Serving low-resource hospitals in the DRC
This year, we were contacted by a doctor from the Democratic Republic of Congo (DRC) to set up a Friends of David Nott Foundation (FDNF) society – our very first FDNF in Africa. In a bid to support the development of African doctors in hospitals with poor resources, we provided funding for teaching tools used to upskill medical professionals in deep DRC territory.
In June 2023, a WHO report found that the number of internally displaced persons (IDPs) in the DRC has more than doubled to 6.3 million, since the end of 2022. The crisis has emerged as decades of conflict and food insecurity soars in the DRC, made worse by extreme flooding and disease outbreaks throughout the Ituri and North Kivu Provinces.
Chris Kitumaini, a medical doctor and President of our FDNF in the DRC, arranged a training course for doctors at the Murhesa Medical Center, a modest hospital with very limited resources, medical equipment and staff. He shared:
“We travelled to Bukavu, in the South-Kivu Province in the DRC, and then went onto Kabare’s deep territory to get to the Murhesa Medical Center. We picked this location to train in because it is a hospital with very low income. Resources are so limited there."
"In the operating rooms, there is nothing. Women are giving birth on wooden tables. The doctors there are working with the smallest amount of materials, no beds, no anaesthesia machines. Nothing but the doctors and medical assistants."
Basic medical skills
The surgical teaching team, some of whom had travelled from Bordeaux, taught a range of basic medical and surgical skills to a group of 20 doctors from different territories. Some had travelled from small villages to get to the training in Murhesa Medical Center.
Four courses were delivered during two intensive days of training, using surgical toolkits, mannikins and anaesthesia tools funded by us. Dr Raïssa Kizungu, a cardiologist from Bordeaux, led the management of cardiovascular pathologies in the context of war and environments with limited resources. The team used mannikins to teach the group cardiopulmonary resuscitation (CPR) and essential tools for resuscitation to preserve life in resource-limited settings. Dr Elie Bugashane, a general surgeon, led the management of battlefield wounds and suture techniques in resource-limited environments. Finally, Dr Charles Kachungunu led the management of head trauma and how to deliver excellent nursing care.
During other practical sessions, the surgeons learned how to do a craniotomy to stop serious bleeding, as well as suture techniques to manage wounds in war and low-resource contexts.
A thirst to learn
“Our first workshop, funded by the David Nott Foundation, was a success. We chose doctors and medical professionals who really needed training. It was a big moment for us.
We now want to focus on training in other places that need us the most – villages deep in the Congo forest. Learning simple procedures, like how to secure broken limbs, could really help people that cannot move to other hospital easily.”
We remain committed to supporting medical professionals living and working in countries impacted by war and disaster.
Our new Betty Boothroyd Scholarship Fund
We are delighted to announce the launch of our new Scholarship Fund in memory of our late Patron and beloved friend, The Rt Hon. The Baroness Boothroyd OM. The fund invites applications from medical professionals living, working or volunteering in conflict zones, including surgeons, clinicians and nurses, who wish to further their surgical training.
Our Patron
Betty became our Patron in 2016, when the conflict in Syria was at its most intense. Areas of the country were besieged, civilian infrastructure targeted and the passage of humanitarian aid restricted. Betty would often call our Co-Founders to express her concern at what was happening and ask what the Foundation could do to help.
In conflict, surgeons need a particular set of skills and decision-making strategies to be able to respond effectively to the waves of devastating injuries they encounter daily. The work of training doctors began in Misrata, Libya, moved on to Aleppo, Syria, and we have since then trained 1,825 surgeons and anaesthetists in conflict setting including Iraq, Cameroon, Palestine, Ukraine and many more.
From the very beginning of her journey with us, Betty remained deeply passionate about our training of frontline doctors working relentless hours. In honour of Betty’s commitment to our mission, we are proud to launch the Betty Boothroyd Scholarship Fund.
What’s the funding criteria?
Whether you’re a Sudanese nurse interested in a Masters in Trauma Management, a Palestinian doctor wishing to complete a paediatrics course, or a humanitarian surgeon interested in joining one of our HEST-UK courses, we may be able to support you with funding.
Guidelines
1. Applications are open to any surgical team members who wish to further their medical training or education (e.g. surgeon, anaesthetist or surgical nurse)
2. The training that applicants are seeking funding for can be held anywhere in the world
3. Applicants must meet one of three criteria below:
- Living and/or working in a conflict or catastrophe zone
- Your country of origin is a territory that has experienced conflict or catastrophe, however you currently reside in another country
- You are a humanitarian surgeon who travels to, and volunteers in, conflict and catastrophe zones
“Thanks to Betty’s generosity to our Foundation, she will continue to make a difference to doctors striving to heal their wounded communities for decades to come.” - Elly Nott, Co-Founder
Contact us to apply
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.
