Bristol 4th January 2015
For BSSH Council Meeting 15th January 2015
Report on Nepal Leprosy Project
To BSSH Council
The Nepal Leprosy project (Team Leader D Sammut) is ongoing and BSSH has approved funds for two aspects of this work:
- The sum of £2000 per annum has been granted for a further three year period (2014 – 2016)
- The one-off sum of £3500 to fund two Nepali Fellows who will attend January to March 2015
- The surgical programme
A surgical visit was conducted 15th November to 3rd December. The team members were:
Sam Gidwani, Consultant Hand Surgeon, London (SG)
Nola Lloyd, Trainee Plastic surgeon and tour organizer, Bristol (NL)
James Rogers, Consultant Anaesthetist, Bristol (JR)
Donald Sammut, Consultant Hand Surgeon, Bath and Reading (DS)
The first week was spent in Lalgadh Leprosy Hospital where some 50 patients were seen, assessed, and underwent surgery. In fact, some 90 patients were seen but some were turned down on this visit either because of unsuitability or, from pressure of work, deferred until the next visit. In addition a number of patients will need second stage surgery.
There were two main categories of patients:
- Paralysis from Leprosy, requiring tendon transfers. These included correction of Ulnar paralysis by lumbrical reanimation, or Lasso, adductorplasties, opposition plasty and other miscellaneous procedures, such as amputations, release of contractures, fusion and stabilization.
- Contractures from burns. A number of children with disfiguring and function/growth-impairing burn scars received treatment, mostly by various plasties, excision of scars and full thickness grafts.
- Other: Some congenital anomalies, contractures secondary to osteomyelitis or fracture, late trauma
The second week was spent in Kathmandu where a lecture programme was conducted (by DS) to the Plastic surgery team led by Prof Shankar Rai, in Kathmandu Model Hospital and Kirtipur Hospital.
On the way back to the UK, DS stopped over in Abu Dhabi and delivered a lecture (on the leprosy work) to the Etihad Charity Volunteers. This further consolidated the valuable links with Etihad airlines which has kindly provided the return flights for the four team members and it is hoped that this link will continue. DS has also been invited to provide articles, images and contribution to Etihad publications, as part of the return on this link.
The BSSH contribution for this year was used to provide various items of kit for the Lalgadh and Kathmandu units. This has included:
Outpatient kit, such as Blood pressure monitors, stethoscopes, examination lights and magnification, pulse oxymeters, temperature probes etc
Power saws and Power drills, as well as consumables such as sawblades and Kwires
Various instruments for theatre
Physiotherapy rehabilitation tools
New ‘Little Sister’ sterilizer (provided free by Eschmann, cost £3000) – expenses on Courier and customs in Kathmandu
Suction machine for theatre
As on previous visits, consumables were largely obtained through personal contact from various hospitals, particularly Circle Healthcare (DS). For some reason, Local anaesthetic is never included in this contribution and must be purchased (approx £300).
In addition, SG obtained a generous contribution of £1000 from the London Bridge hospital, which enabled us to buy relatively large items of kit on this occasion.
The next visit is planned for 20th November 2015 and the team will consist of the same members.
- The Fellowship programme
Three Fellows will visit the UK this year, from the Kathmandu unit of Prof Shankar Rai, where DS holds Visiting Senior Lecturer status. These three Fellows have been selected by DS from his personal knowledge of their level of training, and expertise and in discussion with Prof Rai.
The three Fellowships will be funded by contribution from BSSH (£3500) and BFIRST (£3000).
Bishal KARKI: Junior Plastic Surgeon (Hand Fellowship): 17th January to 7th March
Mohan Dangol: Senior Hand Therapist (Hand Fellowship): 17th January to 7th March
Pramila Sakya (Cleft and Burns Fellowship): 7th March to 25th April
Bishal Karki will shadow DS and supplement with attendance at Southmead Hospital, Bristol
Mohan Dangol will attend the Hand Therapy Unit in Southmead Hospital, Bristol
Pramila Shakya will attend the Cleft unit at John Radcliffe Hospital with Tim Goodacre and Marc Swan.
These Fellows have been selected by DS with a view not only on their own personal training and development but also in the detailed knowledge of the spectrum and level of activity in their home unit.
All is in now place for these Fellowships, flights secured, accommodation booked, visas obtained and clearance for all hospitals approved.
In addition Mohan Dangol and Bishal Karki will attend two instructional courses during their Fellowship. Ex Gratia places at these course have been kindly granted and the expense will be on transport and accommodation:
- The BSSH Instructional Course in Manchester 30th/31st January 2015 (coincidentally on Tendon transfers and Paralysis, which is highly relevant to their work in Nepal)
- The BSSH Anatomy Dissection Course in Glasgow (organized and conducted by DS) 28th Feb/1st March
Pramila Shakya will also attend two courses during her Fellowship:
- The BAPRAS Instructional Course on Burn Management, in Manchester 9th and 10th March (attendance free and comes as part of the Fellowship bursary)
- The Cleft and Craniofacial Meeting in London 15th /16th April. Attendance fee not waived but application for a small concession has been made
Detailed breakdown of expenses will be provided after the completion of these Fellowships.
4th January 2015