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David Nott
Consultant General SurgeonDirectory:
Expertise:
David Nott is a highly experienced General and Vascular Surgeon. He is an authority in laparoscopic (keyhole) surgery and was the first surgeon to combine laparoscopic and vascular surgery.
David was the first surgeon in the world to perform a totally laparoscopic distal arterial bypass (at Chelsea and Westminster Hospital in 1999) and the first in Europe to carry out a laparoscopic abdominal aortic aneurism repair (Chelsea and Westminster Hospital, 1998).
David has written over 100 papers on various aspects of Vascular and General Surgery.
David has a keen interest in war surgery and works for Médecins Sans Frontières and the International Committee of the Red Cross, and spends time each year providing assistance in war-torn countries such as Afganistan, Iraq and Sudan.
Specialties:General and Vascular Surgery, Laparoscopic Surgery, Keyhole Surgery
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Robin Coupland
Medical Advisor to the ICRCRobin Coupland is a medical adviser in the International Committee of the Red Cross (ICRC).
He joined the ICRC in 1987 and worked as a field surgeon in Thailand, Cambodia, Pakistan, Afghanistan, Yemen, Angola, Somalia, Kenya and Sudan. He has developed a health-oriented approach to a variety of issues relating to violence and the design and use of weapons.
A graduate of the Cambridge University School of Clinical Medicine, UK, he trained as a surgeon at the Norfolk and Norwich Hospital and University College Hospital, London. He became a Fellow of the Royal College of Surgeons in 1985. He is the holder of a Graduate Diploma in International Law from the University of Melbourne in Australia.
As part of his current position he has focused on the effects of violence and weapons both conventional and non-conventional. He has developed a public health model of armed violence and its effects as a tool for policy-making, reporting and communication.
His current work has two tracks: first, the feasibility of an ICRC operational response in the event of use of nuclear, radiological, biological or chemical weapons; second, improving security of health care in armed conflicts. He has published medical textbooks about care of wounded people and many articles relating to the surgical management of war wounds, the effects of weapons and armed violence.
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Is it possible for doctors to provide care without being perceived as taking sides during conflicts? This question is posed more and more as attacks on health workers in war zones increase.
In January 2012, Khalil Rashid Dale, a doctor travelling in a clearly marked International Committee of the Red Cross (ICRC) vehicle to Quetta, the capital of Baluchistan province in Pakistan, was abducted by unknown armed men. Some four months later the doctor’s beheaded body was found in an orchard. Also in January two Médicins Sans Frontières (MSF) health workers were killed in Mogadishu, Somalia. The consequences of such attacks are disproportionate in their impact. A consequence of the Somalia killings led to the MSF closing two 120-bed medical facilities in Mogadishu, which served a population of some 200,000 and which over the previous year, had treated close to 12,000 malnourished children and provided measles’ vaccinations and treatment to another 68,000 patients.
In 2011 Robin Coupland, a former trauma surgeon, now a medical adviser with the ICRC, co-authored Health Care in Danger, a study, which describes how and why health workers get caught in the cross fire and what the consequences are when they do. The study was used to launch an ICRC campaign to raise awareness of the problem and make a difference to health workers on the ground.
For some people however, it is impossible for doctors to provide care without being perceived as taking sides during conflicts. Some argue that as the quantum of humanitarian aid has increased over the past decade, so humanitarian aid agencies have been compelled to rely on sub-contracting in actual conflict areas. This, it is suggested, provides a breeding ground for aid corruption to finance nefarious elites and to further destabilize conflict areas, implying that healthcare activities of humanitarian organisations in war-torn regions have become increasingly politicised. Even agencies that make considerable efforts to disassociate themselves from political actors and project an image of neutrality have not been immune from attack.
Do warring factions perceive health workers as supporting the enemy and therefore see them as legitimate targets? Or are health workers targeted because they represent an opportunity to amplify messages to a global audience? It is likely both are true, but the impact on society as a result of removing vital healthcare in war zones, due to these attacks, can have devastating consequences.
