News

The BFIRST Committee is recruiting!
We will shortly be advertising for two 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. 
A summary of one of the BFIRST resident’s recent experience at the LION is presented in this newsletter.

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 Helen Roberts - Co-chair of the BFIRST Fundraising, Events and Communications Committee

Tell us about yourself!
Having completed thirty-one years as Head of the BAPRAS and BSSH staff in 2020, I often reflect on this position as a privilege and honour.  In the main, it was huge fun and amazing to have worked with so many wonderful people throughout the world. Five years into retirement I remain passionate about British and overseas plastic surgery.  I therefore consider it a further honour and privilege to co-chair the BFIRST Fundraising, Events and Communication Committee. 
Born and raised in Hertfordshire, our best decision was to retire to sunny Sidmouth, Devon and be surrounded by beautiful countryside and the sea.

Tell us about your time with BFIRST?
I managed the administration of the BAPRAS Overseas Committee since its inception, and worked with many to form BFIRST in 2013. This was the vision of the wonderful Barbara Jemec who I am pleased is still involved today. I continued with BFIRST admin until retirement and became a Trustee in September 2020 for three years, when I became an Honorary member.

Why did you want to work with BFIRST?
I remain passionate about the specialty of restorative plastic surgery.  It is wonderful that UK surgeons wish to take precious time out of their busy lives to visit less privileged countries to work with local surgeons to enhance the lives of local patients whose good health is a necessity to provide for their families. The fellowship scheme has enabled many overseas surgeons to hugely benefit from working in UK plastic surgery units, returning home to teach colleagues and benefit patients.

What are your aspirations for BFIRST?
Continue to spread knowledge of the fantastic work of BFIRST, increase the number of global partners and visits overseas. 

What do you like to do outside of work and BFIRST?
I am passionate daily sea swimming, wave height permitting.  Cold water shock therapy sets me up for the day. My aim before the grand age of 70 is to complete a channel relay. Weekly singing with Rock Choir is hugely therapeutic and it was a one-off amazing experience to visit New York this year with 350 other ‘Rockies’ and perform in Carnegie Hall. I am an inexperienced garden potterer. My husband and I enjoy a quiet relaxing life. My 30 year old son is my biggest joy. We all enjoy good food and exploring new restaurants. There are many exciting places to visit, and I am slowly working through a bucket list. I remain PRASIS board secretary (partly because of the truly lovely board members).  This combined with BFIRST, is a perfect balance of retaining brain activity, fun and pleasure.  
 

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

On Mondays and Fridays, we had the hand clinic. This was a fast-paced clinic, including patients with a variety of presentations, including elective problems such as de Quervain’s and Trigger Digits, acute trauma injuries such as Panga lacerations, but also more complex problems, such as brachial plexus injuries and congenital hand problems. There were expected differences to my previous clinic experiences in the UK, for example use of paper-based documentation, in the form of health passports which the patients kept, and the variable availability of drugs and equipment. However, one aspect that was surprising to me was the difference in attitude to patient privacy by both doctors and patients, with two or more patients being seen at the same time by the team in the same clinic room.
 

On Tuesdays, Wednesday and Thursdays, we had theatre lists. On Tuesdays and Thursdays this was based in A&E theatre, where we were able to do WALANT and regional anaesthetic case. On Wednesdays we were based in main theatre, when we performed general anaesthetic cases. As it was the maize harvesting season (Maize is the staple food for most Malawians, usually eaten at least twice a day each day in the form of nsima).  The majority of injuries we treated related to the Maize harvest – injuries sustained harvesting maize with pangas, injuries from pangas during maize theft, and crush injuries from industrial mills used to process the maize so it can be stored for the year. Operating at the LION was very different, all the surgical instruments were re-usable, and in some cases, it was clear that they had been re-used many times. The availability of consumables, such as particular stitch types was variable. Luckily, we only experienced one short power cut during a theatre day. Seeing patients on the ward pre or post operatively was challenging due to the sheer number of patients on the ward – at least 20 patients per bay in the ward, with no patient board to identify where to find our patients. Those needing traction for fractures were in beds, most other patients were on the floor.
 

A particularly interesting case during my visit was a young male patient who had lost his dominant thumb in an industrial maize grinder. This patient required a pedicled groin flap for reconstruction of the wound, which was performed locally by Dr Kachitsa and Mr Stanton assisted by myself and Dr Zulu. The case was guided by Plastic Surgeon, Mr Tony Barabas, from the UK, via Rods and Cones, a remote operating room collaboration service. Mr Barabas had visited the LION in April and had performed a similar case alongside Dr Kachitsa.
 

The Rods and Cones system allowed Dr Kachitsa and Mr Stanton to share their view of the surgical field with Mr Barabas using smart glasses and a secure two-way communication platform.  This  allowed him to hear, see and interact with us at the LION unit as if he were in the operating room, facilitating him to provide guidance without physical presence. This was the second operation performed at the LION using Rods and Cones; undoubtedly there will be many future applications at the LION.
 

While at the LION I also had the opportunity to deliver teaching as part of the BSSH hand teaching series. 
We also had a pizza night out with our local colleagues.  At the weekend managed to hike to Dedza Mountain’s peak of 2198m and we visited the Chongoni Rock Art in caves in in the Dedza Region, some of which were over 10,000 years old.
 

Affiliated BFIRST Projects 

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

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, Dr Olatunde Oyesanya, has already arrived and we look forward to bringing you updates soon!

BFIRST Ganga Fellow

We received a lovely message from Dr Nagasa Wirtu Shanko who last year undertook a two-month observership in Ganga, sponsored by BFIRST.
 
“I am writing to express my heartfelt thanks for the invaluable opportunity to undertake two-month’s, observer and microsurgery training at Ganga Hospital, generously sponsored by BFIRST.
The experience has had a profound impact on my surgical skills, confidence, and the quality of care I now offer my patients. The mentorship, high-volume exposure, and international collaboration were truly transformative.”

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.