“If this training can work in Gaza, it can work anywhere else.”
Dr Israar Ul-Haq joined our HEST-UK (Hostile Environment Surgical Training-UK) course in Bolton to improve his trauma surgery skills before entering the heart of Palestine’s crisis – the Gaza Strip.
Dr Israar Ul-Haq is a doctor with a primary focus on urgent and pre-hospital care. Volunteering his expertise, Dr Ul-Haq joined two separate missions to Gaza, serving in Khan Younis and Deir al Balah.
“As I entered Gaza I felt a mix of emotions—eager to employ the skills I learned from HEST and help those in need, yet wary of the drones I can hear as soon as I entered.”
With minimal resources and an overwhelming patient load, ranging from 500 to 1000 individuals daily according to Dr Ul-Haq, the medical staff faced immense challenges. The injuries they treated ranged from blast injuries and crush wounds, to traumatic amputations and fatal head injuries, or gun shot and sniper wounds. Techniques learned during the HEST course, such as medical triage or procedures for getting access to the chest quickly, such as thoracotomies, were immediately put into action.
It impacted every aspect of my work in Gaza
Dr Ul-Haq shared: “The course impacted every aspect of my work in Gaza, such as understanding the local environment and the types of injuries we encountered. Whether it was performing chest drains, managing blast injuries, conducting debridement, or treating burns, the training equipped me with the necessary skills I needed.
The lectures on burns were very useful, they directly influenced our treatment protocols. Techniques like thoracotomy and bleeding control learned during the course became standard procedures in our daily practice. The emphasis on conducting primary and secondary surveys, along with fast scanning helped us to quickly assess and address critical issues in a high-pressure setting."
Patients that stay with us
“One patient's case is stuck in my head. He presented with a shrapnel injury to his back, which had penetrated his thorax. While we stabilised him initially, signs of Beck's triad (low blood pressure, distended neck veins, and distant or muffled heart sounds) alerted us to a possible cardiac tamponade (a serious condition where fluid builds up around the heart) - I had learned to identify this issue through fast scanning during the course. We rushed him to the operating theatre. Employing techniques like the clamp shell procedure, we successfully removed the bleeding around his heart, stabilising him.”
“We had a four-year-old brought into the hospital with a pneumothorax, severe head injuries, and burns. We immediately admitted the child to the ICU. We performed a chest drain to treat the pneumothorax and employing rapid sequence induction (a method to quickly administer anaesthesia and secure the airway) to stabilise the child's condition. We debrided the wounds at the back and used fluid therapy to manage shock and maintain stability.”
Our course is not just about building medical skills, it's about cultivating problem-solving abilities in the most challenging of circumstances. In environments where resources, staffing, and traumas are at their peak, the course empowers doctors to think laterally and use whatever limited resources they have. From using different pain management drugs to conducting fast scans to evaluate a patient's condition rapidly, every aspect of the training is geared towards equipping doctors with the tools they need to save lives, no matter where they are.
“Upon arrival, another patient had no bleeding or shrapnel injuries, but vitals would not stabilise. drawing on what we learned from the HEST course, we identified a left-sided pneumothorax. Despite initial stabilization efforts, the patient's vital signs remained unstable,” shared Dr Ul-Haq. “I often used the fast-scanning technique taught in the course. ; I detected an additional right-sided pneumothorax. Without hesitation, I proceeded to insert a chest tube, a procedure ingrained in our training. Had we delayed any longer, the outcome could have been disastrous.”
“Gaza is facing unimaginable suffering, and HEST was incredibly helpful there. If it can work in Gaza, it can work anywhere else too.”
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Preparing 36 Kuwaiti doctors for surgery in Gaza
With support from the Foreign Common Development Office (FCDO) and Kuwaiti Red Crescent Society (KRCS), we upskilled 24 Kuwaiti surgeons and 12 anaesthetists who intend to volunteer as humanitarians in Gaza. This marks our first direct partnership with the UK government.
Faculty Lead: Dr Ammar Darwish. Surgical Faculty: Dr Mahmoud Hariri, Professor Steven Mahoney, Dr Saladin Sawan, Dr Juan Robinson. Anaesthesia Faculty: Professor Pete Mahoney, Dr Oliver Harrison and Dr Hussein Nagi.
