News

BFIRST at ICOPLAST 2025

BFIRST were present at the ICOPLAST congress in Cape Town, South Africa this month. Here is Mildred Nakazwe, Consultant Plastic Surgeon from the University Teaching Hospital in Lusaka, Zambia, with Paul McArthur, BAPRAS President, at the meeting.  

 

BFIRST publication in JPRAS Open

BFIRST and collaborators publish invited paper on the “Ethical Considerations of Complex Reconstructions in Resource poor Countries” in the Open Journal of Plastic, Reconstructive and Aesthetic Journal.

We are especially grateful to Adam Reid, the editor of JPRAS for this opportunity, which also illustrates the long term relationships BFIRST builds.

 
Kemi Ayoade was a BFIRST fellow for 6 weeks in Manchester in early 2020; went home and established a WALANT service which she has taught/presented widely and has been taken up in other areas of Nigeria. She sought further microsurgical and hand training so was sponsored by BFIRST to have a fellowship in Ganga in early 2023, then came to Manchester, where she finished the 2 years International Fellow scheme, in December 2024.

Abdulrasheed Ibrahim established a Burns Course in Nigeria with BFIRST, NAPRAS (the Nigerian plastic surgery association) and the Nigerian Burns association in 2015, was a BFIRST fellow in Swansea in Burns in 2017, and now a Co-PI for the BRITE (Breast Cancer Resource for Interspeciality Training and Education) affiliated BFIRST project.

Chihena Banda, is the chief of the plastic surgery unit in Lusaka, Zambia, which is building a curriculum in Hand Surgery with BFIRST.
 
Wee Lam is a past Chairman of BFIRST and head of the project in Cambodia, which has seen local surgeons now operate independently on brachial plexus injuries and Barbara Jemec is the founding chairman of BFIRST, involved in the project in Zambia and the PI for the BRITE project.

Click here to read the paper in full!

 

 

The LION hospital, Malawi Opportunity

We are looking for an upper limb Consultant surgeon (plastics or orthopaedics) to volunteer at the LION in Malawi, from 10th November 2025 – for 4 weeks.

Please let us know if you are interested via this link. 

BFIRST Fellows

This year the BFIRST Fellows will visit: 

• Queen Victoria Hospital, East Grinstead
• Great Ormond Street Hospital, London
• Royal Victoria Infirmary, Newcastle
• John Radcliffe Hospital, Oxford
• Leeds General Infirmary, Leeds
• Wythenshawe Hospital, Manchester

We are looking for ‘buddies’ for our fellows at these hospitals who could act as a point of contact to help with any day-to-day queries and local logistics. If you can help, please let us know via this link.

We are particularly looking for a buddy at Leeds General Infirmary, where Nurunnahar Lata, from the institute of Burns and Plastic Surgery, Dhaka, Bangladesh is currently based for her Paediatric Hand Fellowship. 

 

Meet the Team 

Ahmed Emam: Co-chair of the BFIRST Education, Research and Fellowship Subcommittee

Tell us about yourself!

My name is Ahmed Emam, and I am a Consultant Plastic Surgeon with a special interest in microsurgery and limb reconstruction. I lead Plastic Surgery for the South Wales Major Trauma Network and currently chair the BAPRAS Trauma Special Interest Group (SIG). I am also a committee member of BFIRST. I first trained in Egypt before moving to the UK, where I restarted my training from the beginning and eventually joined the Plastic Surgery Specialist Register.

 

Tell us about your time with BFIRST?

I have been a BFIRST committee member for just over a year and now chair the Education, Research and Fellowship Subcommittee. It has been an enlightening experience, giving me a much closer understanding of the important work BFIRST does and the opportunities it provides.

Why did you want to work with BFIRST?

Initially, I was drawn to BFIRST because of the overseas projects. Outside of BFIRST, I have been involved in charity missions in Ukraine, Ethiopia, Uganda and Pakistan, and I have found these experiences both rewarding and humbling. Being able to share our expertise with those who need it most is incredibly fulfilling.

These missions also provide perspective — they remind us how fortunate we are in the UK and how much we sometimes take our healthcare system for granted. The training opportunities offered by BFIRST were another key motivation. Helping to spread knowledge to teams who might not otherwise have access is a privilege.

 

What are your aspirations for BFIRST?

I would like to see us develop a structured overseas teaching programme in plastic surgery — one that is well attended, delivered by the right experts, and avoids the pitfalls of unregulated “social media surgery.”

