Syria HEST July 2019

The team has recently returned from their latest mission to Syria. With 46 airstrikes occurring since April on healthcare facilities, the most dangerous place to be in Idlib is certainly a hospital. With many hospitals now out of action, millions of people have been left without access to healthcare facilities and doctors have been left to face the challenge of saving lives without losing their own.

In order to confront this problem and the worsening conditions of patients, the Foundation’s Hostile Environment Surgical Training (HEST) Faculty comprising David Nott, Ammar Darwish and Mounir Hakimi recently delivered a HEST course in the Dr Mohamad Wassim Maaz Hospital near Bab Al-Salameh on the Turkish-Syrian border. Their objective was to deliver the course to 24 surgeons and general practitioners from Idlib, in partnership with Syria Relief and the Independent Doctors Association, to improve their skills in emergency trauma surgery, with a specific focus on how to treat blast injuries and gunshot wounds.



Intensifying airstrikes and destruction are slowly forcing everybody towards Idlib city. The only defence they have is to be prepared. The HEST course has aided this in equipping the surgeons and general practitioners with the skills necessary to tackle the increasingly life threatening injuries and rising population, allowing them to significantly improve the outcome for their patients.

The settings where HEST is taught rule out cadaveric teaching, so the Foundation’s whole body simulator was employed for training. Now with its legs removable, enabling faster and cheaper transport, the impact that it made on the quality of training and the ease with which the Faculty could demonstrate anatomy and procedures was excellent. Supporting the simulator was a suite of individual models of organs, blood vessels and key anatomies with which the students could train. The Faculty also trialled two new commercially-sourced neonatal resuscitation models (Laerdal Medical’s NeoNatalie) and two new neurosurgery models (Delta Surgical’s Rowena), which were a great success.


The Foundation’s Faculty are experts in austere environment surgery and deliver tailored training to a globally recognised standard. With the course having been tailored to match the advanced level of the surgeons and general practitioners and the quality of interaction being excellent, the team came away confident with the exceptional impact that it will have on the victims of the conflict.