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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“Maternal health - it's a societal barometer.”
Every two minutes, a woman loses her life to preventable causes related to pregnancy and childbirth. These staggering statistics stress the need for action. In humanitarian crises, where access to healthcare is severely limited, maternal care becomes even more critical.
“800 preventable maternal mortalities are happening every day, and a woman dies every two minutes from a preventable cause. So that's women dying through pregnancy and pregnancy related conditions,” shared Dr Pippa Letchworth, our Faculty Lead for Obstetrics and Gynaecology.”
This sobering reality is what drives our passionate team to develop an obstetrics and gynaecology course aimed at addressing the most pressing challenges in maternal healthcare. In crisis settings, where resources are scarce, the course equips healthcare professionals with the skills needed to perform life-saving surgeries, particularly focusing on addressing the top global killers of women - haemorrhage, obstructed labour, sepsis, and unsafe abortion.
“75% of displaced people are women and children, and one of the five of those women will be pregnant.”
The course covers a wide spectrum of topics in maternal and neonatal healthcare in crisis. Participants begin with trauma training before transitioning into obstetrics to understand the complexities of childbirth emergencies.
Emphasis is placed on neonatal resuscitation techniques with the goal of reducing the number of stillbirths. Subsequent sessions address postpartum haemorrhage management, perineal repair, and navigating challenging deliveries like impaction and breech positions. The course also covers disruptive delivery, crucial for situations where doctors have limited access to caesarean sections.
Beyond the medical realm, our trainers advocate for a holistic approach to maternal health in their teaching. It's not just about reducing mortality rates, it's about understanding the wider implications of maternal deaths on families, communities, and societies at large. Children left motherless are at a significantly higher risk of mortality and developmental issues, perpetuating a cycle of vulnerability.
“There needs to be a call to arms to improving maternal health.”
We must advocate for women's rights, improving doctors access to education and dismantling systemic barriers that perpetuate maternal mortality.
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Joining forces with the Royal College of Surgeons of Edinburgh
In a landmark collaboration aimed at addressing the critical shortage of skilled surgical care in conflict and disaster zones, we are teaming up with the Royal College of Surgeons of Edinburgh (RCSEd) - home to The Faculty of Remote, Rural & Humanitarian Healthcare (FRRHH) - to deliver our Hostile Environment Surgical Training UK (HEST®-UK) course.
Taking place from 3 -7 June at RCSEd Edinburgh, the course celebrates a new era of partnership. Our HEST®-UK course offers surgeons a unique opportunity to enhance their capabilities and readiness for humanitarian crises. Over the course of five days, participants will delve into decision-making and surgical strategies for austere conditions, covering a spectrum of trauma cases including penetrating and crush injuries, orthopaedic fractures, and obstetric emergencies.
Rapid response
Responding to the escalation of the Gaza-Israel conflict in October, two previous HEST®-UK courses were swiftly organised in Bolton in December 2023 and January 2024. Obstetrician and Gynaecologist, Dr Iman Al Mabhooh, expressed his enthusiasm at the opportunity:
“I’m excited about expanding my skill set beyond obstetrics and gynaecology to acquire new abilities that will benefit mothers and their infants in Gaza and the West Bank. I recognise the desperate need for assistance there. This course is unique as it combines obstetrics and gynaecology with trauma care and address complex challenges comprehensively.”
Nick Cartwright, Programmes Manager at our Foundation, said: "Since the DNF’s beginnings in 2015, our team of experienced surgical trainers have upskilled over 1800 doctors and delivered 61 courses in some of the world’s most dangerous corners, including Iraq, Syria, Yemen, Palestine and Ukraine.
With the delivery of our HEST®-UK course in partnership with RCSEd, we will grow the number of upskilled, humanitarian surgeons who are ready to volunteer their skills, make rapid and effective clinical decisions under pressure, and manage the broad range of complex trauma injuries that present in the throes of conflict and catastrophe.”
A significant step forward
Angus Watson, FRRHH Executive Committee Member, said:
“By combining the DNF's expertise with RCSEd's dedication to recognise professional standards in humanitarian healthcare, this partnership promises to empower medical professionals and save countless lives in the face of adversity.”
The Faculty's commitment to supporting surgeons is exemplified by its decision to grant participants of the course a complimentary one-year affiliation membership to the Faculty of Remote, Rural, and Humanitarian Healthcare. This membership provides an invaluable opportunity to connect with a broader humanitarian community within a professional setting tailored for humanitarian, remote, and rural healthcare professionals.
Spaces on the course are limited and will be allocated on a first come first serve basis.
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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.
HELP US FUND MISSIONS IN LIBYA
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
Addressing healthcare challenges in Moldova
In the wake of the escalating conflict in Ukraine, Moldova, a neighbouring country, is grappling with the concern of being somehow drawn into the war. To extend support during these challenging times, the David Nott Foundation, in collaboration with the World Health Organisation, conducted two specialised Hostile Environment Surgical Training-Anaesthesia courses in Moldova.
The refugee influx and healthcare strain
Since Russia's invasion of Ukraine, Moldova has witnessed an influx of over 700,000 refugees seeking peace and safety by passing through its borders. Recognising the strain these precipitates to available healthcare resources, the Foundation has provided ongoing support over four courses since January 2023.
The anaesthesia (HEST®-A) courses, conducted from December 11th to 16th, aimed to up skill 25 anaesthetists to better handle healthcare challenges arising from the crisis. The training spanned six days, with the first three days conducted in English and the subsequent three days in Moldovan.
