Our Overseas Work
Overseas committee members have access to the overseas work resources section, to view this click here. To request permission for access to this page, email email@example.com.
BSSH has been supporting members to perform voluntary work overseas since 2010. From modest beginnings responding to an invitation to lead surgical mission to Holy Spirit Hospital in Makeni, Sierra Leone the work has steadily grown so that in 2019 we have educational projects in 8 low to middle income countries (LMICs). Providing hand surgery education to surgeons and their teams in LMICs is an excellent use of BSSH member’s skills, knowledge and commitment to hand surgery. It is in keeping with the objects of the society “to further the development of hand surgery by education and research.”
In early 2010 ReSurge Africa (a charity supporting the development of surgical services in Africa) invited BSSH to support an ambitious project to develop reconstructive surgical services, including hand surgery, in one of the poorest countries in the world, Sierra Leone. This invitation was bravely accepted by Barbara Jemec who persuaded BSSH Council to provide some initial funding. BSSH members stepped forward to lead multidisciplinary teams including hand surgeons, anaesthetists, therapists and nurses on two week trips to perform surgery and train local staff. This project confirmed the interest of BSSH members in performing voluntary work overseas with many members taking part and a waiting list of interested members developing. The level of interest stimulated BSSH Council to continue their support for this work
We were able to provide support to the Working Hands project in Nepal. This long term project led by Donald Sammut delivers hands on training and mentorship to local surgeons focussing on reconstructive surgery of the hand. BSSH support for this project continued for four years and confirmed the importance of a long term project to train local surgeons leaving a legacy that will benefit patients for years to come
The work in Sierra Leone has continued after temporary suspension during the Ebola crisis. By the end of 2019 BSSH will have supported 19 visits with Holy Spirit Hospital, Makeni now being ready to receive two local surgeon who have been trained in reconstructive surgery for 6 years in Ghana. The first Abdulai is due to return in late 2019, the second Eric in 2020. They will deliver the first reconstructive surgical service in the country and are already beginning with BSSH support to deliver hand trauma training to the countries Medical Officers, surgical trainees and Surgical Community Health Officers. BSSH will continue to mentor the two surgeons.
The success in these two countries stimulated interest in expanding our overseas work and attracted interest from surgeons in other LMICs. Opportunities were identified in Sudan and Malawi. It was felt necessary to form a formal BSSH Sub-Committee to oversee and coordinate this work. The BSSH Overseas Committee commenced its work in 2016 developing a 5 year overseas strategy (see separate item) to contribute to the overall BSSH strategy the overall, ensuring that projects are accessible and visible to BSSH members, ensuring learning from each project and developing an overseas educational resource
The current BSSH Overseas Committee membership is:
- Steve Hodgson, Chair
- Wee Lam
- Jonathan Jones
- Tony Barabas
- Mike Waldram
- Sanjib Majumder
- Roma Bhopal, BAHT Representative
- Alex Nicholls, Trainee Representative
- Rebecca Nicholas, Trainee Representative
Former members, all of whom made a significant contribution have been Donald Sammut, Mark Bransby-Zachary and Rupert Eckersley
We now have projects in 8 countries – Sierra Leone, Sudan, Malawi, Myanmar, Tanzania, Uganda, Ethiopia and Bangladesh. Some of these projects are delivered in collaboration with other surgical associations most notably BFIRST (British Foundation for International Reconstructive Surgery) an organisation of Plastic Surgeons many of whom are BSSH members
Reports of many recent visits to project countries can be found here.
Achievements in 2019
During 2019 we will have supported projects in 8 countries with 23 BSSH members delivering training to a total of over 475 surgeons and associated staff.
March - Hand trauma Course and cadaver course on upper limb approaches, flaps and tendon and nerve harvesting
Following an initial visit in 2017, the committee continue to investigate the current need for hand surgery in Ethiopia as well as a need for collaboration. Hand injuries from trauma are a major problem in this country, with operations performed in all 5 units visited in Addis Ababa. There is enthusiasm from both orthopaedic and plastic surgeons for collaboration in hand surgery to develop further which in was utilised in 2019 through a jointly sponsored cadaveric hand trauma course with BFIRST led by Neil Cahoon at ALERT Hospital.
Team Lead - Rupert Eckersley
September/October – 9 day visit to deliver 2 days COSECSA Hand Surgery Course, 2 day annual hand trauma training to Orthopaedic Clinical Officers and 2 days of training to hand therapists
Working in collaboration with World Orthopaedic Concern and the countries only hand surgeon we have supported delivery of a Hand Trauma Workshop. This workshop was delivered by Jonathan Jones and Bo Polvsen to the countries Orthopaedic Clinical Officers who provide the initial care for all hand injuries. Further workshops and educational support are planned.
Team Lead - Jonathan Jones
Local Contact - Linda Chokotho
May – microsurgery training course delivered
A more recent addition to our projects, the first trip to Myanmar took place in 2018 in collaboration with BFIRST. The Myanmar Project it is almost essential due to the distribution and provision of hand, lower limb and soft tissue surgery between Plastics and Orthopaedics in Yangon General Hospital. In addition, Cambridge Global Health Partnerships also remain keen and committed to collaborate with any future visits to Myanmar if any future BSSH/Bfirst trip overlaps with their aim of improving the delivery of trauma care at Yangon General Hospital.