Kuwait is home to over 4.2 million people. Sandwiched between Iraq and Saudi Arabia, Kuwait is a small but influential country in the Middle East. As the war continues to wage in Gaza, a number of Kuwaiti doctors have plans to volunteer their skills on the frontline. Upon invitation from the FCDO and KRCS, we were pleased to upskill 36 doctors and prepare them for complex trauma injuries.
Our Co-Founder, Elly Nott, said:
“Recognised by the UN as a Humanitarian Center and embodying the values of charity and humanity, Kuwait is a natural partner for the David Nott Foundation. During this mission, we trained 24 surgeons and 12 anaesthetists in partnership with the Kuwaiti Red Crescent Society and the British Embassy, Kuwait.
The doctors have been trained in surgical skills essential for saving life and limb and will contribute to relief campaigns and humanitarian initiatives in the region. There is sadly no end of need for their skills in the world at present and we look forward to further collaboration with our colleagues here in Kuwait for the benefit of those who suffer in conflict.”
The skills required by doctors in Gaza at this time extend far beyond surgery. Being calm in a crisis, able to adjust to the needs of the patient in front of you and adapt to the hospital’s resources – or lack of - are absolutely vital. Doctors and anaesthetists that rely on innovative surgical tools or drugs will only have so much impact in active war zones.
Consultant Anaesthetist and DNF Faculty Trainer, Professor Pete Mahoney, said:
“In conflict zones, there may not be reliable electricity, water or access to medical gases such as piped or cylinder oxygen. You need to be able to pivot and use something called ‘draw-over’ anaesthesia to deliver suitable medication. This is when the use of simple masks or a bag can be used to pull volatile agents (anaesthetic medications) into the patient’s body.
We also taught the Kuwaiti doctors how a simple anaesthesia machine can be constructed from components as they may need to build one in the field with whatever the hospital has. It is critical that humanitarian doctors are able to adapt.”
We know from our Faculty Lead in Palestine that doctors on the ground don’t always have the time or available tools to fix bones together with metal pins. To give doctors other options that require less equipment, we taught Kuwaiti doctors how to set bones with plaster casts, which can help breaks to heal in the absence of pins.
The British Ambassador to Kuwait, Mrs Belinda Lewis, said:
“The fact the UK government’s first partnership with the amazing David Nott Foundation took place in Kuwait is testament to the strong and productive relationship between our two countries. This combination of British and Kuwaiti expertise will undoubtedly support the medical response to the dreadful suffering in Gaza.
I am grateful for the assistance of a number of people in Kuwait who have helped me to bring in this expert team from the UK, and I would like to pay special thanks to Professor Ghassan Abu Sittar, veteran war surgeon and humanitarian, who first suggested this valuable partnership to me.”
President of the Kuwaiti Red Crescent Society and former Minister for Health in Kuwait, Dr Hilal Al Sayer, said:
"On behalf of the Kuwait Red Crescent Society, I extend my appreciation to the British Embassy for their facilitation of the training course throughout this process. I also extend our sincerest gratitude to the David Nott Foundation for their invaluable expertise. Their guidance has empowered our esteemed consultants with the skills needed to navigate the complexities of emergency medical care as volunteer medics in conflict zones whose dedication serves as a testament to the spirit of humanity that defines our National Society.
Last, but certainly not least, I extend my heartfelt thanks to the National Bank of Kuwait for their generous support, we are truly grateful for their partnership.
I am immensely proud of the collaboration that has characterized our time together and am confident that we will carry forward the lessons learned in our shared mission to serve humanity with compassion and expertise."
Until we can support and upskill doctors on the ground in Gaza, we will continue to do all we can from a distance. The delivery of our surgical and new anaesthesia courses to Kuwaiti doctors who intend to enter Palestine as humanitarian volunteers, forms part of our unwavering commitment to the ongoing crisis.
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Teaching 86 war doctors in Vinnytsia, Ukraine
86 more Ukrainian doctors are now armed with trauma surgery skills that will help them improve the care they give to victims injured on the frontline. In partnership with UOSSM International, our trainers upskilled both surgeons and anaesthetists in the Ukrainian city of Vinnytsia.
