Hostile Environment Surgical and Anaesthetic Training (HEST)

Surgeons and anaesthetists rapidly trained to treat trauma injuries in Gaza


PalMed UK in collaboration with the David Nott Foundation run a remarkable four-day Hostile Environment Surgical Training (HEST) course, surgeons and anaesthetists from the UK, Germany, Sweden, Norway and Qatar gathered in Bolton to learn how to treat trauma injuries in the Gaza Strip.
Organised in two weeks in collaboration with Palmed UK, 42 doctors headed for the Middle East were trained to treat complex trauma injuries incurred in the Israel-Gaza conflict. This course not only marks a significant step towards preparing medical professionals for future missions in Palestine but also reflects a shared commitment to saving lives in conflict zones.

Riyadh Al Masharqa, Plastic surgeon and CO for PalMed Europe saied:

“Thank you to the David Nott Foundation. Without them, this training would not have been possible. Together, we are organising this course to assist the people in the Gaza Strip once it is safe and travel becomes feasible. The response from numerous doctors expressing their desire to help has been overwhelming, and we are hopeful to conduct a second course in the coming weeks.”

Addressing urgent medical needs in Gaza, the course was organised in response to the pressing humanitarian crisis in Gaza, Palestine. According to on-the-ground partners, medical professionals are stretched to their limits and hospitals are overwhelmed.
The group included specialists in orthopaedic surgery, cardiothoracic surgery, obstetrics and gynaecology, paediatric anaesthesia, and general surgery. Some brought valuable, first-hand experience from regions affected by conflict, like Afghanistan and Syria, while others joined to grow their understanding of how to treat war wounds before heading on mission.

Dr Iman Al Mabhooh, Obstetrician and Gynaecologist consultant.

“I’m excited about expanding my skill set beyond obstetrics and gynaecology to acquire new capabilities that will benefit mothers and their infants in Gaza and the West Bank. I recognize the desperate need for assistance in this region. This course is unique as it combines obstetrics and gynaecology with trauma care. This training aims to address complex challenges comprehensively and I look forward to it.”

Our surgical HEST and anaesthesia courses were held simultaneously, demonstrating our commitment to enhancing the skills of all those striving to preserve life in the operating theatre.

Dr Douglas Philpott, Anaesthetist

“What has been great about this course is meeting people that have experienced things in the field. From the anaesthetics point of view, it’s been helpful to learn how they deal with limited resources and supplies, and we have been using airway mannequins and practicing with video scopes.”

As war continues to rage, we are working on a second surgical training course with the goal of upskilling even more frontline medical professionals. We won’t stop empowering doctors with the knowledge needed to save lives and limbs against the odds.
We Palmed Europe and UK expressing gratitude to the David Nott Foundation for orchestrating this exceptional course. We eagerly anticipate the next installment.



Hostile Environment Surgical and Anaesthetic Training (HEST)

In collaboration between the Palestinian Doctors Association and the David Nott Foundation, we aim to train and qualify more than 100 doctors who wish to contribute to providing relief to our people affected by the ravages of war in the besieged Gaza Strip.
Hostile Environment Surgical and Anaesthetic Training (HEST)
Developed and led by David Nott, this course is designed to enhance the skills of surgeons and anesthetists, better preparing them for the daily challenges they face in war zones and disaster-stricken areas. It also aims to assist doctors traveling to such regions.
The course equips doctors with the necessary skills to make rapid, critical decisions while preserving medical resources. It covers a range of surgical procedures and addresses common emergencies during disasters and wars, characterized by equipment shortages and a high volume of medical cases requiring urgent interventions to save lives.
Given that working in crisis zones often rules out cadaveric teaching, the HEST course relies on practical exercises, including suturing prosthetic organs and blood vessels, as well as demonstrations on our specially designed full-body simulator. We also simulate mass casualty scenarios, training our surgeons in the decision-making skills needed to prioritize patients and save lives.
The course focuses on cases associated with wars and disasters, ranging from gunshot and explosive injuries to violent injuries resulting from building collapses and fires. It also covers post-disaster procedures, including skin flaps and grafts, as well as the management of orthopedic fractures using external fixation and amputation cases.
During the course, doctors learn how to make decisions and manage emergency cases related to obstetrics and childbirth, including postpartum hemorrhage and cesarean sections.
The course spans a full four days, during which doctors can expect to cover the following specialties:
Primary and secondary survey, Damage control,  Ballistics.  Cardiothoracic trauma.  Vascular surgery,  Head and neck trauma,  Paediatric surgery,  Abdominal trauma,  Orthopaedic surgery,  Plastic surgery, Trauma in obstetrics and gynaecology.




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