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.
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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
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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.
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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.
David Nott: Medics Under Fire
Back in January when I first had the idea of a march to protest against the targeting of healthcare workers in warzones, I couldn’t have imagined how bad things would be by the time we gathered in Trafalgar Square on Saturday 7 May.
We marched – doctors, families, medical students, activists, experts and supporters – to Downing Street under the banner ‘Medics Under Fire.’ That week people had been shocked by the chilling footage of Dr Mohammed Moaz, whose family I knew in Aleppo, walking down a corridor in his hospital seconds before the direct attack on his hospital from an air to ground rocket delivered by a warplane. Dr Moaz was one of the last remaining paediatricians in Aleppo and performed vital work looking after the children of that devastated city.
The hospital was just 500 metres from where I worked in the summer of 2014 and was destroyed, killing 27 healthcare workers and 2 doctors. When I was there, five of my colleagues were killed as were both of the anaesthetists that I worked with. Both were targeted as they went to work in the hospital. One of the hospitals I worked in was bombed at least 10 times.
From Central African Republic and Sudan to the Yemen and Ukraine; ambulances, hospitals and health centres have been bombed, looted, burned and destroyed.
Read the complete blog at: The Hippocratic Post
March with Medics Under Fire
On Saturday, 7 May, 2016, Dr David Nott will be one of the speakers at a march organised by a collection of medical charities to protest against the targeting of hospitals and healthcare workers in war zones.
If you were horrified by the attacks on hospitals last week in Aleppo, which killed the last remaining paediatrician in the city, please come and support us.
We will meet on the North Terrace of Trafalgar Square at 2pm. A number of short speeches will be given before we march to Downing Street to deliver a letter calling for action against those who contravene international humanitarian law to target medical workers. You can find more information here: https://www.facebook.com/
Confirmed speakers include:
David Nott, Founder and Chairman, The David Nott Foundation
Dr Saleyha Ahsan, A&E doctor and film maker
Sidney Brown, Director of Programmes, Physicians for Human Rights
Toby Cadman, International human rights lawyer; President of the International Forum for Democracy and Human Rights
Hamish de Bretton-Gordon, Chemical weapons expert, International human rights lawyer, president of International Forum for Democracy and Human Rights
Ghana Tayara, Union of Medical Care and Relief Organisations (UOSSM)
Rob Williams, Chief Executive, War Child UK