November 2025 Newsletter
BFIRST is a UK registered charity which trains surgeons and their teams working in low to middle income countries to enable them to undertake reconstructive Plastic Surgery independently in an equitable and sustainable manner. Treating functional disability, injury and pathology via surgical treatment helps enable restoration of independence to both adults and children thereby improving quality of life.
BFIRST also provides educational resources for Plastic and Reconstructive Surgeons through our Webinar series.
In the November 2025 BFIRST newsletter we bring you up to date with our latest activities undertaken by BFIRST and hope that they inspire you to get involved!
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News
Wee Lam elected as BSSH President
Congratulations to former BFIRST chair Mr Wee Lam who has been elected as President of the British Society of Surgery of the Hand (BSSH), starting in 2026!
BFIRST Essay Prize
BFIRST Essay Prize (£250.00) 2026
We are delighted to announce the 2026 BFIRST Essay Prize!
The title for this year’s contest is “How can harnessing AI transform surgical care in resource-poor countries – for better or worse?”
We are looking forward to receiving your essay until 23.59 GMT, on 1 May 2026.
The winner will present their work in an upcoming BFIRST Overseas Day or session at the BAPRAS Winter meeting. (Please note we will not fund travel to this meeting however this work can be presented virtually).
Submission
To submit your essay, please send it to info@bfirst.org.uk.
Please provide a separate note with your essay containing your name, grade and current hospital of work. This information will not be provided to your assessors and all essays will be graded anonymously.
Eligibility
- Resident Doctors at all stages and medical students worldwide are eligible to submit an essay to be considered for the prize.
- Submissions made after the deadline has passed will not be taken into consideration.
- Please refrain from using your own title and use the title provided above.
- Please do not include your name in the text of the essay itself.
- Multiple submissions of the same or different essays are not allowed, and only the first submitted essay will be graded.
Word count and document formatting
- Maximum word count 1500 words. Any content beyond the word count will not be assessed.
- Please submit in Word or PDF format.
- Please use double spaced Calibri Font 12 for all content of your essay.
Any deviation from this will result in penalisation.
The LION hospital, Malawi Opportunity
We are looking for an upper limb Consultant surgeon (plastics or orthopaedics) to volunteer at the LION in Malawi, during the following dates:
- 24th May – 19th July 2026
- 13th September – 27th September 2026
- 25th October – 22nd November 2026
If you are interested in volunteering at the LION hospital for some or all of these dates, please let us know if via this link.
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Meet the Team
Mak Tare: Education, Research & Fellowship Subcommittee
 Tell us about yourself!
Mak Tare finished his General Surgery and Plastic Surgery training in India before moving to UK in 1999 as a BAPS Fellow. He worked in Canniesburn Glasgow( BAPS Fellow), Manchester (BSSH Hand Fellow), Chelmsford( Hand Fellow) before joining the London Deanery training program in Plastic Surgery.
As a part of his training, Mak worked in St. Andrew's Centre for Burns and Plastic Surgery, East Grinstead and Royal London Hospital Plastic Surgery units. In order to broaden his horizon, Mak also visited various Plastic Surgery units in Italy, Spain and USA before joining the world-renowned St. Andrew's Centre for Burns and Plastic Surgery in Chelmsford as a Consultant in 2008.
Mak started his clinical journey as a reconstructive microsurgeon dealing with acute upper and lower limb trauma cases, and with the secondary nerve/ tendon reconstruction cases. Over the period of time, Mak developed the elective hand surgery, abdominal wall reconstruction, skin cancer (Melanoma) practice. Mak also started a Septo-rhinoplasty service in the NHS for the post trauma cases with the support of ENT surgeons.
Mak's motto in life is to " Follow the footprints...leave the foot prints".
Tell us about your time with BFIRST?
I joined the BFIRST as a council member in 2024 and became the Committee member in 2025. I am inspired by the wide range of projects; BFIRST has taken over across the continents. I am also inspired by the dedication of BFIRST members in promoting Plastic Surgery training in the underdeveloped countries. I am very keen to participate in the BFIRST projects and visit one of the overseas centers to share my experience in reconstructive surgery with the local surgeons.
Why did you want to work with BFIRST?
As a Plastic Surgery trainee in India, Mak participated in the WHO Leprosy camps with his teachers in the remote and tribal endemic regions of Leprosy. He learnt the fundamentals of tendon transfers in upper and lower limb in these camps. As a reconstructive Plastic Surgeon Mak visited Africa (Ghana) and Bangladesh ( Dhaka) to share his experience with the local surgeons.
