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For doctors and their humanitarian collaborators in war zones, who risk their lives to save the lives of others.
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Attacks against health workers in conflict areas are on the rise. According to the World Health Organisation, 863 health workers were injured or killed in attacks in 2016, an increase on the year before. Despite the growing dangers, doctors, nurses and other health care workers continue to brave tremendous risks to treat the wounded and heal the sick.
A London newspaper - Evening Standard - carried the story of Doctor David Nott who worked for many years in a war torn Zone. Journalist Jasmin Gardener interviewed him about his experiences in Syria.
For two decades trauma doctor David Nott has taken unpaid leave every year to help the victims of the world's war zones.
in mid-October 2013 Nott returned from Syria, where he was training doctors in one of the war-torn country's largest cities, in how to save the lives of those wounded in the conflict. In a city of two million people, just 36 doctors remain. "Every day, 12 to 14 people were coming in wounded. Children, women, normal people - all with gunshot wounds," he explains. Last month an X-ray image Nott took while he was there became front-page news. It showed an unborn baby with a bullet lodged in its skull - the result of pregnant women being targeted by snipers. The mother survived, thanks to Nott's expertise in war surgery.
In the past two decades Nott, 55, has taken six weeks' unpaid leave from his NHS job as a consultant at the Royal Marsden, Charing Cross and Chelsea & Westminster hospitals to do voluntary humanitarian work in conflict zones such as Bosnia, Chad, Iraq and Libya.
Seeing children and pregnant women targeted has prompted him to call the conflict in Syria the worst he has ever witnessed.
"I was in Sarajevo when snipers were targeting civilians," he says. "To see it again, but on a much greater scale, is the reason I've called Syria the worst war zone I've been into?... and probably the most dangerous place to be a doctor because health workers are also being targeted."
Nott was first inspired to "get out and help people" in 1993, when he saw a documentary on the Sarajevo siege. He approached the charity M?decins Sans Fronti?res. "Within three days I'd left my flat in Hammersmith and was in the middle of Sarajevo," he says.
Not every doctor is willing to do this kind of work. "If I had a family and children, would I do this? Probably not," he says. Nott is unmarried, has no siblings or living parents, and no children. "It needs people like me who will take the risk and don't have any responsibilities at home," he says.
Medical students and junior doctors often ask to accompany Nott on his missions, but he says "to take the risk, you need to be someone who can offer significant help". Last year one of Nott's colleagues, a young, newly qualified doctor, was killed in an airstrike in Syria. "It was a big shock to me," he says.
"In the middle of this war, with bombs going off, I gave lectures every evening on how to deal with particular injuries. Over five weeks, we had patients who came in with every single wound that we had discussed."
Teaching "damage control" procedures to stem bleeding and sepsis, and letting patients make a moderate recovery before major surgery, was "revolutionary," says Nott. "The death rate had been very high but now we had a 90 to 95 per cent survival rate. We went through three weeks without losing a single patient."
Since Nott's return to London, he's been advising the doctors in Syria every day by phone. "I was guiding someone yesterday on WhatsApp," he says, showing me images of stitched-up wounds sent to his iPhone.
There are no anaesthetists or physicians left in the city. "An anaesthetist from another country has done a wonderful job training up young boys of 19 to 21 to be anaesthetic technicians. None of them is a qualified doctor - they used to be shopkeepers and IT consultants - but they're now able to intubate and resuscitate." Others have been given a rudimentary training in cross-matching blood.
Of course, with the successes also come tragedy. One of Nott's patients, a 14-year-old boy, came in for a straightforward operation on a three-month-old gunshot wound to his leg that had developed into an aneurysm. The operation went well but one of the technicians accidentally matched the boy with the wrong blood. "This poor boy died in front of my eyes of multi-organ failure. I remember him looking at me and waving because he knew he was going to die?... The guy who did it was trying his best. He didn't have the right training. It's the first time I'd ever seen it happen... The children who died are still bouncing around in my head."
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