Despite over two years of conflict, many doctors in Ukraine are still facing horrifying injuries - and many they were not trained to treat during standard medical training. War inflicts incomprehensible injuries on those it meets. Shrapnel can tear through multiple parts of the body and it’s a medical team’s job to identify which injury needs treating first. This is done by carrying out damage control to find and reduce sources of bleeding before repairs can take place. Under pressure, this isn’t an easy feat but are vital skills that we teach – alongside guidance on how to stay calm and focused - on our course.
The long road
It’s not just immediate care that doctors need to be trained in. War wounds often require months, sometimes years, of rehabilitation and additional surgeries. Our team visited the Superhuman Center in Vynnyky, Lviv, an outstanding facility supporting adults and children who have lost limbs in the war. It is facilities like these, and training like ours, that help doctors carry out amputations in such a way that the victims will recover well or receive prosthetics when the time comes.
Nick Cartwright, our Programmes Manager who led this course and visited facilities at both Superhuman and Unbroken, said:
“There’s a lot of a hardship in Ukraine today, but a lot of hope. There’s a strong desire for our training – Ukrainian doctors want to know they are doing absolutely everything they can for those injured in their communities. Having now upskilled nearly 600 doctors in Ukraine, the country’s healthcare systems are getting stronger, despite the ongoing pressures of war.”
Frontline stories
We interviewed a number of doctors who took our surgical and anaesthesia courses in Vinnytsia. It’s their experiences that drive us to keep going back to new cities, spreading trauma surgery knowledge further across the country.
“People were burning”
“When the war started we had a lot of humanitarian aid it was so helpful. But we still need it – the war hasn’t finished. This course is so helpful and interesting – there’s a lot of information and practical skills. Many things were new for me. It’s great that I now have new skills and knowledge.
I have some experience of war wounds since the war. We’ve had attacks here in Vinnytsia, a lot people were injured. People were burning, some had head injuries, they came to our emergency hospital. I also volunteered in places like Donbass.
The biggest attack here was on the 14th of July. A lot of people were killed, children. It was hard because we didn’t prepare for this. On this course, we saw a video of how colleagues work in an emergency situation. We have some things we need to change on how we will work in an emergency.
I want to tell the world that war in Ukraine is still going on. A lot of civilian people are dying. We need help to win this war – and I hope it will be soon.” - Daria, General Surgery Resident, Vinnytsia
“I’m going to use these skills in my operations”
“I’m a civilian anaesthesiologist in a country that is under war. I’m going to use these skills in planned operations in critical care in my emergency hospital.
Since we always have a lot of patients, with many civilians, internally displaced people, and military, who have trauma wounds, we are always lacking the materials, medication and equipment. Anything we receive (including training) we always use it.” – Igor, Anaesthetist, Vinnytsia
“I hope people are kind”
"I’m a Resident of General Surgery, trying to do all I can in my specialty. I hope I will not use this knowledge (from the David Nott Foundation training) on the battlefield, but Russia is still attacking.
I have some experience of treating war injuries. We’ve had a lot of injured people and deaths. I want to bring attention to Ukrainian refugees too who are now in other countries. I hope whoever hosts them is kind to them.” – Anastasiia, General Surgery Resident, Vinnytsia
As Ukraine continues to be ravaged by war, we have made a commitment to train every Ukrainian doctor in the country. Help us achieve our goal.
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103 surgical life savers in Tripoli, Libya
We’re back from a week in the Libyan city of Tripoli after completing a first-in-our-history mission. We upskilled 103 doctors – the largest number trained on one mission – and trialled our brand-new obstetrics and gynaecology course.
Libya’s history is marked by political turmoil and civil unrest. The uprising against the rule of Gaddafi led to brutal violence against Libyan civilians and instability across the country. Today, 13 years after the ruler’s death, conflict between armed groups continues and Libya’s security remains fragile.
Outside of politics, Libya has been devastated by natural disaster. In September of 2023, heavy rain caused the collapse of two dams, leading to horrific damage and the loss of thousands of lives. Wounds inflicted by violence or natural disasters often require rapid surgical care, with a need to focus on controlling the worst of the damage first.
