British War Surgeon Trains Ukrainian Docs in Conflict Medicine

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Over the weekend, a well-known British war surgeon virtually taught more than 570 Ukrainian doctors and healthcare professionals how to do war-time medicine.

David Nott, MBChB, a surgeon at St. Mary’s Hospital in London, showed them how to treat gunshot wounds, fragmentation injuries, and blast wounds, among other techniques many of them have never performed.

“War surgery is something completely different because you need to have a mindset about war,” Nott told the BBC in an interview. “It’s a completely different ballgame, and we don’t get trained how to do that in this country. Even us in the first world have no real clue of how to manage war injuries.”

Over some 30 years, Nott has treated war injuries in many conflict zones, including Afghanistan, Yemen, the Democratic Republic of Congo, and Syria, which are detailed in his 2019 memoir War Doctor: Surgery on the Front Line. Each year, he takes time to work for aid agencies including Médecins Sans Frontières and the International Committee of the Red Cross.

On Saturday, March 5, he condensed his 5-day surgical training course for working in resource-poor or conflict zones — which typically brings doctors from around the world to the Royal College of Surgeons in the U.K. — into a 12-hour surgical training course.

Nott covered techniques in triage, damage control, and burns, as well as cardiothoracic, orthopedic, pediatrics, and plastic surgery sessions. Colleague Henry Marsh, MBChB, a retired neurosurgeon from St. George’s Hospital in London, conducted the neurosurgery session.

During the virtual course, Ukrainian healthcare professionals learned “a range of skills that can be used when faced with limited resources, from learning how to create make-shift pelvic binders to knowing when to operate without a CT scanner,” according to a statement from the David Nott Foundation.

“This is the only way we can do it at the moment,” Nott told the BBC. “I can’t go there and operate with them. The beauty is I do understand their situation. I’ve been there. I’ve been cowering when bombs come in. I’ve been working in underground hospitals. I know what it’s like. I know what they’ll be facing.”

One of the physicians who took the course, who lives in a suburb north of Kyiv, told the BBC he was afraid he would very likely have to use the training in the coming days and weeks. “If they [were] ordered to take Kyiv, there’s no other way to take it than aircraft bombing,” he said. “There will be mass murder here.”

“It’s a disaster,” the doctor said. “I cannot describe my feelings about it. I’m very sad about it because all these people will have to suffer and die for nothing.”

He said he often hears blasts from anti-air defenses and aircraft flying over, though there had not been a bombing in his region in several days. “Most of our hospitals are empty at the moment,” he said. “Many people left here already.”

Marsh has extensive ties to Ukraine, having traveled there frequently over the past 3 decades to train Ukrainian surgeons, he told the BBC. He called Ukraine a country “struggling to escape a totalitarian Soviet past” — something he saw reflected in its healthcare system.

“All healthcare systems reflect their society,” Marsh said. “Soviet society was totally monolithic and autocratic, and Ukrainian medicine was the same. It’s changed. It’s aspiring to the freedom we take for granted here.”

He said the conflict touches him personally because “I’ve got many friends in Ukraine. One has this feeling of both horror at what’s going on, and disgust. What’s happening is obscene, what Putin is doing. And there’s little I can do to help, which is why I was hugely pleased when David Nott contacted me because of my Ukrainian connections.”

“I’m afraid all the information we shared with them over the course of the day is probably going to become horribly relevant,” he said. “It already is in places like Mariupol, which has been shelled to bits.”

The World Health Organization has confirmed at least 16 attacks on Ukrainian health facilities since the start of the invasion, which have killed at least nine people.

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to [email protected] Follow





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