News

BRITE, THET and BFIRST teamed up this month for a Webinar on Optimizing Breast Cancer Care through Multidisciplinary Team Training
The Breast Cancer Resource for Inter-speciality Training and Education (BRITE), together with the Global Health Partner Programme (formerly THET) and BFIRST, delivered a webinar on the 14th June 2025 about optimizing breast cancer care through MDT training.

We are grateful for the support and help from the Association of Breast Surgery, UK and to the expert speakers from Nigeria, Ghana and UK. We had 194 attendees, and the discussion was lively.
A short summary of the key speakers and their topics:

• The Power of Multidisciplinary Collaboration in Breast Cancer Care. Leena Chagla, Immediate Past President of the Association of Breast Surgery, Breast Surgeon, Merseyside, UK.
• Building Effective Multidisciplinary Teams. Trupti Kulkarni, Radiologist, Manchester, UK.
• Implementing Evidence-Based Guidelines in MDT Practice Harleen Deol, Breast Surgeon, Lister, UK.
• A Cultural adaptation of the MDT toolkit for breast cancer for Nigeria and Ghana, Paa Hoyte-Williams, plastic surgeon from Kumasi, Ghana.
• Addressing Barriers to MDT Implementation Abdulrasheed Ibrahim, project co-PI, plastic surgeon from Zaria, Nigeria

There were break-out rooms for smaller groups and panel discussions with Nigerian and Ghanaian policymakers, nurses and doctors for: Strategies for ensuring the long-term sustainability of MDTs including resource allocation, leadership support, and continuous evaluation, developing a roadmap for future MDT development and expansion, incorporating stakeholder feedback, the role of policymakers and hospital administrators in supporting MDT implementation.

This promises to change the face of breast cancer MDT in Nigeria and Ghana.
The recording will be available on the BRITE website, which is under construction.


BRITE expanded into Enugu
The Nigerian BRITE team went to Enugu, the capital of Enugu state.

Enugu is a city in southeastern Nigeria and the capital of Enugu State. Known as the “Coal City” due to its rich coal mining history, Enugu played a major role in Nigeria’s early industrial development. Today, it's a regional centre for politics, culture, and commerce in the Igbo-speaking region. Enugu serves as a regional medical hub in southeastern Nigeria, offering general and specialized services, with breast cancer treatment predominantly taking place at the University of Nigeria Teaching Hospital, Ituku-Ozalla, and complex oncological breast reconstruction taking place at the National Orthopaedic Hospital, Enugu.

The BFIRST Committee is recruiting!
We will shortly be advertising for three new consultant positions on the BFIRST committee.  These positions will be advertised via our mailing list, social media and the BAPRAS monthly bulletin.

The LION Malawi
An opportunity for an upper limb/hand Consultant Surgeon (plastics or orthopaedics) to volunteer at the Lilongwe Institute for Orthopaedics and Neurosurgery (LION) in Malawi has arisen, for the following dates:

• 15^th September 2025 – for 3 weeks
• 10^th November 2025 – for 4 weeks

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

Zambia
We are looking for an upper limb surgeon to go to Zambia!

We require a Consultant or post CCT upper limb surgeon or staff grade, together with a hand therapist. Consultants are also welcome to bring a Fellow or Trainee.

The dates are flexible, and flights and accommodation will be funded up to a maximum of £1000, with negotiable additions.

If interested please contact Barbara Jemec (Jemec.barbara@gmail.com) for further information with a short description of yourself and experience.

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 require ‘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.  

Meet the Team 

Ms Siobhan O'Sullivan - Finance, Governance and Policy Subcommittee

Tell us about yourself!
My name is Siobhan, and I’m a Plastic Surgery Registrar based in London. I originally studied Psychology at the University of Liverpool before completing a postgraduate medical degree at the University of Manchester.

During my time at university, I developed a strong interest in Global Health. This led me to take part in overseas projects in Tanzania and Romania, and to contribute to several initiatives focused on global healthcare challenges. I also worked closely with refugee doctors preparing for their PLAB 2 exams, through the REACH programme at Salford Royal Hospital.

Following medical school, I moved to London for my foundation training, where I discovered my passion for Plastic Surgery. I spent my F3 year as a Junior Clinical Fellow in Plastics and Burns, which further confirmed my interest in the specialty. I then entered Core Surgical Training and have been working as a Plastic Surgery Registrar ever since.

