years, Nott has provided emergency care in Syrian clinics and has trained the remaining health workers in triage techniques and basic surgical skills. When he’s back home in London, he provides trainees with real-time advice about cases through text messaging. In February, Nott and his wife, Elly, launched a foundation dedicated to preparing doctors for war zones. About 30 Syrians attended its first training session in southern Turkey.
Read the full article here.