The Observer: In Aleppo’s destroyed hospitals the dead lie with the living
David writes for The Observer
I don’t think that in all my years of doing this I’ve ever seen such dreadful pictures of injuries, of people lying on the floor of an emergency room, the dead mixed with the living.
One colleague, who I speak to all the time, was in despair, sending me all these photographs, and saying: “David, you have to do something to help us.” But what can I do?
The message out of eastern Aleppo is that there are no hospitals functioning at all. They have all been repeatedly attacked in the past few days. Some were able to evacuate, but one was totally and utterly destroyed by rockets and bombs. I heard that two doctors were killed and 16 other staff injured and I am afraid that one of the dead may be a brilliant surgeon, who would be a particularly serious loss.
There is another hospital that we haven’t even had a message from. So, I suspect they are out of action, but we know nothing about the staff or the conditions there.
The Aleppo hospitals have been re-opened so many times, underground or at new locations, but between the bombing and the siege I don’t know if it will be possible to resurrect them this time. There is so much equipment that you need in order to operate and there is no sterilisation and no monitoring machines for anaesthetics. Even if the hospitals saved some machines they can’t run them because the generators have been destroyed or are out of fuel.
The taking out of every hospital and medical facility that gives hope and help to civilians is not a coincidence. The medics have such fantastic morale that you would not imagine them giving up, but I have an awful suspicion that this is the endgame.
Read the full article here.
Skype Blog: The first ever known surgery over Skype with Dr. David Nott
Skype was developed in 2003 to help people stay together, no matter where in the world they happen to be. Since launch, we’ve discovered many weird, wonderful and original ways that people use video calling. From pet sitting to interior design. From working out to personal stylist advice—people really do use Skype in the most creative ways.
Recently, we came across the The David Nott Foundation, a UK-based charity which gives surgeons and medical professionals the skills they need to provide relief and assistance in conflict and natural disaster zones around the world.
Founded by Dr. David Nott and his wife Elly, The David Nott Foundation’s main focus is to improve the standards and practice of humanitarian surgery in conflict and catastrophe areas around the world. Both are passionate about helping those less fortunate than themselves and their efforts in treating victims in areas of catastrophe goes from strength to strength. We caught up with Dr. Nott, “the Indiana Jones of Surgery”, and found out how Skype features in their mission to help surgeons develop their skills for warzones—and how he and his wife started volunteering their time:
“I started in Sarajevo in 1993. I watched a film called The Killing Fields with my Dad and I had a fascination about different places and helping people. The film was about a friendship between a journalist and a local interpreter in Cambodia during the civil war but essentially about people helping each other. And then something sparked in my head, that I’d like to do something like that myself. When I became a consultant, the first thing I did was to volunteer my services to Médecins Sans Frontières in Sarajevo. I should have only stayed for a couple of weeks but I ended up staying for three months.”
Dr. Nott tells us how technology and Skype came into the picture. “In 2007, I believe I was the first person ever to receive details of how to perform surgery via text messages in the Congo. This was when a friend of mine texted me the procedure of how to take off somebody’s shoulder and arm. This was in the Congo, in the middle of a jungle, without any help or anything!”
And then after surgery by text message, came the first ever known surgery performed over a Skype video call.
Surgeons in Aleppo sent me a picture of a man whose jaw had been blown off by a fragment in a bomb blast. They asked me what they thought they could do. I took the pictures around to several of my colleagues to get their opinions on what they thought was the right thing to do to fix it. The doctors in Aleppo had never done this sort of operation; they’d never mobilized a myocutaneous flap (which is a muscle and tissue flap that rotates into the neck). They’d never mobilized a muscle before either, so that’s where Skype came in. They had a phone attached to a selfie stick so I could view everything. The operation started at about 8 in the morning and went on until 4 in the afternoon. It was very complicated but it worked 100%. Using Skype was fantastic because it allowed me to see what they were doing in real time. I was telling them which bit to cut, which bit not to cut—I directed them all the way through, from the moment they picked up the knife to the moment they put in the stitches.”
Read the full article here.
Philanthropy Age: ‘You carry on because you’re saving somebody else’s life’
British surgeon David Nott has spent two decades operating on thousands of people in war zones, making life and death decisions under fire. Now he hopes to pass his hard-earned skills on to a small army of frontline volunteers
There’s a simple reason why I keep going back: I feel sorry for those who are caught up in conflict. Everyone needs access to healthcare, and I try to be the person to provide it. I first volunteered in the besieged city of Sarajevo, Bosnia, in 1993 after seeing TV coverage of the conflict. What happened to me there changed my life. I’ve worked in conflict and catastrophe zones ever since: from Liberia and Darfur, to Haiti, Syria and Yemen.
