BSSH Overseas Committee - Malawi 2019

A summary of our latest overseas course

08 November 2019 (Last updated: 8 Nov 2019 14:25)

Over the past decade members of the BSSH Overseas committee have worked jointly with international surgical communities towards improving management of hand conditions through delivering training courses in lower to middle income countries across Africa. The primary objective is to advance education, training, standards, research & practice in surgical care in these regions. Each tailored to the specific needs of the local health care context. Since the first successful collaboration between BSSH and AO Alliance in Malawi in 2015, the work in this country has evolved and strengthened year on year. Currently BSSH is invited to run a course for surgeons in training and physiotherapists from COSECSA countries at Queen Elizabeth Central Hospital, Blantyre and a separate course for Orthopaedic clinical officers in Mangochi, Malawi with focus on clinical areas that WHO considered as essential.

The instructional course sponsored by BSSH was jointly organised by Nick Sheppard, consultant Plastic surgeon, Jonathan Jones, consultant Orthopaedic surgeon, and Tilinde Chokotho, Malawian consultant Plastic surgeon. The faculty was composed of the above-named surgeons in addition to Martin Wood, consultant Orthopaedic surgeon, Jeremy Stanton, consultant Orthopaedic surgeon, Shan Shan Jing, Plastic Surgery trainee as well as senior therapists: Sarah Mee, Debbie Stanton, and Zoe Clift from the UK. The course was supported by Linda Chokotho, a local Orthopaedic Hand Surgeon, Noha Nyamulani from COSECSA, Whitney Bartlett, the Country Coordinator for COSECSA and Emma Brighton from BSSH. The hand therapists ran a parallel BAHT course. The objective was to provide doctors and other healthcare professionals with guidelines for the management of hand conditions. Financial support was given to delegates travelling from outside Malawi towards their expenses.

Twenty- two delegates attended the course including two from Tanzania. The Malawian delegates also travelled far and wide from four major medical centres across the country. All were doctors at various stages of their training. The majority attendees were males and five were females. A significant proportion was either in the first or second year of training. The course was spread over 2 days. The format featured a preand post-course test to assess and consolidate the delegates’ core knowledge, a series of interactive lectures, small group and practical sessions, and unique to this year, advanced sessions for subspecialty interests. The doctors and therapists from the parallel course were integrated for the practical sessions this year. This gave the therapists the opportunity to observe/perform tendon repairs and doctors the opportunity to learn more about splinting from their colleagues.

Delegate feedback was overwhelmingly positive. All rated the entire course “Very good” or “Excellent”. The most popular sessions with the highest ratings were XR assessment of the hand, clinical case discussions and hand examination on Day 1; and upper limb burns, carpal fracture and dislocation and wrist fractures on Day 2. The integrated practical sessions were very well received. They provided the perfect platform for network opportunities.

Overall this trip was deemed a great success. The previous ventures in Malawi have galvanized the evolution of these courses year on year. More delegates are travelling from further afield to attend. Partnerships with the local and international faculties were vital in forging ongoing collaborations within and outside of the country. During this trip, discussions were made on potential long-term research projects with other international visitors in the country, which sparks new exciting opportunities. All of these positively reinforce the work carried out by the BSSH Overseas team aiming to deliver a more sustainable high-quality care for all. Of course, significant challenges still present in delivering healthcare education in remote and lower socioeconomic communities. These include the logistics and cost of delegates’ travel, delivery of the course on limited resources, and provision of course materials with its potential legal implications. Further there is always an element of unpredictability. One is required to expect the unexpected. Great flexibility, positive attitudes and teamwork are the key to over come these challenges. Every member of our team on this visit was experienced in delivering the service. The evaluation was very good, and we feel that the objectives were achieved.