What do you like to do outside of work and BFIRST?
I enjoy spending time by the seaside. I love swimming, I am learning to surf, and I also enjoy diving with my daughter.

 

Webinars

Our online lecture series kicked off in September with Hand Anatomy and examination with Shan Shan Jing from St George’s Hospital in London.

Please follow our socials for updates about further webinars.

If you have missed any of the webinars from last year, you can watch them on our website including some fantastic webinars for revision of key topics within Plastic Surgery!

Education

Free online surgical skills course!

Interested in developing your basic surgical skills?

Mr Hamid Tehrani, Consultant Plastic Surgeon, is collaborating with BFIRST to offer 3 different online surgical skills courses. They are fully virtual and can be completed at your own pace and will be most useful for medical students and junior surgical trainees.

If you are interested in enrolling yourself or junior colleagues in this course for free please contact BFIRST on info@bfirst.org.uk

 

Projects 

Zambia

This month Mr Earl Gardner, from South Tees, Middlesborough visited the Lusaka University Hospital collaboration in Zambia, with Sintayehu, Hand Therapist from the ALERT Hospital, in Addis Ababa, with the aims of teaching and training the local team (doctors, allied medical team, and medical students) in hand surgery and rehabilitation, and developing a local postgraduate Hand Surgery Curriculum based on common presentations locally.

We look forward to bringing you more reports from this project soon!

Here is Sintayehu (on the right of the picture) demonstrating splinting with the local therapists.

She was able to teach the team the correct splinting for extensor and flexor tendon rehabilitation, including the yoke splint and her recommendations include:

1. For the team of hand surgery and rehab: Build the interdisciplinary approach to patient care to improve rehabilitation outcomes like what we do in my country: We PTs and surgeons have a joint clinic session to discuss our patients once in a week. We’ve also a format with detailed surgery information that the surgeon must complete to hand over his patients to the therapist.
2. Maintain such types of visits to follow up the progress and facilitate online teaching programs for the sharing of resources and knowledge.
3. Search for donation for the hand splinting materials (thermoplastic) and exercise tools.

Ethiopia

BFIRST plans to visit the ALERT Hospital, Addis Ababa, Ethiopia in January 2026. Rebecca Shirley and James Chan, from Stoke Mandeville Hospital, Aylesbury, UK, will be delivering a microsurgical course, with local and BFIRST faculty, live operating and training for surgeons and scrub staff, to support the local microsurgical service.

The courses will be run with six training microscopes donated and shipped out by BFIRST. They have just cleared customs after 4 months!

The Gambia

Planning is underway for a joint BFIRST and Interburns trip to the Gambia in November this year. Updates to follow.

 

Affiliated BFIRST Projects 

Breast Cancer Resource for Inter-Breast Specialty Training and Education (BRITE). 

This project is now coming to an end.

We have successfully trained over 600+ Health Care Professionals involved in the treatment of breast cancer; in advanced breast cancer care and improved communication in the Multi-Disciplinary team (MDT) looking after these patients.

Well-functioning breast cancer MDTs improve the outcome and survival of patients, and the project will now look to having inter-speciality training added to the curriculum with the West African College of Surgeons and the Ministry of Health in both Nigeria and Ghana.

We are in the process of processing data collected through the last 18 months for publishing, which we will share as write.

In October we have two more scholars who have been pivotal to this project (Drs Kwame Darko, Plastic Surgeon, Korle-Bu Teaching Hospital, Accra Ghana and Cephas Batta, General Surgeon, National Hospital, Abuja, Nigeria), visit Dr Leena Chagla, immediate past President of the Association of Breast Surgery (ABS), in Merseyside and West Lancashire NHS Teaching Hospitals for an immersive experience of the MDT.
Professor Abdulrasheed Ibrahim, Ahmadu Bello University, Zaria , Nigeria, and the Co-PI for this project is attending the Euro Breast Cancer 2025 conference in Paris, France in December.

Fellowships

BFIRST Fellows

We have selected six 2025 BFIRST fellows!
Dr Amanuel Tebikew Kebede from Ethiopia
Dr Mekonen Eshete Abebe from Ethiopia
Dr Olatunde Abdul Oyesanya from Nigeria
Dr Most Nurunnahar Begum from Bangladesh
Dr Ebere Oshinachi Ugwu from Nigeria
Dr Nangandu Amanda Malungo  from Kenya

This year’s fellows have been matched with consultants in East Grinstead, Great Ormond Street Hospital, Royal Victoria Infirmary, John Radcliffe Hospital, Leeds General Infirmary and Wythenshawe Hospital. 