Participants expressed satisfaction with the course structure, emphasising the benefit of discussions and supervised practical activity over a lecture-heavy approach. As the anaesthetists underwent training, they raised concerns about resource availability and hospital capacity in the face of refugee movements. In response, our highly skilled teaching faculty offered valuable advice and information.
Innovative training models
The courses saw three UK-based faculty members delivering in-person sessions, with an additional faculty member, the Foundation’s lead consultant for anaesthesia, delivering a virtual training session on chemical weapons.
The David Nott Foundation's HEST®-A course in Moldova not only aimed to enhance the skills of healthcare professionals but also addressed specific challenges posed by the Ukraine crisis. By fostering collaboration with WHO and adapting the course content to local needs, the Foundation continues its mission of providing essential medical training in conflict zones to save lives and alleviate human suffering.
“There is nothing more heart-warming, more fulfilling, than seeing the impact of our work through the stories of those we teach. To see that connection brought to life is truly a testament to our mission.” - Hannah Graham-Brown, Programmes Officer at The David Nott Foundation
Doctors rapidly trained to treat trauma injuries in Gaza
During a remarkable four-day Hostile Environment Surgical Training (HEST®) course, surgeons and anaesthetists from the UK, Germany, Sweden, Norway and Qatar gathered in Bolton to learn how to treat trauma injuries in the Gaza Strip.
Organised in two weeks in collaboration with Palmed, 42 doctors headed for the Middle East were trained to treat complex trauma injuries incurred in the Israel-Gaza conflict. This course not only marks a significant step towards preparing medical professionals for future missions in Palestine but also reflects a shared commitment to saving lives in conflict zones.
"Thank you to the David Nott Foundation. Without them, this training would not have been possible. Together, we are organising this course to assist the people in the Gaza Strip once it is safe and travel becomes feasible. The response from numerous doctors expressing their desire to help has been overwhelming, and we are hopeful to conduct a second course in the coming weeks." - Riyadh Al Masharqa, Plastic surgeon, PalMed
Addressing urgent medical needs in Gaza
The course was organised in response to the pressing humanitarian crisis in Gaza, Palestine. According to on-the-ground partners, medical professionals are stretched to their limits and hospitals are overwhelmed.
The group included specialists in orthopaedic surgery, cardiothoracic surgery, obstetrics and gynaecology, paediatric anaesthesia, and general surgery. Some brought valuable, first-hand experience from regions affected by conflict, like Afghanistan and Syria, while others joined to grow their understanding of how to treat war wounds before heading on mission.
"I'm excited about expanding my skill set beyond obstetrics and gynaecology to acquire new capabilities that will benefit mothers and their infants in Gaza and the West Bank. I recognize the desperate need for assistance in this region. This course is unique as it combines obstetrics and gynaecology with trauma care. This training aims to address complex challenges comprehensively and I look forward to it.” - Dr Iman Al Mabhooh, Obstetrician and Gynaecologist
A troop of volunteers
For the very first time, 11 FDNF volunteers from our Friends of The David Nott Foundation (FDNF) and Trainees of The David Nott Foundation (TDNF) societies volunteered to help arrange and assist during the course. This joint effort meant it could be organised at lightning speed, rapidly creating a network of well-trained war doctors.
“Given not only the humanitarian crisis in Gaza but with the targeting of healthcare workers in particular it's never been more important to strengthen our healthcare colleagues and equip them with the skills to do their incredibly difficult jobs and to support them through a very precarious situation.” - Nadia, FDNF Manchester President
Our surgical HEST® and anaesthesia courses were held simultaneously, demonstrating our commitment to enhancing the skills of all those striving to preserve life in the operating theatre.
"What has been great about this course is meeting people that have experienced things in the field. From the anaesthetics point of view, it's been helpful to learn how they deal with limited resources and supplies, and we have been using airway mannequins and practicing with video scopes."- Dr Douglas Philpott, Anaesthetist
We’re committed
As war continues to rage, we are working on a second surgical training course with the goal of upskilling even more frontline medical professionals. We won’t stop empowering doctors with the knowledge needed to save lives and limbs against the odds.
Our latest training in Palestine
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.”
Royal Parks runners help us train more doctors
We are continuously amazed by our supporters. This year's Royal Parks Half Marathon saw many of our supporters take to London's streets to raise thousands for doctors living and working in the world's most dangerous corners. Thanks to their determination, doctors in territories such as Ukraine, Yemen, Palestine and Syria will receive the surgical training needed to treat traumatic injuries and save lives.
Our photographer and videographer, Lucy Lyon, swapped her camera for trainers and took part in the Royal Parks Half Marathon with her brother, Duncan. Together, the pair have raised over £3000 for our mission.
"It was an amazing day in many ways. Golden leafed London parks with warm sun, every shape and ethnicity, age and gender moving along side by side, in a steady tide, for thousands of different causes.
Everyone smiled, no one pushed or shoved. There was a human tree, and a very hot lion, tiger, and a bear. Even a rhino. A man with a fridge on his back, and people in wheelchairs.
The supporters were everywhere, drumming and cheering us along. It was a morning well spent and all the while jogging along beside me was my little brother.
We agreed that running that distance together was more like running with a pet - a silent but constant companion. And the best bit about running in your late 40s is the gratitude you feel to those legs and feet for their constancy and power.
We have so far raised enough to support the training of at least two surgeons from a conflict zone, who will go on to save hundreds of lives in their region."
If you'd like to set yourself a challenge or raise funds for a cause that changes the lives of communities in conflict, get started today. Thank you to each and every person who supports our mission.