15 April 2026 (Last updated: 15 Apr 2026 16:07)
Lucius (Therapist), Kachitsa (Consultant), Ali Mohammed (Fellow), Anne Perriseau (Consultant), Shahd Nour (BSSH Trainee), Miranda (Therapist), Vera (LION Resident), Isaac (LION Resident)
Introduction
February was a busy, hands-on, and truly rewarding month at LION, with a strong mix of complex trauma, teaching, and team spirit. Shahd Nour took over from Kajal Gohil mid-February, and due to an unexpected consultant gap, ended up stepping into a much more “hands-on” role than anticipated. Together with Dr Precious Kachitsa Phiri, the inaugural LION Hand and Upper Limb Consultant (in waiting), they both led the service during this period. This developed into a strong collaboration between trauma and plastic surgery, ensuring continuity in delivering complex care. One of the highlights for Shahd was working closely with the BSSH Hand Fellows, Fatoumatta Jaiteh (from Gambia) and Ali Mohammed (from Tanzania). The Fellows are senior Orthopaedic trainees living in Malawi who are used to independent practice and very enthusiastic to develop their hand surgery subspecialty skills.
Hand Surgery
The Hand team saw 214 patients in hands clinic and 245 through hand therapy, reflecting just how much the service continues to grow. The number of operative cases performed in February was 46 patients, several of which were complex trauma cases. These included some devastating trauma such as mangled hands, spaghetti wrists, deep forearm/elbow panga injuries with divided nerves requiring sural nerve cable grafting and others with severe soft tissue loss needing pedicled groin flaps. Alongside this, there was a steady stream of open fractures and infected wounds as well as more routine cases like trigger fingers and De Quervain's releases, which helped balance the workload.
Shahd raised the pedicled groin flap concurrently as Kachitsa and Isaac debrided the hand. This image captures the later stage of the procedure during flap inset.
The hand team are treating many soft tissue injuries requiring extensive skin cover. The LION desperately needs a powered dermatome, and this is being purchased from Zimmer. In the meantime, the team need some better quality humby knives/blades and silicon spacer/rods as soon as possible. Jeremy Stanton (Equipment Lead) will be reaching out to past volunteers and the BSSH membership to liaise with their hospitals for any unwanted equipment.
Research
Trigger finger and DQT continues to be unusually prevalent and a study initiated by Rahel Kassa (Ethiopian Consultant) is being conducted by Fatou and the hand team. In addition, Lucy Lester is coordinating a study in hand injury prevention.
Surgical Education Training
Teaching also took on a life of its own and Shahd led the Tuesday morning "Hand Anatomy Glove" teaching session after the trauma meeting, which quickly became a favourite. The residents were incredibly engaged, and by popular demand, the Hand team were asked to cover more anatomy the week after.
Hand Therapy
The coordination with hand therapy was another real strength this month. Working closely with Miranda, the Hand team were able to provide joint care from clinic to surgery through to rehabilitation. The team often assessed complex patients together in OPD, discussed their needs early and making sure they were in the correct splints, which made a noticeable difference to patient outcomes. Lucius and the local therapists are excelling in their work and have reached the point that they can run the hand therapy service on their own, which is most encouraging.
Social /R&R
Outside of work, there were some memorable moments for the team. Shahd and Miranda made the most of their three weekends together – visiting Blue Zebra Island, celebrating Miracle's 8th birthday, exploring the expat farmers' market, and travelling to Dedza, where Shahd (slightly over-enthusiastically) bought enough pottery to leave her 11kg overweight at Kamuzu International Airport. The hand team also explored the Zambia fabric market and took on hikes in Dedza and the Zomba rainforest, finishing with a swim at William's Falls.
Crashed pub quiz night at Kaza Kitchen with 10 minutes to spare, got adopted by this wonderful crew (names forgotten, memories made), and proceeded to win the Disney songs round.
A wholesome moment came in Dedza, where they met two University of Sheffield medical students, Cecily Gallagher and Rachael Kay, who were on elective in Blantyre. In true team spirit, Rachael lent Miranda a pair of hiking trainers for the trip, and in return Shahd invited them both to visit the LION for a day – which they did. The BSSH LION Project has welcomed visits by UK medical students helping to inspire the next generation of global surgeons.
Shahd, Alex (hike guide), and Miranda after completing their hike at Dedza — teamwork makes the dream work.
The hand team is constantly changing but the team working and the handover between all the healthcare professionals involved works like a “well-oiled machine” and the BSSH LION Hand project continues to accelerate with confidence towards its goal of a sustainable hand unit at the LION in less than 2 years time.
🦁 BSSH LION LEADERSHIP TEAM 🦁
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