Professor Eshete from Ethiopia and Dr Nangandu Malungo from Kenya have finished their fellowships – see their reports below!
 
Other fellows:
Dr Most Begum is with Ms Bourke in Leeds, learning about congenital hand surgery. 
Dr Amanuel Tebikew is just finishing his placement with Mr Tickunas at East Grinstead, learning about hand surgery and head and neck surgery. 
Dr Ebere Ugwu has just been in Newcastle with Mr Sainsbury, and is now starting in Manchester with Mr Baker, learning about breast surgery.
Dr Ali Azeem is planned to come to Oxford and Newcastle, to learn about craniofacial and head and neck surgery.

BFIRST Fellow in Taiwan

Dr Tobi Abass, from the Ahmadu Bello University Zaria, Nigeria has started his one-year BFIRST sponsored fellowship in Taiwan, in microsurgery, at the E-Da Hospital in Kaohsiung, with Professor Seng-Feng Jeng: “I have safely arrived, and I am excited to begin this valuable learning experience.”

We will bring you more soon!

Professor Mekonen Eshete

Professor Mekonen Eshete from Ethiopia has completed his BFIRST fellowship focused on ear reconstruction, cleft lip and palate, and hand surgery. He has already held an ear reconstruction workshop back home!
 
Introduction
I was awarded the BFirst Fellowship from June 30, 2025, to August 14, 2025. During this period, I undertook an observership at three leading UK institutions:

 

• Ear Reconstruction Service, University Hospitals Division, Royal Hospital for Children & Young People, Edinburgh, with Mr Kenet Stewart
• Great Ormond Street Hospital for Children, London, with Mr Neil Bulstrode
• Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, with Mr David Sainsbury

Experience at Host Institutions
I was warmly welcomed at all three institutions. This supportive environment gave me the opportunity to observe complex cases closely and to discuss each case with senior colleagues. Although this was not a hands-on fellowship, it provided a unique chance to learn advanced techniques and decision-making processes through focused observation and discussion.
 
During my time at the Newcastle Cleft Care Centre, I also attended a multidisciplinary cleft care clinic. This gave me valuable insight into how comprehensive care is delivered through collaboration among surgeons, speech and language therapists, orthodontists, and other specialists.
 
I was also able to share my experiences from Ethiopia with my hosts, fostering mutual learning and professional exchange.

Prof Eshete with Mr Ken Stewart

Key Learning Points

• Gained a deeper understanding of surgical approaches and techniques in ear reconstruction, cleft lip and palate, and hand surgery.
• Observed multidisciplinary teamwork in managing complex cleft cases and ear reconstruction, and had injury and other cases.
• Learned best practices in patient assessment, preoperative planning, and postoperative care in high-resource settings.

Ear carving experience with Mr Ken Stewart

Application of Experience Back Home
On returning to Ethiopia, I plan to use this experience to:

• Enhance Patient Care: Apply the knowledge gained to improve the quality of ear reconstruction, cleft lip and palate, and hand services.
• Promote Multidisciplinary Collaboration: Advocate for and develop multidisciplinary care pathways similar to those observed at the Newcastle Cleft Care Centre, Edinburgh, and London ear reconstruction centres
• Train and Mentor Colleagues: Share my insights with colleagues and trainees to strengthen local capacity.
• Maintain Professional Links: Continue collaboration with my mentors and peers from the fellowship for ongoing support and exchange of expertise.

  

Prof Eshete running an ear reconstruction workshop in Ethiopia

I also had the chance to visit some important and historic places in the UK:
In Edinburgh, I visited the Surgeons’ Hall Museums, which are very rich in all aspects. I also visited the National Museum of Scotland, where Dolly the sheep is displayed — I was lucky to see Dolly in person. I explored Edinburgh Castle as well, which was an excellent experience.
 
In London, I visited the Surgical History Museum, the Old Operating Theatre Museum and Herb Garret, and attended a church service at the cathedral. I also watched games at Wimbledon, visited the British Library, where I received a reader’s pass valid for three years, and had the chance to sit and read there. I took a boat trip along the Thames River, which was a memorable experience.
 
I also visited Oxford University, which provided an excellent opportunity for learning, networking, and relaxation. The castles in Edinburgh and Newcastle were also outstanding places to explore. Overall, it was a truly enriching and unforgettable experience, for which I am very grateful.