REGISTER TODAY
Funding paediatric trauma training for two Ukrainian surgeons
In the wake of ongoing conflict, we have taken a significant step in supporting Ukrainian doctors. To further strengthen Ukraine’s medical workforce, we sponsored two doctors, paediatric surgeon Dr Dim Ershov and anaesthetist Dr Olga Panasiuk, to attend the Paediatric Advanced Cadaveric Trauma Surgery (PACTS) course for surgeons.
After the war erupted, Dr Ershov, and Dr Panasiuk were recruited as surgeons for the Ukrainian army. The two doctors previously met our Co-Founder, Professor David Nott, during one of our surgical training courses in the country. Since March 2022, we have trained over 400 surgeons during 12 surgical training courses in cities such as Odesa, Kyiv, Dnipro, Poltava, Lviv and Zhytomyr.
Deepening our impact
In a bid to strengthen our support for medical professionals in war and catastrophe, we’ve expanded our offering beyond our flagship Hostile Environment Surgical Training (HEST) course. We worked with leading anaesthetists to develop an anaesthesia course and will be developing a nursing course next year, with the goal of saving even more lives inside and outside the operating theatre.
We also provide scholarships for frontline doctors in need of additional training. Dr Ershov and Dr Panasiuk were funded by us to attend the PACTS course in Newcastle.
The course, led by Dr Suren Arul, a paediatric surgeon who previously served in the military, is a two-day intensive program that blends surgical procedures with anaesthetics and nursing. The course incorporates realistic scenarios, including intensive role-playing at six different tables with various surgical cases, simulating the pressured experienced in war zones.
"They kept us on our toes"
After their two days of training, we met up with Dr Ershov and Dr Panasiuk to ask about their experiences. “Teamwork in the training program put us in a more realistic situation.” shared Dr Panasiuk. “The models were very interesting, very realistic. They kept us on our toes - as we would be during real surgery.”
"We extend our heartfelt appreciation to the David Nott Foundation for their unwavering support. As Ukrainians, we wish to express our deepest thanks to David and the entire foundation for their tireless efforts. Through multiple courses, they have saved lives and limbs, standing as champions for Ukraine and democratic freedom. PACTS will equip us with the skills to be more effective. Without their support, we would undoubtedly be prone to making several mistakes."- Drs Ershov and Panasiuk
Protecting Ukraine's children
“Undoubtedly, Dim and Olga can now return to Ukraine equipped with the skills and knowledge to perform life-saving procedures and surgeries, said Dr Suren. "Their participation in the PACTS course, sponsored by the Foundation, has undoubtedly elevated their capabilities, allowing them to make a significant impact in their homeland."
As conflict in Ukraine persists, we will continue to provide training and support to doctors in need. Thanks to a new wealth of knowledge, Dr Dim Ershov and Dr Olga Panasiuk will give more of Ukraine's children hope for the future.
41 Syrian doctors upskilled to screen and treat women with cervical cancer
Dr Saladin Sawan, Consultant Surgeon in Gynaecological Oncology and one of our faculty trainers, recently returned from a surgical mission in Idlib, Syria, upskilling 41 surgical residents and specialists to screen for and treat women with cervical cancer. Here, Dr Sawan shares his hopes for healthcare and future training in northwest Syria.
Syria remains engulfed in a complex humanitarian crisis. Over a decade of conflict has forced more than 12 million people to flee their homes and left displaced communities with reduced access to food, shelter and protection.
Cancer under the radar
Due to a buckling healthcare system and greater focus on other urgent needs, many are not seeking or receiving the cancer screening, diagnosis or treatments they need. Medical professionals also face challenges with transferring patients over the border to Turkey, which means cancer patient numbers in-country are growing.
Cervical cancer is preventable and curable, as long as it is detected early and managed effectively. According to the World Health Organisation (WHO), it is the 4th most common form of cancer among women worldwide.
Our faculty trainer, Dr Saladin Sawan, travelled to Idlib to upskill Syrian surgeons to offer the best possible surgical care for patients with gynaecological cancers including cervical cancer.
“During my mission, I delivered gynaecology training to a group of doctors. Every day, we practiced surgical techniques. We used chicken thighs and a cutting-edge mannequin, provided by the David Nott Foundation, to practice performing cervical smears, colposcopies to assess the cervix for cancer or pre-cancer changes, and diagnostic punch biopsy, in addition to safely performing treatments for pre-cancer cell changes, in the form of loop excision (using heat to remove cells). Each doctor had hands-on practice and then we put skills to the test in operations.”
