20 August 2024 (Last updated: 2 Sep 2024 16:28)
“IN THE BLEAK MID WINTER” – IN MALAWI
Gladys Ngondo (BSSH Hand Fellow), Fleur (Therapist), Eileen Walsh (Therapist), Alex Griffiths (Ortho Trainee), On the balcony of LION
Whilst those in the UK will be languishing on the mediterranean beaches or having fun in the Lake district, Cornwall or Devon, the BSSH LION Hand Team is experiencing Malawi in “mid-winter”, average temperatures of about 16 -26 degrees Celsius, which is most agreeable for mid winter! The clinical workload remains heavy and the demands unrelenting with a significant no. of complex cases, many requiring MDT input, especially for multiple tendon PNI and severe infection cases. The workload is managed by one Consultant, with the Fellow and the trainee, with a week overlap at changeover times and ad hoc visits by BFIRST Surgeons (approximately once a quarter).
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Wee Lam assessing a child with radial dysplasia in the BSSH hand clinic and with the BSSH Hand Surgeons (Alex Griffiths and Jonathan Jones) and LION theatre nurse (Grace) in LION main theatres.
In July eminent Congenital Hand and brachial plexus surgeon Wee Lam joined the team following FESSH and enroute to Singapore. As BSSH President Elect and past BFIRST Chair, Wee Lam’s visit proved to be valuable in terms ofsharing of experience and guidance on future development of the project as well as help in the Hand clinic and doing some children’s hand surgery.
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Alex Griffiths, Professor Amit Tolat and Jean Mtambo, the LION Resident (ST3) in ED theatre July 2024 & Jonathan Jones and Wesley, the new LION Resident (ST3) in June 2024
The processes at LION are well established and training of the Malawian registrars is paramount during these clinical sessions and also for theatre nurses, therapists and OCOs on the MDT. Jean Mtambo the last resident who excelled has been replaced by Wesley. The Malawian residents rotate every 2 months, whereas the LION Hand Fellow changes six monthly. This is proving to be a very useful way of training and improving the chances of a sustainable subspecialty hand service.
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Pinelopi Novak (Ortho Trainee), Fleur Nicholas (Hand Therapist) Guests of the Mahonga Family at their church. The BSSH “Red Lion” Returning to Benetolo House after a full days work at LION.
The team stay in rented accommodation in Lilongwe, namely Benetolo House, which is on Ufulu road (see above the photo of the entrance).Charles (The Maintenance /Gardener) and Mercy (Housekeeper and Cook) and the security guard William seem happy, settled at Benetolo House and do make the Volunteers feel like they are in a family home. The team have felt safe in the house and to date there have been no security issues.
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Rachel Jiya (LION Director of Nursing) and the BSSH LION Hand team with the British High Commission delegation at LION 9th July 2024
On the 9th of July 2024, representatives from the British High Commission visited the LION. Boston Munthali (Hospital Director), LION executives and the BSSH Hand team hosted Fiona Ritchie (High Commissioner) and Amy Potter (Health adviser) during their first ever visit to the LION.Issues discussed included the rising figures of RTA deaths (Malawi ranked 3rd in the world) and a new national initiative to reduce the no. of preventable deaths convened by the British High Commission, ongoing support for the BSSH LION Hand Unit and also help with the procurement of much needed vac dressings for the complex soft tissue wounds and infections.
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A sign on the road side near the Nkomo mission Hospital a public reminder about the risks of infection.
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Eileen Walsh volunteer therapist at LION says farewell to Lucius Beautiful Sunset at the LION as the team head back after a distinguished 9 weeks as a to Benetolo House after a challenging weeks work.
The wider BSSH Malawi Project also remains active and is further enhanced by the BSSH LION Project activities and its far-reaching effects as part of its portfolio. We are delighted that Bright Mwafuli, a Year 3 Plastics Trainee from Queens Central University Hospital in Blantyre, will start as the 2nd BSSH Hand LION Fellow on 1st August 2024. We say farewell to Lt. Col. Gladys Ngondo, who, after completing her Hand Fellowship, has been deployed to the DRC in command of a field hospital for a UN peacekeeping mission. She hopes to return to the LION in the future and wishes to pursue a career as a subspecialty hand surgeon.
Lt Col. Gladys Ngondo (BSSH LION 1st Hand Fellow), Gift (LION Scrub Nurse and Wesley (BSSH LION Hand Resident) Bright Mwalfulirwa is the 2nd BSSH LION Hand Fellow starting 1st August 2024
Our current Therapist Eileen Walsh on site shared a couple of good news patient stories:
Jumbe is a 25-year-old man from Lilongwe who sustained a traumatic amputation of his right thumb during a road traffic accident in May 2024. At the time, Jumbe was a passenger on an ox cart.
Jumbe presented to the LION unit and was then referred to the hand team for management. He was admitted to the LION for six weeks and underwent multiple washouts, debridements, and BTM of his right hand. He has been motivated in his rehab while inpatient at the LION, wearing his customized splints and engaging in a hand therapy program.
Nine weeks post-injury, he is happy with his progress and is now able to form a functional gross digit grasp with his dominant hand.
Case 2
George Moses is a 25-year-old man who works as a chicken vaccinator in Lilongwe. He sustained an injury to his dominant right hand while driving an ox cart that was hit by a passing minibus in May 2024.
George presented to the LION ED and was referred to the BSSH hand team. He had a traumatic amputation of his middle finger, followed by debridement of non-viable tissue and amputation of his ring finger. George has been very motivated and engaged in regular hand therapy sessions, focusing on AROM, PROM, and scar management. He has regained functional pincer and tripod grasp. George is very happy with his progress and feels he is at a functional level to return to chicken vaccinating in August.
We are immensely proud and grateful for everyone's contributions to Lion. To steer this initiative forward, we need all hands on deck. We are constantly seeking passionate individuals to join our team of volunteers, helping to develop Malawi's first dedicated hand surgery service. Open to specialist trainees in plastics, orthopaedics and therapists, at any stage of their training.
If you are inspired to join this exciting and transformative project, please contact the BSSH Secretariat at secretariat@bssh.ac.uk
Help Lion - Donate now.
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 LION Leadership Team
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