At the age of 31, I was diagnosed with Primary Ovarian Insufficiency, leading to early menopause. This personal experience has inspired me to become an advocate for women facing similar challenges. I wrote a book titled My Life on Pause, which documents my journey, and I now speak regularly at conferences and events to raise awareness and promote better understanding of these conditions.
 

Tell us about your time with BFIRST?
I joined BFIRST four years ago and have held several roles within the Residents Committee, including Membership Coordinator, Events Coordinator, and most recently, Vice-Chair. I now sit on the BFIRST Finance, Governance, and Policy Sub-committee, contributing to the organisation’s strategic development and direction.

Over the years, I’ve had the privilege of representing BFIRST at various conferences across the UK and internationally, including Amsterdam. One highlight was coordinating and leading the BFIRST/BSSH Global Overseas Day in Leeds last year — a fantastic opportunity to bring together professionals with a shared commitment to global reconstructive surgery.

In December, I was part of the BFIRST team that travelled to The Gambia to deliver a bespoke plastic surgery teaching programme for local healthcare professionals — including surgeons, nurses, and physiotherapists. At present, there is no formal Plastic Surgery service in the country, and we hope to support our colleagues there in developing and establishing sustainable reconstructive care.

During our visit, we observed a significant burden of disease resulting from untreated burn injuries, especially among children. Many patients were living with life-altering burn scar contractures that had gone untreated. This year, we will return to The Gambia in collaboration with our partners at InterBurns to deliver a burns-specific training course focused on prevention and acute management. Our goal is to help lay the foundation for a comprehensive burns service in the region.

Why did you want to work with BFIRST?
I've had a strong interest in global health since my university days. However, once I began clinical work, I found there were fewer opportunities to engage with this area directly. BFIRST offered a unique chance to combine my passion for global health with my career in plastic surgery. It’s been an incredibly rewarding experience — not only in understanding the lasting impact we can have through sustainable surgical partnerships overseas, but also in learning how vital it is to collaborate closely with local teams to build long-term healthcare capacity. I've been fortunate to meet and work alongside many inspiring colleagues through BFIRST, who have taught me a great deal and deepened my commitment to this work.

What are your aspirations for BFIRST?
In the short term, I hope to contribute meaningfully to the development of a comprehensive burns service in The Gambia, helping to reduce the burden of these often life-changing injuries. Looking ahead, I aspire to lead my own global surgery projects once I become a consultant, and to play a role in inspiring and mentoring the next generation of surgeons to engage in global health work.

What do you like to do outside of work and BFIRST?
Outside of work, I love travelling, spending time with friends and family, and being outdoors. I particularly enjoy skiing and scuba diving whenever I get the chance. I’m also passionate about creative pursuits — I find painting and drawing to be a therapeutic outlet, and I’m hoping to spend more time developing those skills.
 

Webinars

There are no webinars lined up for May, but 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 

Ethiopia

Affiliated BFIRST Projects 

Breast Cancer Resource for Inter-Breast Specialty Training and Education (BRITE) Questionnaire. 
Breast cancer presents a growing and disproportionate health burden in Sub-Saharan Africa. While incidence rates are reported to be lower than in high-income countries, mortality rates are significantly higher, creating a stark and tragic disparity. Despite limited cancer registers in Sub-Saharan Africa, the incidence of breast cancer in Sub-Saharan Africa surged by 247%, with Nigeria accounting for the highest number of cases, between 1990 and 2019. Over the same period, mortality rates in the region increased by 184%, with West Africa experiencing one of the world’s highest burdens.

The existence of a well-functioning multidisciplinary team (MDT) increased the 5-year survival of breast cancer patients by nearly 20%.

Last year plastic surgeons from Ahmadu Bello University Zaria, National Hospital Abuja and University College Hospital Ibadan in Nigeria and the Korle Bu Teaching Hospital Accra and Komfe Anokye Teaching Hospital Kumasi in Ghana in partnership with BFIRST and the Association of Breast Surgeons, UK held BRITE courses across both countries, with both up-to-date treatment options and how to make the MDT work well. Nigerian and Ghanaian scholars from all specialties involved in the MDT visited four units in the UK (Luton and Dunstable, East and Noth Herts, Mersey and West Lankashire, and Manchester University Hospitals). We are indebted to the breast surgeons and radiologist (Miss Ruth James, Harleen Deol, Leena Chagla and Trupti Kulkarin) and their teams who hosted them.