Team Lead - Tony Barabas
April – delivered training in hand anatomy, assessment and hand trauma management (lectures, discussion groups and practical sessions) with four one day courses in three centres
September – Mike Waldram led multidisciplinary team to perform surgery and train hospital staff
This long term project in collaboration with ReSurge Africa is to support the development of the first reconstructive surgical unit in this desperately poor country. Since the project was initiated by Barbara Jemec in 2010 we have supported 17 surgical missions involving 36 BSSH members leading multidisciplinary teams. After a 2 ½ year hiatus due to Ebola the missions recommenced in November 2016 with the goal of a reconstructive surgical unit staffed by local surgeons by 2020 remaining on track.
The Holy Spirit Hospital (HSH) was established by Dr Turay and, with help from the Albano Diocese of Italy, now has 70 beds, an Outpatients Department, x-ray, a Pharmacy and two operating theatres.
Team Lead - Mike Waldram
Local Contact - Abdulai Jalloh
We have responded to a request from local surgeons to develop and deliver a series of educational workshops covering the hand curriculum. To date courses on hand and wrist trauma (Jeremy Field, Valerie Nunez, Claire Wildin and Steve Hodgson), nerve injury (Andy Hart and Rod Dunn) have been well received by a large number of local plastic and orthopaedic surgeons. The third course on congenital hand and the mutilated hand is planned for December 2016. The long term goal is to support the development of a Sudanese Society for Surgery of the Hand bringing together the currently separate and generalist groups of plastic and orthopaedic surgeons.
Team Lead - Matt Nixon
Local Contact - Mo Abdelrahman
The main project aims in Tnazani to explore the potential for BSSH and BFIRST supported educational projects in Tanzania and to deliver a three-day educational course covering a wide range of topics to local surgeons. The main local educational needs are soft tissue cover for open fractures and burns contracture management. The plans for the future will be to deliver educational visits including lectures, discussion groups and possibly some demonstration surgery on those topics.
Team Lead - Steve Hodgson
Local Contact - Peter Mwandiga
May – delivered training in hand anatomy, assessment and hand trauma management to Medical officers and Orthopaedic Clinical Officers
Uganda, situated in Eastern sub-Saharan Africa, has a population of 42.9 million, 84% living in rural areas with limited access to primary, secondary or tertiary care. There is 1 surgeon per 100,000 population. In rural Uganda hand trauma is generally managed by the Orthopaedic and Medical Clinical Officers (OCOs & MCOs), rather than trained doctors and surgeons. Committe member Jonathan Jones and the Peterborough Hospital team have established a link with Kisiizi Hospital, supporting work with the Chilli Children charity, helping the local surgeon & theatre staff to run an orthopaedic surgical camp. The team has also run a primary trauma course (ATLS equivalent) in 2016 and teaching sessions in hand trauma to staff, including some Sudanese clinical officers in 2017.
Team Lead - Jonathan Jone
May 2018 – delivered training in hand and wrist fracture management, congenital hand and spastic hand in conjunction with the Bangladesh Society for Surgery of the Hand
During 2019 we will not deliver or annual orthoplastic training in Sudan due to the ongoing political instability making it unsafe. There will be no BSSH visit to Tanzania in 2019. The initial visit in December 2018 identified the need for a BFIRST delivered flap course in 2019 followed by a BSSH hand trauma visit in spring 2020
One of our major achievements in 2019 has been to consolidate the overseas teaching resource which is now in the members section of BSSH website. It covers the whole of the non-elective portion of the hand syllabus and is available to all BSSH members performing overseas work. Under the leadership of Wee Lam we have commenced monthly webinars using Zoom teleconferencing facilities
We will have awarded 5 fellowships during 2019. Three UK trainees have been supported to join BSSH projects – David Bodansky to Ethiopia, David Izadi to Sierra Leone and Shan Shan to Malawi. Two surgeons from our overseas projects have been supported to travel to the UK to speak at our BSSH/BFIRST Educational Day in Edinburgh and then undergo two weeks as observers. Tanveer Ahmed from Bangladesh will observe hand trauma in Leeds and congenital had at Greta Ormond Street. Peter Mwandinga from Tanzania will observe hand trauma in NW England
Team Lead - Sanjib Majumder
Local Contact - Tanveer Ahmed
Looking to 2020
We have exciting plans for next year with visits planned to all our project countries. Highlights include an invited 2-3 day contribution to the West African College of Surgeons (WACS) annual meeting in Abuja, Nigeria in February. This will give us the opportunity to develop relationships with surgeons form the 20 WACS countries. Building on the projects in Malawi and Uganda we are in discussions to make a c=similar contribution to the Confederation of Surgical Societies of East, Central and Southern Africa (COSECSA). Our long term goal is to work with these two surgical organisations to develop an accredited Hand Diploma designed for surgeons in Africa
In summary, BSSH Overseas Committee is here to help coordinate and support members performing valuable work overseas. Maximum benefit will be produced by supporting sustainable long term projects with a focus on educating local surgeons to perform high quality hand surgery. It is important we collaborate with and learn from other surgical charities such as BFIRST and WOC. There are many opportunities for members to get involved. These include joining our contact list, volunteering to take part in established projects or proposing further projects.
How to get involved
- Volunteer to join a visit to a project country (see project lead details above)
- Apply for a BSSH Overseas Trainee Fellowship open to BSSH Associate Members
- Volunteer to host a webinar
- Apply to join the BSSH Overseas Committee when the expression of interest is circulated in early 2020
- Suggest a new project country
If you would like to get involved in any way please email Steve Hodgson, Chair, BSSH Overseas Committee at firstname.lastname@example.org