Lion Hand Unit – January 2026 Update

24 February 2026 (Last updated: 24 Feb 2026 15:52)

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

It’s the rainy season in Malawi with plenty of green vegetation, healthy goats on the roadside, a beautiful garden at Benetolo House (team accommodation) with mangoes, pineapples and avocados in season. In Lilongwe, the red dusty sunbaked roads are now tarmacked (with the occasional deep pothole!) and the journey from Benetolo House to LION now only takes 15 mins, compared with 30 mins in 2023. The economic crisis has continued to deepen along with the foreign exchange challenges, meaning that the Kwacha is devalued, the black market is thriving and shop prices for essential items such as sugar, flour, butter and rice are exorbitant. So volunteers have to budget using the approved banking apps (E.g Mukuru) to keep enough kwacha in their pockets to manage expenses.
 

Hand Surgery 

LION saw a spike in Hand trauma over Christmas and New Year, especially with the “panga” injuries to the wrist and hand, which meant it took most of January to catch up with these complex repairs. Fortunately, Gill Smith joined Jonathan Jones, Lucy Lester and Fatoumatta Jaiteh (Hand Fellow) in January providing more hand surgical power in the form of double lists in main theatre and ED minors theatre.

 

      

Lucy Lester & Hand Fellow Fatou operating and with the team in ED Minors @ LION

Lucy Lester completed her impressive 6 months volunteership in January, having achieved so much clinically and professionally. She was a galvanising force for the BSSH LION Hand Unit project – a “big hand” to her for a job very well done! She is replaced by Kajal Gohil who was at KCH/LION 2 years ago and what a change she has seen! Makes a real difference having volunteers come back to LION. Martin Wood also succeeded Jonathan Jones at the end of January.
 

 

 

 

 

 

 

 

BSSH LION Hand team using the “Handme” retractors kindly donated by June Medical) LION to good effect. Easier and more versatile than Lead Hand.

The surgical team saw 198 patients in the LION Hand Clinics (Monday and Friday Mornings) during January 2026. The team performed surgery on 39 patients (trauma and reconstruction) during this time, 3 of which were bilateral cases. The majority were trauma and reconstruction but there were few minor LA cases e.g Trigger finger and carpal tunnel releases performed to compliment the heavy trauma load.
 

Equipment & Sterilisation Services
 

      

 

 

 

 

 

 

 

 Jonathan Jones and Martin Wood with Yohanne and the CSSD doing some “in house” training on implants, especially the  Medartis Aptus Wrist & Hand sets.   

Organisation and consistency of the hand surgery sets has been a challenge resulting in equipment not always being available at surgery and some sets being mixed up. In January the hand team held weekly training sessions for the sterilisation dept. staff on the wrist and hand implants and our thanks to Yohanne and his team for their engagement on this. These staff will also be rotated to visit our hand lists so that they get a better understanding about how, why and when we use the relevant instruments in our cases. 
 

Nurse Training at LION
 

          

Nurse Hand Practitioner Maryann Kihembe with Elizabeth (Lead Clinic Nurse) in Hand clinic.

 

For the first time the LION received a hand nurse specialist volunteer, Maryann Kihembe from Peterborough city hospital. Maryann amazingly managed to carry out training sessions on wound care for the all the OPD, A&E and general ward nurses within a 2 week visit. Maryann also recommended and implemented restructuring of the dressing clinic i.e to separate the plaster room from the dressing room as an infection control measure. She spent time with the surgical team in theatre and appreciated taking part in complex hand trauma surgeries. Maryann also got to spend time with Rachael Jiya and helped audit the electronic wound care and falls assessment tools. Maryann will continue providing guidance, documentation and advice for the LION nurses for the rest of the project period.
 

LION clinic nurses Tamanda and Joanna showing improved efficiency in the dressing room i.e patients being seen “2 by 2” following restructuring of the OPD hand clinic.

Surgical Education Training

Teaching and training continues to flourish with a re-start of the original curriculum again at Module 1.1 by Jonathan Jones in the new year, boosted by a 'Hand Case of the Week' presented by our enthusiastic BSSH LION Fellow. Miss Gill Smith also gave an excellent guest talk on the basic principles of assessing and managing congenital hand conditions during her brief but productive visit to LION. 

The BSSH Malawi Education team, lead by Kate Owers, are looking forward to delivering a Wrist and Carpal Fracture Fixation Course at LION in October and funding permitting, taking the successful Hand Course from last year, to support our LION Project colleagues in Ndola, Zambia, as they develop the country’s first hand unit. 

 

 

Kajal Gohil and Martin Wood teaching on “the mangled hand” @ LION  following the relaunch of the BSSH LION Hand curriculum. 
 

 

Hand Therapy

The project has reached 2026! The new year says goodbye to Sara who volunteered for 3 months and will be missed and says hello to returning hand therapist Kat who volunteered two yeas ago.

Kat "It is such a pleasure to come back and see all the changes over the last two years. It is a joy and privilege to observe how much Lucius has grown as a hand therapist. His confidence and skill and evident and its heart warming to watch him in turn train Pricilla, who is hard working, diligent and always on time. "

In total 220 patients receiving hand therapy in January 2026 and there were 35 DNAS

With the start of 2026 new goals have been set for the hand therapy team, which mainly centre around Lucius taking a more significant leadership role within hand therapy, inducting and training new volunteers and running the day to day shop. We are also trying to set up a formal referral process with red and green team for their post op patients and educate the doctors on the potential of hand therapy.

 

Summary

The project continues to grow from strength to strength attracting highly motivated and skilled volunteers with significant global surgery experience to join the rota surgical and therapy rota. More importantly surgeons from all over the African continent (Malawi, Ethiopia, Tanzania, Zambia and the Gambia) are contacting the LION Hand Unit applying for the Hand Fellowship programme. This is most encouraging. With 2 years to go, we are seeing that there is a very real prospect of a sustainable hand service at LION in addition to the general upskilling by the LION Orthopaedic Team in the management of Hand Trauma cases.

We are grateful to all the volunteers and supporters of this inspirational and groundbreaking project for all their efforts in so many ways. Outgoing GPC chair, Chrishan Mariathas, updated BSSH council at their first meeting of the year. He reports that “Council were, once again, incredibly supportive of the project.  This was reinforced by first hand accounts of the partnership, unexpectedly delivered by council members and trustees who have volunteered themselves”
 

Please do continue to help us finish this project well by sharing this good news via your surgical networks. We still require another £150,000  to get us “over the line”. So a big shout to the BSSH membership “please consider undertaking more fundraising in your hand units (Cake stalls, social media posts, sponsored cycle rides, ski runs, mountain climbing or half marathons) –  “Help us to Heal The Hands of Malawi” Zikomo, Zikomo

 

Volunteer surgeon Kajal Gohil enjoys a peaceful moment after a days work @ LION.

 

BSSH LION LEADERSHIP TEAM

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