19 June 2024 (Last updated: 24 Jun 2024 12:04)
Whilst everyone in the UK is caught up in a “snap shot” election, with all the political turmoil unfolding, the people of Malawi are in mourning after their Vice President Dr Saulos Chilima was tragically killed in a terrible accident on a flight to Msuzu this week. He has been VP since 2014 and was much loved by the nation especially the young. President Chakwera described him as “good man, devoted Father and formidable VP”. We stand with our friends at the LION Hospital at this sad time.
LION Hospital main courtyard
Meanwhile, the team is working hard, and we pay a special tribute to Sean Walsh, who has just returned after a 12-week stint as lead hand surgeon for the BSSH LION team. A steady hand at the wheel, he is on the Leadership team and serves as the Clinical Supervisor for Gladys Ngondo, our first Hand Fellow. He has played a pivotal role in writing SOPs for us and resolving many issues at LION.
May and June 2024 have been some of the busiest months in terms of surgical caseload to date for the project. Having Gladys as the Hand Fellow has meant that the team has the capacity to run their own operating list or OP clinic and simultaneously assist the LION Residents or Consultants when requested with complex hand and upper limb cases in the main operating theatre. The emphasis on training continues, and the team tries to make every clinical encounter with the local team a learning opportunity. In terms of operative cases, approximately 70% of the BSSH team cases are performed by the Fellow, LION Residents, or the LION team's local medical officer (FY3 grade)..
Alongside working with Sean Walsh, Matthew Bellamy a medical student at Sheffield university, President of the Orthoplastic Society and regional ambassador for AO promoting undergraduate surgical education who has recently spent a week at LION with the team after receiving the Medical Student Elective bursary from BSSH, said:
“I had a truly unforgettable week in the Lilongwe, getting involved in lots of different clinical work. Busy theatre days, lots of interactive teaching and full clinics were packed with interesting cases and learning opportunities. The team were extremely welcoming and helped me wherever they could. The team, project, hospital and volunteers are doing amazing work and I feel very privileged to have been able to be a part of it for a week. Sean, Sandra, Gary, Eileen, Charles and Mercy (to mention a few!) made the week an amazing experience.”
Sean Walsh with Eileen Walsh and Gary Masterton at Lion
Lt. Col. Gladys Ngondo (to the left of Sean Walsh) is nearing the end of her six-month Fellowship experience at the BSSH LION Hand Unit and is now in the UK at the Pulvertaft Hand Unit for a two-week Travelling Fellowship. She has excelled during her time with us, both clinically and in taking part in teaching sessions for all members of the wider MDT. We are sure she will use her new skills in her role as a military surgeon and teach many others to do the same.
Carlos Prada, a trainee from Chile (also an IFSSH 2022 Fellow), has recently finished his stint at the LION and played an exemplary role in the hand team. He has reflected on his time in Malawi.
"I was quite fortunate to be able to volunteer for almost three months at the LION unit at Kamuzu Central Hospital, Lilongwe, Malawi. The LION Hand Unit project is a unique global surgery and educational experience that anyone who has an interest in surgical training, healthcare in underserved areas, and global health should strongly consider! I had the chance to be part of an interdisciplinary team with whom I shared much more than work and even made new friends! I also interacted with different Malawian healthcare professionals in a beautiful, newly built facility.
During my time at LION, I was also involved in the training of the hand surgery fellow, orthopedic residents, and orthopedic clinical officers while collaborating to provide hand surgery care to over a hundred patients with a wide variety of hand injuries. This was an unforgettable experience for me. Sometimes it was difficult, and the cultural differences challenged me to be more flexible and open-minded. Nevertheless, I would definitely recommend volunteering for this wonderful project. I’m sure I was lucky to be part of a project that will have a huge impact on the care of the people of Malawi. Apply as a trainee! You will have fun, learn a lot, and fill your heart with the experiences lived in the warm heart of Africa!”
Tom Beech BAHT (left) with Carlos Prada BSSH Trainee
.jpg)
Kate Owers, Education Lead for the BSSH LION project, has also recently returned from a two-week visit and reports:
“Having been involved with this very special partnership for over 18 months, it was a truly wonderful opportunity and a huge privilege to finally be able to visit the LION, meet the extended MDT, and work alongside them and our current BSSH team of volunteers.
The main aim of my visit was to review our BSSH LION Hand Teaching programme in situ. This bespoke, modular curriculum continues to be developed by our dedicated Education Team, comprising Consultants, Hand Therapists, and Trainees. A special mention must go to Jia Choong, George Hourston, Simon Parker, and Ben Wood, who have done the lion’s share of resource collation. We have been working hard behind the scenes on the teaching programme, which has been running ever since we started ‘on the ground’ in Malawi in January 2023. However, the teaching has really gained traction this year, now that the move to LION from the old hospital is complete and our hand patient pathways and staff timetables are settling. During my visit, I was able to work alongside many members of our wider MDT and had the chance to discuss their various education and training needs. Additionally, I was privileged to assist our volunteers in the busy operating theatres and review patients with them on the ward and in the clinic, which was both eye-opening and extremely rewarding.