Dr Sawan trained 41 local doctors during the mission, which will improve cancer patient care while strengthening northwest Syria’s healthcare system in the long-term.
“I performed approximately 14 surgeries of different magnitude, some small procedures, some far more complex, for example radical hysterectomies for cervical cancer patients and debulking surgery for women with ovarian cancer. We used operations as teaching opportunities for local doctors – residents were assisting me and watching over my shoulder. We trained anywhere between three and seven obstetrics and gynaecology residents per day. Some doctors followed me, but I made it my goal to visit as many hospitals as I could to deliver training to those who could not travel. I was very happy.
I felt appreciated amongst a family of doctors and health professionals who looked after each other to deliver the best they could for their patients in some of the most difficult circumstances. I was certainly privileged to have had the chance to be with them.”
Eliminating cervical cancer
Due to ongoing conflict and accessibility issues, doctors in northwest Syria have limited access to training. The province also lacks a screening programme for cervical cancer prevention and early detection, leading to increased numbers of cases that require complex, radical surgery.
“WHO launched an Elimination of Cervical Cancer Elimination Initiative, which mainly targets low-income countries. The local doctors are really excited about establishing this program for women in Syria. They know the benefit, they believe in its value and importantly they feel it is only right to do since women disproportionately suffer the results of human papilloma virus infection which causes cervical cancer, unlike men. This would promote healthcare equity.”
In his training, Dr Sawan actively encouraged the local doctors not to fear making mistakes.
“Doctors become more confident and patients as a result will be safer. We strive for the doctors to test, try, play, make mistakes. The intention is that the doctors are more competent by the time they perform the operation on patients.
I am lucky to be part of the David Nott Foundation where the emphasis is also on building local expertise and sustainable care by training local health professionals in crisis areas. The donated equipment and surgical instruments meant I was able to deliver comprehensive training without compromises.”
Glimmers of peace
“Around me in Idlib, despite being in a region struck by war, there were people trying to rebuild their lives. Developing roads, restaurants opening, people moving into the city. People have started to live their lives – the dust of war settling and communities trying to get their lives back.”
Since Dr Sawan’s mission and apparent signs of a healing community, the Regime has targeted 45 cities and towns in four days, killing 52 and injuring over 240, according to an October recent report led by Assistance Coordination and Information Management Units (ACU, UMI). Despite glimmers of hope, northwest Syria remains in the thralls of conflict.
What’s next?
As unrest continues, the need for training and sharing of knowledge remains. We are committed to upskilling even more obstetric and paediatric residents in northwest Syria, but there’s much more to do.
“Outside of returning to deliver more surgical training, we also want to deliver dedicated cervical cancer screening training to residents,” shares Dr Sawan.
On-the-ground partners have also identified other, urgent areas of need.
“A local humanitarian organisation, the White Helmets, are looking to develop training for paramedics, including resuscitation and emergency obstetrics, gynaecology and neonate training. To make sure we provide the right training material for paramedics, we want to speak to them to understand exactly what their needs are in the field.”
We’ll continue to do all we can to support medical professionals in Syria.
The Rt Hon. The Baroness Boothroyd OM, our beloved Patron
It was with great sadness that we learnt of the passing of our beloved Patron and friend, Baroness Boothroyd.
People like Betty Boothroyd do not come around often. She fought hard to enter Parliament, succeeding in doing so in 1973. She had a distinguished career serving on many select committees and as a whip before making history by becoming the first woman Speaker of the House of Commons. She won respect for her firm but fair application of the rules of the House and admiration for her authority, warmth and wit.
Her presence and unmistakeable star quality elevated any meeting she attended and to have Betty as our Patron was a point of huge pride for all of us. She took a keen interest in our work and would often call David or I, having watched news reports from Syria or Ukraine, and ask what we could do to help. She was with us from the start, when we launched the Foundation in 2016 at the Royal College of Surgeons of England, and she will leave a space quite impossible to fill. We will honour her legacy by striving to be as fearless, and as tireless, as Betty.
A star has gone out in Britain tonight, but the heavens are all the brighter for her presence. For your service to our country, support for our Foundation and friendship to David and I; thank you Betty.
Elly Nott, CEO and Co-Founder
26th February 2023
Scholarship to help Nepalese student reach more people following earthquake disaster
A postgraduate student who has treated more than 25,000 people cut off from healthcare following an earthquake has received a prestigious scholarship to further his work.
Dr Aban Gautam, who is originally from Nepal and currently studying for a masters in clinical research (MClinRes) at the University of Plymouth, was selected to receive the David Nott Foundation scholarship.