Mak takes his role as a consultant trainer very seriously. He is always keen to share his knowledge and experience with the younger generation. At St. Andrew's Centre, Mak is an educational supervisor for British Plastic Surgery trainees and international fellows.
Mak's passion for training attracted him to BFIRST as it would offer an opportunity to train the wider group of trainees across the continents.
What are your aspirations for BFIRST?
I would like BFIRST to take up more educational activities and training projects in the underdeveloped countries of Africa and South America. I would like to create more training opportunities for the overseas trainees in the established UK Plastic Surgery units. I would like BFIRST to be an independent, financially stronger and a very well-known body for international training. We at BFIRST believe in creating the second line of competent Plastic Surgeons.
What do you like to do outside of work and BFIRST?
I love listening to Classical music with my wife and playing golf with my son in the free time.
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Webinars
BFIRST 2026 Webinar Series
We are delighted to announce the start of the 2026 BFIRST Webinar Series! Offering focused, high-quality sessions for the global plastic surgery community, our first two webinars are now confirmed:
10th January 2026: Setting Up an Orthoplastics Service, Mr A Emam
Mr Ahmed Emam is a consultant plastic and reconstructive surgeon based in Swansea, with a special interest in microsurgery and limb reconstruction. He leads the plastic surgery for South Wales Major Trauma Network and currently chairs the BAPRAS Trauma Special interest Group (SIG) and is co-chair of the BFIRST Education, Research and Fellowship Subcommittee.
21st February 2026: Microsurgery, Mr J R Srinivasan
Mr Srinivasan is a consultant plastic and reconstructive surgeon based in Preston, with special interests in microsurgery and head and neck reconstruction. He is the Clinical Director to the Plastic Surgery Department in Lancashire Teaching Hospitals NHS Trust, a BAPRAS Council Member, and has been on the BFIRST Committee since September 2025.
Additional webinar dates and topics will follow throughout the year as we continue to expand our programme.
Please follow our socials for updates about future 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!
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Projects
The Gambia
In November, the BFIRST team returned to The Gambia for our second collaborative trip with Interburns and GAMMED. Building on last year’s success, this visit focused on burns education and hands-on training to support the development of the country’s first plastic surgery service.
Over the week, we delivered three training days to 63 participants, including two Essential Burn Care (EBC) courses and a Community Burns Care (CBC) day. We were especially pleased to welcome seven traditional healers, helping strengthen community links and improve early burns management in the region.
Alongside teaching, the team joined GAMMED in clinic to review over 50 patients with complex reconstructive needs and provided theatre-based training on several burns cases. A standout moment was the collaborative management of a 16-year-old boy with 80–90% TBSA burns — a powerful example of what local leadership and global partnerships can achieve together.
We were delighted to reconnect with local trainees Dr Amadou, Dr Sirra and Dr Bakary, whose dedication to establishing a Gambian plastic surgery service continues to inspire us. We were also joined by Dr Daniel, a trainee from Ethiopia, who spent the week learning about the local system and sharing his ideas and expertise for potential future collaboration — an exciting development for the wider regional burns network.
The trip highlighted the value of long-term partnerships and the importance of supporting local trainees as they move towards independent practice. We look forward to building on this work in 2026 with a more focused week of hands-on theatre training.
Thank you to everyone who supported the programme — a fantastic example of sustainable, collaborative global surgery in action.
Zimbabwe
BFirst trip to CURE International Children’s Orthopaedic Hospital, Bulawayo, Zimbabwe.
In November, members of the BFIRST team (Drew Fleming, Jamil Moledina, Jessica Steele) returned to Zimbabwe.
Introduction
Having successfully undertaken a mission in 2024 (JM and DF) we were invited to again undertake a mission to the Cure hospital by Mr Andrew Hodges FRCS(Plast) {the resident Plastic Surgeon}and the Hospital Director Mr Jonathan Simpson. The plan again was to help with operating and teaching on a range of children with congenital and acquired differences of the hand. Jess Steele from Salisbury joined us this year. We flew out to Bulawayo via Johannesburg and landed in Bulawayo on Sat 6th November. We were met with unseasonably heavy rain for the first 3 days but otherwise were delighted with warm days and sunny skies – when we were out of theatre! Accommodation had been organised with a very comfortable B&B and superb staff to look after us – Jamil and Jess also dab hands in the kitchen! On the Sunday prior to the start of the very busy week we were again personally escorted around the Matopos National Park by Senator David Coltart, the Mayor of Bulawayo. This is a World Heritage park characterised by massive granite rock formations and rock art dating back to early man…and highly recommended for any visitors to Zimbabwe! We were entertained for lunch and a game drive at Farmhouse Matopos (www.farmhousematopos.com) the highlight being a pair of endangered white rhinos.