Surgical toolkit for any crisis
In a bid to empower Libyan doctors with skills to treat wounds caused by war or natural disaster, we partnered with the Libyan Board of Medical Specialties to deliver four surgical training courses in parallel. Over five intense days, our team of expert trainers delivered two trauma surgery courses, two anaesthesia courses and a brand-new obstetrics and gynaecology course.
According to a 2023 UN agency report, a woman dies from pregnancy or childbirth every two minutes. During conflict, women are less likely to seek maternal care and hospitals are under-staffed or under-resourced. That's why our trainers created a bespoke obstetrics and gynaecology course to help doctors better protect mothers and their babies in war and catastrophe.
During the week, we trained 103 doctors. Doctors we’d previously upskilled in Libya also joined our training faculty and led the teaching of a number of our modules for the first time. Dr Aisha Alghamji was one of them.
It really was paralysing
Dr Alghamji shared: “I remember I have a case of a 70-year-old lady. We found there was a huge bleed in her tummy. Most of her blood is – in minutes – almost drained out. It really was paralysing – what to do? She doesn’t have that much time.
"That lack of knowledge paralysed me. She is a living, human being – with dreams, hopes, a whole community. She is part of it. It keeps haunting you, that feeling. What I could do differently?"
She lost her life.
After 2018 when I attended the course with the Foundation, there is something shifted in my way of thinking. It did that thing for me, that confidence the surgeon needs to do more than their best – to run the extra mile for the patient.
I faced another case similar to it (this lady). I told immediately to me brain – ‘damage control! Damage control!’. I was able to send her home. She is alive, she is a grandmother, she is everything.”
A resilient healthcare system
Dr Moez Zeiton, Consultant Orthopaedic Surgeon and our Faculty Lead for Libya, said: “It is a privilege to have had the opportunity to lead the single most ambitious series of courses for the foundation, training over 100 doctors in a week. It was a huge effort from the foundation’s team and superb faculty to get over the line.
Candidates in Libya travelled from every part of the country with many travelling over 1000km to participate in our surgical training. Their eagerness to learn and share their own experiences was evident and they will now be equipped with the skills needed to deliver high quality care to their patients. "
This marks the beginning of continued training in Libya and a commitment to gifting doctors with extensive trauma skills to handle any challenge.
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Our second mission for Palestine's medical workforce
In the ongoing Israel-Gaza conflict, tens of thousands have lost their lives and hundreds of thousands are now displaced. Hundreds of casualties have been reported in the West Bank. Our commitment to supporting affected communities continues and we will do all we can until we reach doctors on the ground.
Despite recent escalation, Palestine has been engulfed by conflict for decades. Recognising a need for upskilled doctors, we first delivered a Hostile Environment Surgical Training (HEST) course in Ramallah in March 2017 and another in 2022 in collaboration with Juzoor. We also taught Palestinian surgeons on our latest UK Train the Trainers course, giving them the skills needed to teach their own peers.
“I love Ramallah. But we don’t have control of our borders,” shared Dr Salwa Najjab, Co-Founder and Chairwoman at Juzoor in 2022.
“We are living in a big prison. Our people should be exposed to the world. We are very happy and thankful to the David Nott Foundation, to come and see what we are doing, to understand our situation and see it in their eyes.”
Following the resounding success of our Hostile Environment Surgical Training (HEST)-UK course for doctors heading to Palestine, we once again joined forces with Palmed to train another group who intend to offer their skills on the frontline.
At Bolton University, we taught six anaesthetists and 31 surgeons from the UK, Germany, Ireland, Denmark, and Norway. The doctors share a common passion for using their hands to help those affected by the aggression on Gaza.
Dr Israar Haq, a general surgeon who joined our course shared, "If you have any grain of humanity in your heart, you want to help."
BBC spotlight
BBC-Northwest took notice of our efforts and joined our training. They spoke with experienced surgical trainer, Dr Rebekka Troller, who shared: "The aim is to give the doctors the skills to do damage control, save lives, be the first to respond, and stabilise a patient before they can be transferred."
Our presence at Bolton University also attracted attention from university professors, medical students and doctors. They explored our world-class teaching models and extended a warm welcome to our team in appreciation of our commitment to war doctors.
