David Nott on his three decades of conflict work
Volunteer surgeon David Nott tells Jessamy Calkin about life on the humanitarian front line
Last week, David Nott was cycling to his day job in Paddington listening to the radio on his headphones, when a song came on that reminded him of a “joyous time” in his life, before any family responsibilities, “where I felt I could do whatever I wanted – and I was so excited because I was about to go off to a war zone”.
Going to a war zone is not the obvious thing that springs to mind from the word “joyous”. But then David Nott is not an obvious man.
“Conflict work was the only thing that made me feel alive,” he writes of his volunteer missions as a surgeon in War Doctor, his bestselling book.
It is full of close scrapes that would make most people shudder – the time in Sarajevo when the ambulance he was travelling in was hit by snipers, or the operation in Syria when the object he removed from a woman’s leg turned out to be a detonator, or when the nurse standing next to him in Yemen was felled by a bullet, or how several members of Isil turned up in the operating theatre in Aleppo to monitor his surgery on one of their fighters. Or even the incident in the outside lavatory in Sudan when the strange squelching sound turned out to be a python, “at least two foot in circumference”.
Anyway, now, he says, he has huge responsibilities, “and it’s an equally joyous time – just different”. He met Elly Jupp at a charity event, they were married in January 2015 and have two daughters, Molly and Elizabeth, aged
‘He’s just a bloody good surgeon, the best, never mind all that sexy war stuff’
five and three. Elly runs the David Nott Foundation, which they founded the year they married and is now flourishing. Its main purpose, in conjunction with organisations such as Médecins Sans Frontières (MSF) and ICRC (International Committee of the Red Cross), is to train surgeons and medical professionals to work in conflict and natural disaster zones around the world.
What really got it off the ground, he says, was his 2016 appearance on Desert Island Discs, a memorable episode when he and Kirsty Young both sounded as if they were in tears, and he told a story about a lunch in Buckingham Palace shortly after he returned from treating badly injured children in Syria. When the Queen asked him about it he was unable to reply, and realising how traumatised he was she suggested they feed the corgis some biscuits, which they did in empathetic silence.
The story went viral, and the donations came pouring in: “That’s what really made us fly,” says Nott. He has just returned from Yemen, where the world’s worst humanitarian crisis is raging and Houthi leaders are responsible for withholding muchneeded aid. After a lengthy journey through several dangerous checkpoints, Nott and his faculty of four were escorted by MSF, who provided the security and negotiated with the Houthi regime to allow them to run the course – they trained 33 surgeons in five days. They took with them their most prized possession – and the only one of its kind – a life-size silicone model of a body, named Heston after the Hostile Environment Surgical Training course. Inside are organs and all kinds of skin flaps “and a proper heart. We can chop it in two for travelling”, says Nott cheerfully. “And you can open the head, arms, tummy. It’s fairly soft, it feels like a normal human being. It’s an amazing piece of kit to teach people with – it does everything, apart from bleeding.”
It was enormously expensive to construct, and everyone, he says, “wants to pinch it. On the last day, the Houthis were after it – we had to lock it up in my room with padlocks. “[The training] is a distillation of 25 years of my war surgery experience, plus my other surgical experience, in a five-day course, and if I can brag about it, I would say it’s the most comprehensive course in the world.”
Nott has been going off on missions since 1993, when he first took unpaid leave to volunteer in Sarajevo with MSF. His time is now split between teaching and his NHS job as a consultant vascular surgeon at St Mary’s Hospital, Paddington. He is, according to a fellow consultant, “just a bloody good surgeon, the best, never mind all that sexy war stuff ”.
Over the years, he has had to treat the consequences of some of the most evil human behaviour imaginable – dreadful injuries inflicted by barrel bombs, snipers deliberately targeting pregnant women’s stomachs, nineyear-olds raped by Janjaweed in Sudan – but also witnessed acts and gestures of the most extraordinary kindness and loyalty. How does he reconcile these opposing sides of human nature?
“There are some people who use their power to make things better and have a positive effect on people’s lives, there are others who use power to destroy everything around them. I think the majority of humans are good.”
He often became extremely depressed after missions – once he started screaming while treating a private patient who was complaining that she’d had to wait six weeks to see him about her thread veins, when he’d just returned from a particularly horrific trip to Darfur. (He blamed a bad attack of sciatica, and left the room.) It developed into full blown PTSD, but he recovered after a course of cognitive behavioural therapy.
But he must also question how he has managed to survive so many close calls
– is it luck or is it God? “I don’t think it’s either,” he says. “You can’t stop bullets or bombs, obviously, but you can develop relationships with people whereby they don’t want you to die – or they don’t want you to be in a situation whereby your life is at risk.”
The biggest threat to aid workers is road traffic accidents and kidnapping, he says. “When I was in Aleppo in 2014 I was the only Westerner in Syria, apart from the people who had been kidnapped – James Foley and Alan Henning – who were then beheaded by Jihadi John about 40km away from where I was.”
‘I knew there were jihadists going across the border … Hague refused to see me’
Next month he is going back to Idlib, Syria’s last remaining rebel-held bastion, to teach. He hasn’t been to the country for a year, but keeps in touch with his surgeon colleagues there, often advising them by WhatsApp – he shows me some messages, all addressing him as “Abu Molly” (father of Molly). Nott is a modest man, but he has been responsible for saving many, many lives – and not just on the operating table. There was the baby girl who had days to live after suffering severe head injuries in the Haiti earthquake, whom he managed to get to hospital in London. (She now lives in Leicester with her adoptive family, and he visits her regularly).
There were the children and doctors who were saved when, partly via his intervention, they were bussed out of Aleppo during the siege in 2016.
In that instance, he got help from Andrew Mitchell MP, but berates the fact that he has never been consulted by politicians over matters where he could clearly contribute. “I’ve been to places that politicians have never been to. I came back from Syria in 2013 and I knew there were all these jihadists going across the border; I banged on William Hague’s door and he just refused to see me. I could not understand why the foreign secretary would not talk to me.”
If he were in a position of power in the Government now, he would encourage the development of incentivised global health schemes for doctors and nurses: “It gives them a mass of experience they can then contribute to the NHS.”
These days he gets a lot of requests from all over the world to volunteer, but most he has to turn down. But if there was another earthquake in Haiti? “I think, yes, I would, because it’s important to not lose the fact that I am a humanitarian surgeon.”
Right now he’s off to Paddington to do a quick carotid endarterectomy. He loves working for the NHS, but in disaster and war zones he can save several lives every day; here it’s more like one a month. “And how many lives will be enough?”
War Doctor: Surgery on the Front Line by
David Nott is published by Pan Macmillan. Buy now for £9.99 at books. telegraph.co.uk or call 0844 871 1514