 
Clinic
Andrew Hodges had been accumulating cases for us to review with country-wide referrals and a total of 41 patients were seen in clinic on Mon 8 th Nov. This day-long clinic was held together, with Andrew leading, visiting Plastic Surgery Registrar from Harare Rutendo Makiwa, Bhekinkosi Swene (Cure plastic surgery trainee) senior nursing sister and resident Orthopaedic surgeon Laurence Wicks popping in!. The patients were all children with hand problems including congenital anomalies, acquired birth trauma related problems and neglected trauma (Andrew does most of the burn-related work himself so we only saw one case of old burns). We also saw some follow-ups from last year’s mission. Of these 16 were selected for surgery for the following 4 days in 2 theatres including 2 free flaps. In the latter part of the week we were joined by Tinashe Mutarisi, another Plastic Surgeon registrar from Harare.
 
Theatres
The operating theatres, anaesthetists and nursing staff were all of the highest standards and hugely facilitated what turned out to be a very busy but productive week. ‘Mr T’ was the go-to man for all major equipment issues. We had taken some latex-free gloves for Drew (Jess forgot to take hers!), Nieverts needle holders and assorted Vicryl Rapide suture material – otherwise all equipment excellent. Reminder next time – take some smaller K-wires!
The following operations were performed by the visiting team:
- *Left free fibula to radius (previously distracted Bane 3 radial dysplasia)
- Wind-blown hand with release and FTSG 3 digits
- Arthrogryposis with 1 st web release and flap + intrinsic releases
- Arthrodesis DIPJ’s for burn Boutonniere contractures with FTSGs
- Pollicisation for Blauth type 4 in radial dysplasia
- Arthrodesis thumb IPJ and rotation osteotomy previous free toe transfer (from 2024)
- Centralisation for radial dysplasia type 4
- Macrodactyly bilateral feet – right central ray amputation x2, left great toe amputation and on-top plasty D3 to 1
- *Free ALT to forearm (previous Volkmann’s)
- Chondrodesis thumb + 4 flap z-plasty to 1st web + ¾ th web syndactyly release + FTSG
- Scar revision dorsal hand and neuroma removal
- Release 1st web, intrinsics transfer and sagittal band reconstruction (cerebral palsy)
- Zone 5 extensor + flexor reconstruction with grafts + median and ulna nerve grafting (2 year old saw injury)
- CP for wrist fusion + thenar muscle slide + extensor plication
- CP for bilateral thumb 4 flap Z-plasty, thenar slides, FTSG and chondrodesis MCPJs.
- CP 1st web 4 flap Z-plasty, chondrodesis MPJ and Huber transfer
Both free flaps were done and dusted by 6pm with no take-backs and good post-op recovery. Plans for free gracilis to at least 2 cases are in place for next visit! The wards are delightful, spacious, well staffed and with accommodation for parents next to the children’s beds. There is a 1 bed HDU on the ward. There is also a 20 bed dormitory to accommodate children + parents awaiting surgery as many of these families had travelled from all over Zimbabwe (Harare, Mutoko, Hwange, Mutare, Plumtree, Masvingo etc).
 
Aim
The aim of this trip was to teach and operate on a range of children’s hands to enable both Andrew, locally, and hopefully the visiting surgeons from Harare, to refresh and acquire a new skill set to help further children going forward. We believe and hope this was achieved in addition to obviously helping these children upon whom we operated on. Feedback has been enthusiastic and the possibility of another visit is certainly on the cards. It would be good to teach the Harare registrars some more of the fundamentals of hand surgery which they confess is sadly lacking from their current curriculum due to theatre and expertise constraints in Harare.
We would like to thank Andrew and his wife and excellent Anaesthetist Sarah for their at-home hospitality; Jonathan Simpson, Sam Weston-Simons and Laurence Wicks (resident Ortho surgeons)and all the Staff at Cure Bulawayo for their kindness and hospitality during our visit – and of course the delightful children and their families.
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!
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Fellowships
BFIRST Fellows
The 2025 BFIRST fellows have all completed their BFIRST fellowships!