Our latest course for Palestine reaffirms our unwavering commitment to helping communities facing the horrors of war. We remain steadfast in our mission to empower medical heroes and make a lasting impact on the lives of those in need.
80 surgeons and anaesthetists upskilled in Kyiv, Ukraine
Our new Chief Operating Officer, Tim Law, recently returned from his first mission. Tim supported our trainers to deliver two surgical training courses in Kyiv. With logistical support from our partner World Health Organisation (WHO), 80 surgeons and anaesthetists from frontline cities learned how to treat mass trauma injuries using world-leading surgical teaching models.
To continue upskilling Ukraine’s frontline doctors, our team embarked on the challenging journey to Kyiv, first flying into Poland and travelling by bus to our final training location two days later. Despite a temporary bus breakdown in scorching heat and consequent concerns about entering Lviv before curfew, our trainers arrived safely in Kyiv and began preparing teaching materials, tools and models for the arrival of more than 80 Ukrainian doctors.
Over six days, our faculty of trainers delivered two condensed hostile environment surgical training (HEST) courses, rich in trauma surgery teachings and practical sessions.
This year, we expanded our course to include anaesthetics – a vital component of trauma surgery care. During this mission, two new faculty trainers, Dr Ian Tyrrell-Marsh and Dr Tom Dolphin, led our anaesthetics module and upskilled 22 anaesthetists from across Ukraine.
Doctors united in learning
Although united by a shared desire to manage catastrophic injuries, attendees came to our training from different Ukrainian cities.
Tim Law, our COO at the Foundation, shared: “Participation in the course was designed such that about two thirds of doctors came from front-facing oblasts or provinces. They came from Zaporizhizhia, Dnipro, Kyiv and beyond. Most of them were based in civilian hospitals.
A lot of their cities are subjected to bombardment on a reasonably regular basis. As we’re still seeing in the news, attacks lead to casualties of war, some of which are military, but many are everyday people.
Often civilian hospitals treat both civilian and military casualties, as many frontline fighters are transferred from military hospitals to make space for the next round of injured.”
Unrivalled education
Witnessing my first surgical training course in action – there is no doubt it is world-leading education.
"It was fascinating to be able to see the real value that the David Nott Foundation can add to the skills of medical professionals forced by circumstance to react to the challenges presented by armed conflict. It’s world-class education delivered by seasoned practitioners, and based on years of accumulation of course materials and conflict-specific skills.
The combination of experience within the training faculty, course material quality and the practical sessions with Heston, our human body war wound simulator, enables demonstrations that otherwise aren’t possible in Ukraine,” continued Tim.
Cadavers cannot be used for teaching in Ukraine, and our war wound model has been described by surgeons as even more effective than cadaver training.
Some shared that they’ve never had access to such state-of-the-art materials and were excited to be able to take our hand-made silicone hearts back to their hospitals to continue their practice of cardiac suture repair.
Remnants of war
Although the likelihood of active conflict in Kyiv has lessened, remnants of war can be seen in and around the city. Air raids are a common backdrop, often ignored by locals as they try to continue with their everyday lives.
On the road from Lviv into Kyiv, you can see signs of Ukrainian defence. Minefield markings, skull and cross bone signs and string between trees signpost dangerous land.
On the anniversary of Ukraine’s independence, approximately 40 Russian military vehicles had been lined up along the main street. A sign that although life goes on in Kyiv, national pride and the community’s acknowledgement of their country’s continued battle remains.
“We aim to continue to develop this world-class training, such that we can continue to deliver training in the world’s most challenging environments, enabling medical professionals to enhance their skills whilst remaining close to where they are most needed", shared Tim.
"We will develop our offering to include new modules on hospital management and surgical nursing and are in the process of building a second synthetic full-body simulator and of increasing the scale of our teaching faculty. Taken together, this should enable us to increase the scale, scope and quality of our future interventions. Thank you to our supporters for helping to make these dreams a reality.”
Dr Esayas Mustefa - Becoming the calm in any storm
Dr Esayas Mustefa is the only general surgeon within a 130km radius in Ethiopia. When we trained him during one of our UK HEST courses, we knew we’d come across a very talented surgeon who would make an outstanding trainer. We’ve since upskilled Esayas to become a David Nott Foundation trainer, upskilling his peers. Here, he shares the impact of his new skills in the Afar region of Ethiopia.