The BRITE team is conducting a questionnaire survey to determine the inter-specialty competencies required by members of the MDT to work together holistically within the breast cancer care pathway.
 

Please click on the appropriate link below for consultants, residents and nurses to take part in the survey. Thank you!

Consultants                    Residents                   Nurses
 

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. The fellow at Wythenshawe has already arrived and we look forward to bringing you updates soon!

2025 BFIRST Fellow Report: Dr Olatunde Oyesanya
LESSONS FROM WYTHENSHAWE - My BFIRST Experience.
I have always wanted to be a plastic surgeon with international standards and experience, and the British Foundation for International Reconstructive Surgery & Training (BFIRST) afforded me this. The fellowship occurred at Wythenshawe Hospital, Manchester from April 29th to June the 9th.

Ailbhe Kiely, my BFIRST buddy, the best there is, received me on arriving the hospital and helped ensure I got a SIM card, hospital access ID card and in-hospital accommodation within a few days of arrival. Accommodation was at the Baguley Residence which was modest. I was especially grateful for the electric heater which shot back at the “cold stare” of Manchester weather at the time.

I had three birds and one stone - Burns, Hands and Microsurgery, and a 6-week duration. My BFIRST coordinator, Kate Radcliffe, graciously linked me with supervising consultants to steer my journey over two weeks each.

The Burns Unit (Mr Sheikh Zeeshan)
I was warmly welcomed into the unit under the amiable and watchful care of Mr Tony Olekwu who greatly eased the transition into the new environment alongside Mr Hassouna and Drs Kene and Miriam. I experienced the importance of team work, commitment to designated roles and celebrating together in creating a positive work environment. This reflected in other units I transited through. The ward managers Sue Gibbons and Pauline Gillard were resourceful in providing guidelines for day-to-day running of a burn unit. I look forward to a collaborative research, comparing a particular burn dressing agent used in Nigeria versus that at Wythenshawe.

Hands (Mr Anuj Mishra)
Mr Anuj arranged a remarkable itinerary through a didactic two weeks, pairing me with several consultants and himself at Wythenshawe, Withington and RMCH. The exposure was enlightening. I learnt firsthand the application of Suzuki frame, removal of a Giddins frame, Dupuytren contracture and its surgery, fractional tendon distraction, USS-guided schwannoma surgery, triple procedure for thumb hypoplasia, amongst others. The Brachial Plexus/Nerve Clinic was another interesting exposure.
I met the great Mr Duff at the Neurofibroma Clinic of RMCH. There I discovered evolving care of NF patients with use of Selumetinib and its effect in improving prognosis of paediatric NF. I also observed that severe presentations of NF were common in UK as in Nigeria. The difference was in higher diagnostic assessments, better insurance coverage and availability of interventional medications as opposed to limitations from out-of-pocket care in Nigeria. The waiting list, however, tilts in favour of the latter.

Breast & Microsurgery (Mr Ben Baker)
This was the hallmark of my visit.
I heard of a microsurgery practice station at the residents’ office which had previously been dismantled. Mr Bedford, witty and altruistic, kindly helped resurrect the set-up, graced me with a starter pack micro-instrument and a one-on-one practice session with him. I got further guidance from Mr Reid and other residents who shared insights on how they overcame some technical learning curves. There were few DIEP cases during my visit allowing me time to practice further. I proceeded to perform my first successful microvascular anastomoses (venous and arterial) on chicken wings I bought. (I had a mini solo dance to that!) Live dissections for DIEP pedicle still appears to be delicately more challenging than actual anastomosis to the IMA. I believe with time one is able to get accustomed to this. The end-results are pleasantly remarkable compared to the pedicled flaps I am used to.

Other Activities

1. Travelled to London to attend the Royal Society for Medicine’s seminar at a discounted rate. The theme - future of surgical careers - brought my attention to the value of MDT work in bridging the gap between where we are and where we can be, between ideas and their reality. The program concluded nicely with highlights on the pros and cons of social media for doctors, and how best to navigate through this evolving landscape. Mr Nadey Hakim, a team lead in the first-hand transplant in the world and one of the facilitators for the RSM day, coincidentally frequents Nigeria - the bonding was instant!

