15 April 2026
Lucius (Therapist), Kachitsa (Consultant) , Ali Mohammed (Fellow), Anne Perruisseau-Carrier (Consultant), Shahd Nour(Trainee), Miranda (Therapist), Vera (Resident), Isaac (Trainee)
Introduction
March was a busy, hands-on month at LION, with a strong mix of complex trauma, teaching, and team spirit. Shahd Nour left the unit on 14th of March. Dr Anne Perruisseau-Carrier arrived from Paris on 12th of March as the Hand consultant, and worked closely with the BSSH Hand Fellows, Fatoumatta Jaiteh (from Gambia) and Ali Mohammed (from Tanzania). The Fellows are both 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 215 patients in hands clinic and 245 patients attending hand therapy, reflecting just how much the service continues to grow.
The no. of operative cases performed in March was 46 patients, several of which were complex trauma cases. These included spaghetti wrists, and severe soft tissue loss needing reverse radial forearm flaps. Alongside this, there was a steady stream of open fractures, infected wounds and skin grafts as well as more routine cases like trigger fingers and De Quervain's releases, and more challenging cases as cerebral palsy patients needing hyperselective neurectomies and tendon lengthening.
Drs Anne, Fatou and Ali performing a reverse radial forearm flap
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 (Re: LAD Appeal- LION Airpowered Dermatome). 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 (now back in the UK) is coordinating a study with Fatoumatta Jaiteh in hand injury prevention.
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. Miranda and Anne travelled to Dedza, where they took on therapeutic hikes in the footsteps of many previous LION volunteers.
Summary
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” with the weekly teaching programme going well for both residents and OCOs. The BSSH LION Hand project continues to accelerate with confidence towards its goal of a sustainable hand unit at the LION in January 2028, less than 2 years time.
🦁 Dr Anne Perruisseau-Carrier & the BSSH LION LEADERSHIP TEAM 🦁
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