In places wracked by war or natural disaster, there are few surgical provisions. There are limited blood supplies, few drugs and no diagnostic aids to speak of, so you rely on your medical skill. Yet, in war, most of the senior surgeons will have fled and it is the junior medics who are left behind. They may know basic surgical techniques, but they are faced with the most difficult wounds imaginable, from gunshots, snipers, IEDs and mines.
I take part in up to three missions a year with organisations such as Syria Relief, Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC). I go for three weeks at most if it is a really hot war zone; six weeks if the frontline is further away. If there are no casualties from the night before, my day starts around 7am, with a security briefing at 7.30am. I take an hour to visit patients and from 9am there are either new patients to see in the clinic or, if there are casualties in the emergency room, I begin operating. I can be doing that all day and sometimes all night. At my longest stretch, I operated for 22 hours. You forget the time, although you’re absolutely worn out. You carry on because you’re saving somebody else’s life – and then somebody else and somebody else. You sleep where and when you can.
In quieter periods, I teach. In Syria, for example, there are lots of junior surgeons who are not particularly well trained. They accompany me in the operating room and we do the surgery together. I show them first, and then they pick up the knife, scissors and forceps. Speed and accuracy are very important. I teach techniques to limit blood loss, and quick procedures. You get very engrossed in surgery – even though you are in a war zone, your mind is utterly focused on the job at hand.
Read the full article here.
David Nott receives Special Recognition at Pride of Britain Awards 2016
Every year for the past 23 years, David has taken several months’ unpaid leave from his NHS job in London to work as a volunteer for aid agencies including Médecins Sans Frontières, the Red Cross and Syria Relief.
The world’s most experienced conflict surgeon has operated with makeshift instruments, by torchlight and in constant fear for his own life.
He refused to stop operating when IS fanatics burst into his theatre in Syria and even when ordered to leave a hospital in the Gaza Strip which was due to be targeted by an air strike.
David, 59, recalls: “Everyone was leaving. But I knew I couldn’t possibly leave this little girl alone. I said to the Red Cross anaesthetist with me, ‘Do you want to go?’ He said, ‘No, I’ll stay with you’. So we stayed together, both believing that all three of us would die.
“But I carried on with the operation and as the minutes ticked by, I tried not to panic.
“I was expecting the worst, but I kept on operating.
“We were supposed to be blown up, and I was thinking, ‘If it happens, I’ve done a lot with my life really’.
“If our time was up, I just wanted to be there to hold the little girl’s hand.”
He has carried out lifesaving operations on victims of conflict and catastrophe in countries ranging from Bosnia and Afghanistan to Liberia, Haiti, the Central African Republic, Gaza and Nepal.
In Aleppo in Syria, he worked in a makeshift hospital saving lives as barrel bombs rained down.
The carnage affected him more than any other conflict, and it took him months to readjust after returning home from the visits.
“It’s such a tragedy I can’t find the words,” David says.
His humanitarian work began in 1993. He flew to Bosnia after seeing the conflict on the news.
“I’d seen a man on TV crying as he searched for his daughter among the rubble after a bomb blast in Sarajevo,” David says. “I made a snap decision. I was overwhelmed by the necessity to help.”
The married father of one was awarded the OBE in 2012 for his work in war zones, which he fits in around surgical roles at three London hospitals.
He is also a qualified pilot and has served with the Royal Auxiliary Air Force as a volunteer surgeon, holding the rank of wing commander.
David has also raised hundreds of thousands of pounds for charitable causes and has set up the David Nott Foundation, a charity training surgeons to carry on his work in war zones and natural disaster areas. “It’s the legacy I am trying to leave,” he says. “To be a war surgeon is a fine art, knowing the right thing to do for a patient with what’s available. If you do too much, that patient will die as surely as if you do too little.”
David’s dedication to saving lives is simply extraordinary. We are all horrified by the humanitarian disaster in Syria, but he has risked his own life to make a difference there. His reserves of compassion and courage are boundless.PRIDE OF BRITAIN JUDGES
Read more here.
The Mail on Sunday: The abomination in Aleppo from Russian bomb.
David Nott for The Mail on Sunday
The text message from Aleppo flashed up on my phone as I was curled up on the sofa watching animated film The Good Dinosaur with my wife and 14-month-old daughter. It came from a much-loved Syrian friend, a surgeon like me.
Written in haste, it read starkly: ‘Massacres in Aleppo today… 168 cases arrived at the hospital. All of them civilians and mostly children.’