2. The North-West Hand Society dinner was a delightful gathering in a relaxed atmosphere that showcased the balance between work and play. It was an invite I was honoured to attend. I met with exchange fellows from South Africa and New York, and tasted new European dishes too.

3. My six weeks fellowship concluded its last weekend at the BSSH instructional Course at Manchester. I gained refreshing insights on inflammatory and degenerative arthritis of the hand. The hands-on sessions were very resourceful, especially for ultrasound and PIPJ fusion. Highlight was when I was making enquiries with the BSSH admin on who to contact concerning the founding of BSSH. I wanted info to help guide the founding of the Nigerian Society for Surgery of the Hand (NiSSH). I was introduced to Mr Jonathan Hobby, IFSSH Member-at-large (Europe & Africa), who coincidentally also had a mandate to connect with Africa!

Challenges
Applying for a visa on time was the main challenge. I experienced slow response time from the HR spanning about 2 months before getting a contract which contained key elements in applying for a visa. The BFIRST Letter of Acceptance which came much earlier was required in a separate field.

Conclusion
Reflectively, this six weeks BFIRST fellowship has corroborated my interest in microsurgery which I intend to pursue career-wise. In addition, within my first week of return home, it has already fostered conversations with other plastic surgeons who have begun moves to establish an NiSSH. Overall, I have learnt the value of normalizing MDT meetings making it a routine with dedicated schedule. I have also seen the need for team-based approach to innovations, and the role of industry in loaning of equipment to stimulate implementation.

Kudos to BFIRST and its amazing team for this laudable initiative, and for the wonderful opportunity awarded to me. You have definitely ignited a new chapter in my career trajectory. Thank you.


BFIRST Fellow update: Dr Kemi Ayoade
Kemi was a BFIRST fellow in February 2020, and then completed further microsurgery training at Wythenshawe Hospital, training under Mr Adam Reid and Mr Jason Wong in 2023-4. Since then, BFIRST has sponsored a microsurgery fellowship in Ganga, the Canniesburn flap course, the London Hand and Wrist course, and the BAPRAS conference for the past two years.
 

Kemi returned to Lagos, Nigeria in January 2025, where she works at the National Orthopedic Hospital, Lagos. Her vision is to establishing the hospital’s first consistent microsurgical reconstructive service. The foundations of this vision involved forming a Multidisciplinary Team, sourcing microsurgical instruments through donations, and building morale, promoting teamwork, and developing a learning culture.

Kemi performed her first free flap in Lagos within 8 weeks of returning home. To date she has completed 5 free flaps (4 anterolateral thigh, 1 latissimus dorsi). Four of these have been successful, with one flap experiencing a partial loss. Kemi has also performed one brachial artery repair (post traumatic laceration) and multiple lower limb pedicled flaps.

ALT for exposed bone:

First Bilateral ALT Free Flaps:

Pre-op, post op and ambulating.

In April 2025, Kemi organised a local microsurgery course, where she trained six residents.

We are very proud of Kemi’s achievements, and look forward to seeing and supporting her future endeavours!


Ethiopian BFIRST Ganga Fellows
BFIRST have sponsored six doctors from Ethiopia to each attend a two-month observership and microsurgical training in Ganga, India.

Dr Nagasa Wirtu Shanko
Dr Dagmawi Geremew Zinaw 
Dr Adamtachew Geta Tamir
Dr Tigist Zewude Siyoum
Dr Adera Tenagne Ambelu
Dr Zerihun Yirgu Beyene 

Message from the Ethiopian BFIRST Ganga Fellows:
“Forwarding our deepest gratitude to the entire BFIRST team, and our mentor Dr Abraham, and all staff at Ganga Hospital for making this fellowship possible for us. We believe we have gained an invaluable experience from this stay, specifically in aspects of microsurgery and hand surgery.  We hope that we will be able to put into action what we learned from this centre, wherever we will be, practicing in our community. It is our heartfelt wish that we can collaborate in further endeavours at our centres regarding the field of Plastic and reconstructive surgery in the future.”
 

We hope that supporting the Ethiopian BFIRST Ganga Fellows will facilitate the availability of sustainable microsurgery in Ethiopia and the training of resident doctors in Microsurgery. We look forward to hearing more from the Ethiopian BFIRST Ganga Fellows about how they are using the skills and knowledge learnt during this observership.

Fundraising

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!
 

How can I help?

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.