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.

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.

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 Queen Victoria Hospital, East Grinstead

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)

Dr Malungo practicing microsurgical skills.

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