I also really enjoyed getting involved in delivering some teaching myself, including an interactive ‘workshop’ on Hand Flaps (using gloves, marker pens, and nail scissors!) and contributing to our new weekly small group OCO teaching sessions. OCOs (Orthopaedic Clinical Officers) are our non-medically trained practitioners who see and treat many trauma patients in Malawi. There are not enough qualified doctors to manage the heavy trauma workload, with RTAs sadly on the rise and panga knife injuries frequent. Therefore, these are an extremely important group for us to support, and they are keen to learn. In fact, there are only 16 Orthopaedic Consultants in the whole country, and I was struck by how relentlessly busy the hospital is, with all staff working hard to keep up, often in challenging conditions and without all the equipment we might expect to be available to us in the NHS. I was especially impressed by all our volunteers who have to adjust to working in unfamiliar surroundings and contribute to every aspect of their patients’ care.”
Kate and the team after delivering a Tuesday morning BSSH LION Hand Unit Teaching session and a happy student learning how to design flaps in the hand
Despite the many and various challenges faced, often daily, this partnership has created a multidisciplinary Hand Service where before there was none. This is something to be extremely proud of, and we need to keep the momentum going. The BSSH/BAHT Team is making a huge difference every day by delivering specialist clinical teaching—in Handover, in Clinic, and in Theatre—and supporting our Consultant colleagues, Hand Fellow, Residents, our new Senior Medical Officer, Dr. Jean Mtambo (see her report below), Interns, and Hand Therapists to better manage these patients. They are also inspiring Medical Students in Malawi to consider developing a special interest in this field—an important job, as we aim for the long-term sustainability of this Service.
The BSSH LION Hand Unit Education and Training plans for the future include further refinement of the Teaching Programme to better suit the needs of its East African LMIC setting, teaching other members of the MDT, such as the ward nurses, theatre nurses, and radiographers, and running practical courses for the junior doctors and therapists in the impressive new LION Training Centre currently under construction. There is so much we can do, so please get in touch if you think you might be interested in volunteering.
During my trip, I was also fortunate enough to have the opportunity to visit a local orphanage near Mponela with Tom Beech, our Hand Therapist. We saw the fantastic work being done by the Inlight Charity Foundation (inlightcharityfoundation.com) to feed, care for, and support 90+ children who might otherwise not receive an education or any vocational training when they are older. I also experienced a ‘Mzungu moment’ (‘Mzungu’ is the local friendly term-of-endearment used to describe “Aliens,” “White visitors,” or someone who “comes and goes”) when I offered to help harvest the maize from the cob and then try to stir the nsima (the staple food of Malawi) for the children’s lunch. I quickly realized that these were no easy tasks and caused much hilarity for the many onlookers with my rather poor ability to do both jobs. I now have even more appreciation for the strength and dexterity required by the ‘working hands of Malawi’ and the importance of our presence at the LION"
Tom Beech BAHT, Raphael Katondo (Founder of Inlight Charity Foundation) and Kate Owers, taking a gift of Soya Protein to the local orphanage at a village near Mponela & Kate learning how to harvest maize from the cob and then try and stir the nsima, much to the amusement of the entire orphanage!
Although it was a short visit, it was invaluable in terms of finally being able to meet and connect with our LION colleagues face-to-face, witness first-hand the challenges of developing this sustainable Hand Service in Malawi, and reflect on the incredible progress that has been made to date. I was also able to cement some of our teaching/training aims going forward, and I have no doubt this trip has strengthened my ability to help coordinate these aspects of the BSSH LION project. This, in turn, supports our overall aim to create a sustainable Hand Service by educating, empowering, and enabling the local team. It was an incredible experience, and it is extremely rewarding to be involved in the development of a new Hand Service in such a beautiful and welcoming country – Tiwonana!”
Short report from Dr. Jean Mtambo:
"I am the Senior Medical Officer currently working with the Hand Team at LION Hospital, situated within Kamuzu Central Hospital in Malawi. My job is crucial in ensuring patients with hand problems receive optimal care. For instance, individuals suffering from hand-related trauma and soft tissue injuries require meticulous treatment. My journey in this role is marked by a commitment to excellence, innovation, and compassionate patient care.
Within the dynamic landscape of Malawi's healthcare system, where resources can be scarce and challenges abound, I have dedicated myself to mastering soft tissue cover techniques. Understanding their role in restoring both function and aesthetics to the hand is paramount. Through dedication and collaboration, I am part of a team of skilled professionals providing comprehensive care tailored to each patient's unique needs. Despite encountering obstacles, we strive to deliver the highest standard of treatment.
Beyond my clinical duties, I am deeply engaged in educational endeavours, imparting knowledge and skills to the next generation of healthcare providers. By fostering a culture of continuous learning and mentorship, I aim to establish a legacy of excellence that extends beyond my own tenure. Leading hand surgery in Malawi fills me with pride. Each patient I treat represents an opportunity to significantly impact their life and enhance healthcare in our country."
Dr Jean Mtambo
Girl Power – the future Hand Surgeons of Malawi; BSSH LION Hand Team Senior Medical Officer Dr Jean Mtambo (right) and Gladys Ngondo, Hand Fellow (left) with Kate Owers after Hand Clinic
For those who may not have the time to commit at this stage, please do consider helping us to fundraise. We have to raise a further £40,000 to meet this years budget. Whether it be a cycle ride or marathon, a cake stall in clinic or a tombola, every little bit helps. Please visit our Just Giving Fundraising Page to register as a fundraiser or just contact the secretariat to give a one off donation (Platinum, £1000, Gold £750, Silver £500 or Bronze £250. Help us to Heal the working Hands of Malawi.
BSSH Malawi - LION Hand Unit - JustGiving
View Other News Articles