An experienced team of trainers have just returned from delivering two HEST courses in Dnipro and Kharkiv. Here, consultant neurosurgeon and faculty member Pete Mathew shares his experience of teaching frontline doctors in Ukraine and what makes a course successful.

After David volunteered in Ukraine in April, it became clear there was an urgent need to return and deliver our war surgery training course to doctors in the country.

We decided it was best to send a small but experienced team, consisting of David, myself and Ammar Darwish. The three of us have worked in a number of war zones over the past decade – and Ammar and I have been part of the Foundation’s teaching faculty for years.

Reaching as many doctors as possible

To have a bigger impact, we decided to deliver two courses in Ukraine. We held one three-day course in Dnipro and another in Kharkiv – two cities that have faced significant attacks over the past few weeks.

To enter the country and support us on our mission, we worked with UOSSM International. Together, we travelled from Poland and made our way to our first training destination – what appeared to be a teaching facility in Dnipro.

On the walls, there were pictures of students happy and smiling, a stark difference to Ukraine’s present reality.

Training overseas is always a leap into the unknown. We never quite know where the teaching location will be. We don’t always know what sort of doctors will arrive. But it always comes together.

Once we got our bearings, we set our equipment up before the doctors arrived – from Heston our war wound model to David’s comprehensive training videos on a projector. Heston is an excellent teaching aid for describing injuries or techniques.

Making an impact in Dnipro

In Dnipro we had over 30 attendees of varying seniority and specialties – junior doctors, consultants, emergency doctors and an anaesthetist. We had a fantastic Ukrainian translator with us, which was amazing. Different doctors arrived on different days, which is quite normal in an emergency, resource-poor setting. They need to return to treating patients on the frontline.

Sometimes it can take a little time to gain the trust of attendees. We need to prove our worth – which is absolutely understandable.

Creating a community

Some of the surgeries are quite simple, but the hurdle is finding the confidence to do them under challenging, high-stress circumstances. We want doctors to feel empowered – sometimes all that’s needed is confidence. We want doctors to feel inspired to learn and try the techniques they’ve seen on our course.

We hear from those we train that we offer a morale boost, but perhaps more importantly we provide a forum for surgeons with different levels of experience to have discussions and raise questions – a safe space for doctors to debate views.

Speaking with the doctors we met in Dnipro, it was clear they were resigned to the inevitability of returning to the frontline after our course ended. They are solemnly grinding away.  Some of the very junior doctors were more anxious about returning to work.

The road to Kharkiv

After three days, we packed up and travelled up to Kharkiv to deliver our second course. The group – 28 doctors – were very happy to see us.

Back-to-back courses can be very tiring, but we are always happy to do it. It’s always very tempting to do two in a row, to reach more people.

There was a marked change in behaviour from the beginning to the end of our courses. Being an effective teacher requires getting your message across with enthusiasm. If you don’t feel drained after a course, or you don’t see excitement in your audience, you haven’t given it everything.

You also need to be able to adapt to the needs of your attendees. It’s important to be flexible and go off-script – to deliver the course in a way that best suits those in front of you.

Standing in solidarity

When training in active war zones like Ukraine, an experienced team, support from the Foundation and partners like UOSSM International are important.

I hope our training has boosted Ukrainian doctors. As long as this war wages on, we will continue to offer whatever support we can.

Read our story in the BBC