The scene of family contentment at my home in South-West London instantly dissolved. For the next 48 hours I dispensed advice, directed an operation and issued general instructions via instant messaging service WhatsApp to medics 2,500 miles away as they fought to save the lives of children pulverised by ball-bearings from cluster bombs dropped from the skies above the most benighted city on Earth.
Those injured had been lined up in an orderly queue at the time, waiting for bread to feed their starving families. As it transpired, 50 children were taken to hospital M10, the codename used by local doctors to disguise its location. Twenty were dead before they got there; others would succumb to their injuries.
Of the rest, no one knows for sure because over the next few days the hospital – which moved underground in 2014 – was repeatedly blasted from above, on at least one occasion by Russian bombs, until finally it was no more.
That Saturday evening, my colleagues in Aleppo sent me photos of many victims, not only so I would help but also in the hope I would alert the world. A world that isn’t listening and that has averted its gaze.
There were dust-covered dead children; mangled infants teetering between life and death; a little boy, one of the luckier souls, holding his smashed hand aloft; there were X-rays in which ball-bearings lodged in spines and brains appeared as little white spots.
Some of the images I couldn’t bear to open – there were just too many – and there are those I did open and that will never leave me. It was all so painful. Two brothers, for instance, aged about four and six, were pictured side by side on a trolley, life ebbing from them with each passing hour. Later I would learn they both died the following day because there were no fluids to give them and no ventilators available. No one knew their names.
Read the full article here.
Press Release: The Rt. Hon. the Baroness D’Souza CMG to be Chairman of the Trustees of The David Nott Foundation
London, 10 October 2016: The David Nott Foundation is honoured to announce that The Rt. Hon. the Baroness D’Souza CMG has agreed to become Chairman of the Foundation’s Board of Trustees.
Baroness D’Souza said: ‘The anguish we all feel about the plight of those caught in war zones is in part eased by knowing that the David Nott Foundation is there to carry out its pioneering work. Long may it continue.’
Baroness D’Souza was elected by Lords members as the second Lord Speaker on 18 July 2011 and took office on 1 September 2011, serving until the conclusion of her term in August 2016. As Lord Speaker she attended and spoke at ceremonial occasions on behalf of the House of Lords and met visiting dignitaries and heads of state.
David Nott commented: ‘From the start, Baroness D’Souza has been an invaluable source of encouragement and guidance to our Foundation. She has provided the most wonderful support to Elly and I for which we are so grateful and we are just so thrilled that she has agreed to be Chairman of the Trustees. We are growing so rapidly in our activities and she will bring vitally important experience, energy and drive to the Board as we expand and further professionalise our operations.’
Baroness D’Souza becomes Chairman of the Trustees at an exciting time for the Foundation as it expands its activities and programmes. The past six months have seen a huge increase in demand for the training the Foundation provides under David’s leadership. Activities have included:
- The inaugural David Nott Foundation Hostile Environment Surgical Training (HEST) course, held in Gaziantep, Turkey, in April.32 Syrian surgeons travelled from Homs, Hama, Idlib and Aleppo to attend.
- The second HEST course was held in Aden, Yemen, at the invitation of MédecinsSans Frontières in July and trained 43 local surgeons.
- 2016 will see two further HEST courses; in Gaziantep again for Syrian surgeons and in Gaza in December at the invitation of the International Committee of the Red Cross.
- Our first three David Nott Foundation scholars were trained by David on the course he directs at the Royal College of Surgeons of England, Surgical Training for the Austere Environment (STAE), in July.We trained two Libyan surgeons and one Syrian.
- The Foundation is in discussions to develop a state of the art simulation model which will be a teaching aid on the HEST course.
- The Foundation is in talks with technology developers to design an app that will serve as a resource for doctors and also a way for the community of humanitarian surgeons trained by David Nott to share experiences and advice.
- In September, David Nott directed a life-saving operation to a team of 6 surgeons in Aleppo using Skype and What’s App; the first known incidence of the technology being used in this way.
- The Foundation, led by David Nott, has spoken out passionately and frequently against the targeting of medical facilities and civilians in Syria’s civil war and advocated for humanitarian access to besieged and heavily-bombed areas.
ENDS.
Notes to editors
For further information contact Suvi Dogra: [email protected] or +44(0)7920 135796.
About The Rt Hon The Baroness D’Souza CMG
Baroness D’Souza was elected by Lords members as the second Lord Speaker on 18 July 2011 and took office on 1 September 2011, serving until the conclusion of her term in August 2016. She was appointed Chairman of the Trustees of the David Nott Foundation in September 2016. She succeeded Baroness Hayman, the first elected Lord Speaker. She took her place on the Woolsack to oversee work in the Lords chamber on 5 September 2011. She entered the House of Lords in 2004.