Since my first training with the Foundation in December 2021, the war has been a bit calmer in Afar. There have been a few leftover soldiers, but it is calmer. Nonetheless, with the energy and resource invested in us, many patients have been helped because of my training.
Controlling bullet damage
I remember a patient with a bullet to the right of his groin. That day, I remember I was home. The emergency surgeon didn’t call me and did a laparotomy, but then decided he needed me to come in when he saw the damage.
There was an extensive haematoma (build up of blood) in the pelvis. I thought it was a vascular injury but didn’t have the proper instruments or stitches to fix it.
That’s when I did damage control.
I got proximal and distal control of the bleeding, which I learned on the course. I managed to dissect the haematoma and with the help of the other surgeon, I did a bypass. This means putting in a tube conduit that bypasses the dissection, allowing blood to carry on flowing through the vessels as normal.
We transfused him with blood and transferred him to specialist care, to have his vascular surgery. It was great.
Passing on life-saving skills
I’m also really, really happy to share what I’ve learned on the course. We have two emergency surgeons and I do my best to teach them.
They didn’t know how to do colectomies, resections, anastomoses, or some basic decision making in difficult times. I’ve taught them these things, and also when to operate and when not to operate.
Now they know to ask me – they call to ask me questions. We have a good working relationship.
The difference between life and death
I’m now also confident with abdominal injuries. I’m a better surgeon, and those I teach are better, because of the training I had with David.
Explosive injuries, I was never used to. I usually see bullets. Even seeing photos of explosive injuries used to get to me. But seeing David’s live videos in training stimulated me to be ready for anything.
Calm in a storm
In all honesty, no matter how many patients I saw or the injuries I faced – bullets, road traffic accidents – every time I opened an abdomen, I used to get nervous. No matter how much I’m used to these patients, I don’t know how to describe it. The anxiety would come.
After I met David, I thought how many years will it take me to get to that level of calmness?
But with the course, I learned to be really calm and collected in demanding situations.
For me, my patients, my future patients, and those willing to learn from me - have all benefitted from my training.
More on our latest Train The Trainers course
“As soon as Russia invaded, we started seeing the wounded”
After troops crossed Ukraine’s borders in March 2022, Igor Belkin, a surgeon from Zaporizhzhia, watched our translated war surgery videos in a bid to better treat devastating wounds inflicted by the war. Last month, Igor furthered his skills and training during our latest HEST course in Ukraine.
Faculty Trainers in Zaporizhzhia and Lviv: Professor David Nott, Dr Pete Mathew, Dr Ammar Darwish, Dr Rachael Craven, Dr Ian Nesbitt.
“On the night of the 7th of May, the first attack on our hospital took place. Hospital walls and communications were damaged,” shared Igor. “After that, the shelling of Orikhov became even more intense. The hospital was shelled again later in May, which led to it being evacuated.”
Igor was forced to transfer to a military hospital in the field to continue treating the injured. Right from the beginning of the war, he and his team were faced with severe trauma injuries - many of which they had never seen before. Patients with internal and external damage caused by blasts, penetrating wounds and severe burns were entering their doors for the first time.
“I decided I needed to study combat trauma. A medical colleague told me about videos made by Professor David Nott.”
Armed with life-saving tools
Just days after Russia’s invasion, we ran a 12-hour surgical training course on zoom with former consultant neurosurgeon and author, Dr Henry Marsh. Together, David and Henry trained 573 Ukrainian surgeons, giving them surgical techniques, tools and tips for treating a range of traumatic war wounds. It was only when David lost his voice 12 hours in that the training stopped.
As attention started to mount around our online training, we created a series of surgical training videos in a bid to reach even more doctors in need of life-saving skills.
“It (the video series) was very informative, clear and concise. In just a few hours of viewing I grasped the main fields of trauma medicine - damage control and important techniques for cardiovascular surgery.”
Upskilling 114 Ukrainian doctors
Last month, David and a team of our trainers travelled to Zaporizhzhia and Lviv to deliver our HEST course. 114 doctors and anaesthetists were empowered with the knowledge needed to treat neurological, plastics, vascular, cardiothoracic, paediatric, orthopaedic and abdominal trauma cases – creating a powerful network of multi-skilled surgeons.