Prof Eshete with Mr Neil Bulstrode

Conclusion
The BFirst Fellowship has been a transformative opportunity, expanding my knowledge, skills, and professional network. By observing world-class practices and participating in multidisciplinary discussions, I am better prepared to initiate ear reconstruction, which is lacking currently in my institution and country, and to improve cleft services in Ethiopia and to share my learning with others.

Dr Nangandu Malungo 

Dr Nangandu Malungo from Kenya has completed her BFIRST fellowship at East Grinstead focusing on breast, burns and skin cancer.

Dr Malungo outside Queen Victoria Hospital, East Grinstead

I would like to express my sincere gratitude for the opportunity and support given to me, to enable me travel for the BFIRST fellowship in the United Kingdom. The Clinical attachment was at Queen Victoria Hospital (QVH), In West Sussex, England. The period was 6 weeks from 23th July 2025 to 3rd of September 2025.

Dr Malungo outside the Paediatric Burns Ward at Queen Victoria Hospital

Highlights
I was able to observe many reconstruction surgeries:

• Immediate DIEP flap for breast reconstruction (Unilateral/Bilateral breast reconstruction)
• Delayed DIEP for Breast reconstruction
• Immediate Bilateral TUG, VUG flaps for breast reconstruction
• Complications- Hematoma evacuation post DIEP, Contractures
• Nipple reconstruction
• Implant to flap breast reconstruction
• Removal of implants
• Breast Implant Capsular Contracture – Implant removal
• Hand Trauma – digital nerve repair, Tendon repair, Hand Traumas
• Scar treatment – Keloid excision, Rhinophyma
• Skin Cancers- excision and local flaps, SLNB for Malignant Melanoma
• Burns – Split thickness skin grafts, wound debridement, acute management in burn unit

Dr Malungo with Mr Nav Cavale, BFIRST President, at St Thomas Hospital.

Other experiences:

• Clinics - General plastics, Burns, Scars, Facial palsy – synkinesis and symmetry with Botulinum toxin
• Visit to St Andrews Burn Centre at Broomfield Hospital in Chelmsford
• Visit at St Thomas’ Hospital – Plastic surgery unit (Courtesy visit with Mr Cavale)

Appreciation:
To the host team at QVH lead by Dr Hazari for Breast reconstruction and Mr Dheansa for Burns. The team at St Andrews Burn centre. The housing unit near the hospital made it very easy to access the hospital. I am grateful for the set of Surgical Loupes that I received from BFIRST. They will go a long way in helping with reconstructive surgeries in my setting.

This was a beneficial experience, and I hope to apply some techniques in our practice at Moi Teaching and Referral Hospital.

Fundraising

This month Stuart Watson completed the Steall Marathon to fundraise for BFIRST 

Stuart Watson, retired Consultant Plastic Surgeon, Canniesburn Unit and Honorary BAPRAS member, BFIRST committee member, ran the Steall Marathon on 20th of September to fundraise to support a BFIRST project to help develop burn care in The Gambia.

Stuart Watson, retired Consultant Plastic Surgeon, Canniesburn Unit. Honorary BAPRAS member, BFIRST committee member.

This was an incredible achievement and to date Stuart has raised £3750!

If you would still like to donate you can at the at the Go Fund Me page.
Your donation will go directly to supporting Burn Care in the Gambia. You can contact Stuart by text on 07786688988 if you wish to donate by alternative means. Thank you.

Surgical Scrub Hats 

This year we will be selling re-usable BFIRST surgical scrub hats! More details to follow!
Funds raised will help us educate and train surgeons in resource limited countries.

Other

Open Hand Therapy Initiative

 

 

The Open Hand Therapy Initiative aims to improve hand injury care in resource challenged settings in order to reduce disability, improve quality of life and increase chances of work for people with hand injuries and conditions.

They provide accessible, relevant and captivating learning opportunities for generalist occupational therapists and physiotherapists that motivate ongoing development for hand-injury care.

They also invite hand therapists acquainted with the challenges faced in low to middle income countries to participate in strengthening hand injury care in these settings by sharing their expertise.

For more information click here https://openhandtherapy.org/

Volunteering

BFIRST is keen for surgeons, nurses and allied specialists to all get involved. Please do get in touch if you are interested. Reconstructive surgery is a team sport!

Also, if you have ideas for new projects that you would like to start, perhaps in new countries, or in areas we already work in, we would love to hear about these, and discuss further.