Political career
Before taking up the post of Lord Speaker, Baroness D’Souza was Convenor of the Crossbench Peers (2007-11). As Convenor, Baroness D’Souza was a member of the following committees: Administration and Works Committee, Liaison Committee, Privileges and Conduct Committee, Selection Committee, Procedure Committee and House Committee. She was also previously a member of European Union Sub-Committee F.
Human rights and development work
Baroness D’Souza has a special interest in human rights and development issues. She was a director and consultant for the REDRESS Trust (director 2003-04, consultant 2004-06), executive director of Article 19 (1989-98) and trustee at a range of human rights and development organisations. In her previous career, Baroness D’Souza lived and worked in southern Europe, Africa, Asia and Oceania.
Research work
Baroness D’Souza was director of an independent research group focusing on development and emergency aid and has researched the economic origins and alleviation of famine.
She was an independent research consultant for the UN from 1985 to 1988. She also worked for the Nuffield Institute of Comparative Medicine (1973-77) and Oxford Brookes University (1977-80).
Academic background
Baroness D’Souza studied Anthropology at University College London. After graduating in 1970, she studied for her Doctor of Philosophy at Lady Margaret Hall, University of Oxford. She taught anthropology at both the London School of Economics (1973-80) and Oxford Brookes University (1977-80)
About David Nott OBE FRCS
David has been a Consultant Surgeon at Chelsea and Westminster Hospital for 23 years where he specialises in general surgery. David also performs vascular and trauma surgery at St Mary’s Hospital and cancer surgery at the Royal Marsden Hospital.
For the past twenty three years David has taken unpaid leave each year to work for the aid agencies Médecins Sans Frontières, the International Committee of the Red Cross and Syria Relief. He has provided surgical treatment to the victims of conflict and catastrophe in Bosnia, Afghanistan, Sierra Leone, Liberia, Ivory Coast, Chad, Darfur, Yemen, the Democratic Republic of Congo, Haiti, Iraq, Pakistan, Libya, Syria, Central African Republic, Gaza and Nepal.
As well as treating victims of conflict and catastrophe and raising hundreds of thousands of pounds for charitable causes, David teaches advanced surgical skills to local medics and surgeons when he is abroad. In London, he teaches the Surgical Training for the Austere Environment (STAE) course at the Royal College of Surgeons of England.
In 2015 David established the David Nott Foundation with his wife Elly. The Foundation supports surgeons in developing their operating skills for warzones and austere environments.
About The David Nott Foundation
The David Nott Foundation is a UK registered charity which provides surgeons and medical professionals with the skills they need to provide relief and assistance in conflict and natural disaster zones around the world. As well as providing the best medical care, David Nott Foundation surgeons train local healthcare professionals; leaving a legacy of education and improved health outcomes.
Founded and led by renowned British surgeon David Nott, the Foundation benefits from his passion for advancing the best in surgical research, practice and teaching as well as his commitment to helping vulnerable people in some of the most dangerous and disadvantaged places in the world.
The Times: Surgeons save Syrian lives by Skype
The messages arrive at all hours of the day and night, the vibration of a mobile phone signalling that another life hangs by a thread in Aleppo.
For the renowned British trauma surgeon David Nott and other doctors in London, Seattle, Washington and West Virginia, the Russian-backed onslaught on the city has been a daily reality.
They are a loose network of doctors who provide real-time medical support, often via WhatsApp and Skype internet services, to the desperately overstretched and sometimes dangerously inexperienced medical staff in the besieged areas of Syria.
Read the full story here.
BBC Newsnight: The doctors ‘breaking the siege’ in Aleppo via Skype
The battle over Aleppo has been raging for more than five years – with the Syria city under siege for much of this time.
The medical and humanitarian situation is desperate.
Two years ago, British doctor David Nott got into Aleppo to help train doctors there. Now he’s helping to get round the siege by directing life-saving operations via Skype. He spoke to BBC Newsnight.
Watch the full report here.
BBC Radio 4: ‘Aleppo doctors facing armageddon’
A British volunteer is worried for his colleagues as two hospitals in Aleppo, Syria, were hit during an aerial bombardment and are vulnerable to further attacks.
David Nott is a British surgeon and has worked in the hospitals and trained some of the doctors who treat people with the terrible injuries inflicted by these bombs.
He told World At One reporter Becky Milligan of his concerns for the doctors still working there and how he feels like a father to many.
More here.