“I was very pleased to attend this course and meet David personally. I got very concise, practical information and was able to practice my skills and learn how to provide assistance in areas of medicine I don’t specialise in.
I’m grateful to David, his entire team, and the foundation for sharing their great experience and imparting their knowledge of medicine in war zones”
Before the course, I used to use a technique called a lateral thoracotomy which involves turning the wounded onto their side (entering the chest from the side). Given the fact that chest injuries can make patients very unstable, this sort of movement could worsen conditions.
Now, I only do thoracotomies while patients are on their backs. This is a far better method for both surgeons and anaesthetists to approach trauma injuries.
I also learned how to use external fixations to secure bones and now perform fasciotomies on patients needing urgent pressure release in the limbs.
This sort of knowledge, acquired from experienced frontline doctors like David and the team, will help me and my fellow Ukrainian doctors save more lives.”
We’re committed to training and instilling confidence in Ukraine’s doctors until the war is over.
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Upskilling doctors in Malaysia during Tripartite Conference
In December, we were delighted to be invited by the Royal College of Surgeons of Edinburgh (RCSEd) to attend the AFSM Tripartite Conference 2022 in Borneo, Sarawak. We upskilled 42 doctors and medical students during a condensed, one-day Hostile Environment Surgical Training (HEST) course.
Faculty Lead: Dr Pete Mathew. Faculty Trainers: Dr Una Walsh, Dr Ankur Thapar and Dr Pippa Letchworth. Programme Support: Christie Norris.
The Academy for Silent Mentor (AFSM), RCSEd, College of Surgeons Academy of Medicine of Malaysia (CSAMM), and the Ministry of Health of Malaysia (MOH) joined forces to develop a comprehensive 3-day conference program on healthcare challenges in the 21st century.
Our Faculty Lead Dr Pete Mathew (right) delivered a lecture to conference attendees. He shared details of his experience as a neurosurgeon, working to save lives in conflicted countries such as Afghanistan and Iraq with the Royal Air Force, and volunteering with humanitarian organisations such as the International Committee of the Red Cross before joining our team as a surgical trainer.
Wounds seen in war
The following day, we delivered a condensed version of our Hostile Environment Surgical Training course to 42 participants covering damage control, cardiothoracic and vascular surgery, maxilla-facial trauma, plastics, and obstetrics and gynaecology.
Using our human simulator model, Heston (below), the group got to grips with a range of injuries commonly seen in conflict and mass emergencies, such as penetrating head wounds and shrapnel injuries.
They manoeuvred skin flaps on Heston’s body, practicing how to cover blast injuries and encourage healing, and performed lung twists in Heston’s open chest to stop severe haemorrhage.
We also used our new, state-of-the-art birthing simulators to allow attendees the opportunity to experience how to manage challenging deliveries, such as obstructed labours, breach positioning, or C-sections.
Care without boundaries
Rural communities in Sarawak often have limited access to healthcare due to their remote locations. For some, it can take many days to reach hospital facilities. Outstanding local charities such as Mercy Malaysia and Andante coordinate regular medical and dental visits to communities in urgent need, thanks to the generosity of trained volunteers.
Basic clinics have also been built in hard-to-reach regions, with the goal of ensuring expectant mothers receive better care. Outreach doctors who take part in our comprehensive obstetrics training could have a significant – and potentially life-saving - impact in rural communities.
Professor Angus Watson, Consultant General and Colorectal Surgeon and Chair of the Research RCSEd Committee, said:
“Having an internationally renowned charity, like the David Nott Foundation, delivering their highly acclaimed course to healthcare providers in Malaysia, was one of the highlights of the conference.
The feedback received from course participants was very good and we hope this is the start of a highly productive global partnership between the Royal College of Surgeons of Edinburgh and the Foundation.”
Speaking of our training, a medical student from University Putra Malaysia who attended the course, said:
“Me and my medical peers participated in the Hostile Environment Surgical Training (HEST) during the conference. We were deeply amazed by this course. It gave us very different exposure from other courses we’ve been to.”
We look forward to exploring future courses in Malaysia and thank the RCSEd for their invitation.
Watch our video and reflect on 2022's successes