Towards the danger

‘I work in a trauma centre in Manchester. You might face a mass casualty two or three times a year. In Gaza, you see it every day, with very limited resources.’

Ammar Darwish has two working lives. Most of the time, he is a major trauma surgeon at Manchester University NHS Foundation Trust. However, several times a year, he travels to some of the world’s most dangerous conflict and disaster zones to carry out humanitarian work.

As clinical director and global lead for faculty with the David Nott Foundation, he is also responsible for training doctors working in international hot spots, building capacity and helping them to save lives.

It’s a life of contrasts – and of personal risk. But it’s one he wouldn’t change.

‘Since 2012, I’ve been working with David [Nott], going on missions to Syria. I’ve seen how David works and the kind of expertise he has, particularly for dealing with war injuries and trauma surgery. I’m interested in this field of surgery; helping, supporting and treating war-injured people – men, women and children who are caught in these conflicts and a lot of them are just innocent people,’ he says.

Born in Aleppo in Syria, Mr Darwish moved to the UK some 26 years ago – although he had spent time as a child in Manchester when his father was training in paediatrics. It is, he says, his Muslim faith, which helps drive him to undertake what are often dangerous missions in the world’s conflict zones.  

‘It’s part of my faith to help the people who need my help, especially if I have a special expertise,’ he says. ‘I have the expertise that means I can go and help people who need it most in war-torn countries. They have limited resources, limited facilities, and limited numbers of experienced doctors to deal with these things, and I feel it’s my duty as a doctor and as a surgeon to go and help my colleagues in these areas, and to help wounded civilians.’

His first mission was in Gaza when he was still early in his training, around 16 years ago. ‘I saw what the doctors did, especially the senior surgeons, and how people benefited from that, and I felt that this was what I wanted to do – it’s the exact thing I wanted to do for the rest of my life, and I haven’t looked back.’

Since then, he has taken part in some 50 missions, leaving his job and his family in Manchester to work in the world’s trouble spots – carrying out surgery and training doctors in places including Gaza, Syria and Ukraine. It can be difficult to make the switch between working in the NHS and in sometimes desperate circumstances overseas, he concedes, but it does make him appreciate what we have in Britain.  

‘I know what the other side of the picture is. I always tell my family and friends that we’re lucky to have the NHS in spite of all the difficulties we have, such as limited funding, but we are very lucky to have this kind of health system in place in case we get ill. People in war-torn areas have nothing, literally nothing. They’ll be lucky to find a doctor to look after their families, look after their children.’

The contrast can be difficult for him as a health professional who wants to do his best for people, he says. ‘In a field hospital, you have limited resources, limited medicines, limited facilities to do tests to diagnose illness. You get people who come in with very advanced stages of disease. For example, you’ll get young patients in their thirties with advanced colon cancer that has spread everywhere and they are terminal. The picture is completely the opposite there – we’re very lucky to have the NHS.’

Despite every precaution taken by charities operating in the area, Mr Darwish is aware he is risking his life by continuing to go on missions. ‘In Syria, for example, it’s extremely dangerous, and we worked in field hospitals operating underground,' he says. 

He understands it is his choice to take these risks but that local doctors don’t have this luxury. ‘They go through this every day. Their families are at risk – they don’t know if their families will be safe. They don’t know if they will go back and find their houses bombed. I come back [to Manchester] to a safe environment, to my house, to my family who are safe. But they have those worries every single day.’

Again, his faith helps him to deal with the risk. ‘I pray,’ he says simply. ‘I pray every day, five times a day.’

And it’s not only while on duty that the risks abound. ‘When I was in Gaza last January [2024] there was an air strike directly on our safe house. We were supposedly in a green zone and supposedly it had been de-conflicted. We were hit and we were in the house. If the rocket had come three or four metres further into the house, it would have hit where we were sleeping.’

His employers are supportive about his missions, he says, and he has managed to negotiate a system where he does extra work when he is in the UK and is granted extra leave in return. ‘My colleagues have been fantastic too,’ he adds.

He also has an understanding family, including his wife, who is a humanitarian psychologist, and a son and daughter who are at university.  

‘Every time I go on a mission, and I say goodbye to my wife, to my mother, and my daughter and son, I feel that part of me is left with them. It’s so hard to detach from them and go away, but they totally understand why I’m going. They will say, “go there, stay safe, and then come back to us”. I think this is something rare, to have such a supportive family, who help me all the way through.’ 

The humanitarian work is worth the risk and the sacrifice, he says, and he is particularly proud to be involved with the David Nott Foundation.  

‘Why I love the foundation so much, and I’m so committed to it, is that you don’t just go and do an operation and come back. No, you go there and you are building capacity for the local doctors and local teams there. You are training them to be able to train their colleagues to carry out these life-saving and limb-saving procedures, and to continue saving lives. I’m really lucky to be part of the David Nott Foundation family.’  

He gains a lot from it personally, he admits. ‘It’s highly rewarding, to be honest, because you see the difference immediately. Once you receive all these patients coming in, children who are injured, you manage them, you treat them. And when they get better, they come and give you a hug thank you, and they go. It’s a beautiful, rewarding thing to do.’ 

(Images by Jennifer Trueland)