The 2026 BFIRST fellows have been selected, congratulations to:
Dr Lambert Onahi Iji from Nigeria
Dr Masroor-ur-Rahman from Bangladesh
Dr Natasha Ilako from Kenya
BFIRST Fellow Updates
Dr Ebere Osinachi Ugwu
My six-week fellowship in renowned hospitals in the United Kingdom (UK) was a memorable learning experience, made possible by the generous sponsorship of the British Foundation for International Reconstructive Surgery and Training (BFIRST). I applied for this fellowship driven by my commitment to providing high-quality, affordable reconstructive care to underserved Nigerian women, with the aim of restoring dignity, improving quality of life, and promoting early presentation of patients with breast cancer. The fellowship was an opportunity for exposure to high volume Oncoplastic and Reconstructive breast surgeries in order to achieve this goal. I also sought to improve my expertise in Cleft and Craniofacial Surgery, and to understudy NHS organisational models adaptable to Nigeria. I am pleased to report that the fellowship exceeded all my goals and expectations.
My fellowship took place at the Royal Victoria Infirmary, Newcastle under Mr David Sainsbury, and at Wythenshawe Hospital, Manchester under Mr Benjamin Baker. Both centres provided rich clinical exposure aligned with my training needs.
Royal Victoria Infirmary (RVI), Newcastle
 With the Cleft Team at the Royal Victoria Infirmary(RVI), Newcastle
Cleft and Craniofacial Surgery: I participated in a wide range of Cleft and Craniofacial procedures including cleft lip repair, cleft palate repair, ear reconstruction and rhinoplasty. I attended the comprehensive cleft clinic and multidisciplinary team (MDT) meeting, where I witnessed the effectiveness of the one-stop clinic model – a system where patients receive holistic care from all relevant specialists during a single visit. This model is ideal for replication in my institution to strengthen cleft care delivery. The professionalism and team work of the Cleft team was truly inspiring.
With the Sarcoma Team at the Royal Victoria Infirmary(RVI), Newcastle
Sarcoma Management: I had the privilege of joining Mr Maniram Ragbir and the Sarcoma Team. I observed the structure, communication flow, and coordinated decision making of an efficient sarcoma MDT. A particularly valuable experience was observing a free osteocutaneous fibula flap for forearm reconstruction after sarcoma excision, which showcased meticulous microsurgical planning and execution.
Dermatoscopy: Exposure to dermatoscopy in the General Plastic Surgery clinics reinforced its importance in early skin cancer detection, especially relevant for Nigeria, where patients with skin cancers often present late.
Laser Therapy: Time in the Laser Suite provided my first practical exposure to medical lasers used for hypertrophic scars, benign skin lesions, acne scars, vascular lesions and skin rejuvenation. This experience has equipped me with foundational knowledge essential for establishing a laser therapy service in my centre.
Wythenshawe Hospital, Manchester
With the Breast Surgery Team at Wythenshawe Hospital, Manchester
This rotation offered dedicated exposure to microsurgical breast reconstruction including twelve DIEP flaps, a DUG flap and a number of nipple reconstructions and symmetrisation procedures. Joint oncoplastic clinics enhanced my understanding of patient assessment and shared decision-making. This was my first opportunity to witness high-volume microvascular breast reconstruction, and it provided exactly the level of exposure and technical clarity I hoped for when applying for the fellowship. The wealth of experience, mentorship and teamwork of the entire breast surgery team made this rotation exceptionally impactful. I also observed a rare case of shoulder reconstruction following forequarter amputation for sarcoma resection using an elbow joint incorporated osteomyocutaneous free flap from the amputated limb.
CONFERENCES/MEETINGS ATTENDED
BFIRST supported my participation in three significant academic meetings/conferences:
 
At the Royal Society of Medicine’s Breast Reconstruction MeetingBreast reconstruction: Global perspectives, past, present and future by the Royal Society of Medicine (Plastic Surgery Section) on 6th September, 2025 in London. Sessions covered the full spectrum of autologous breast reconstruction and innovations such as robotics, 3D printing, and exoscopes. The lecture on improving post-mastectomy breast reconstruction uptake in LMICs, using lessons from India, was transformative. It highlighted community- centred awareness campaigns and early engagement by plastic surgeons – strategies directly applicable to Nigeria. Meeting Mr Brian Sommerlad, whose cleft palate repair technique we use in Nigeria, was a memorable highlight. I was also inspired by the legacy of Mr Venkat Ramakrishnan, in whose honour the meeting was held.
It was an honour to meet Mr Brian Sommerlad at RSM’s Breast Reconstruction Meeting
BAPRAS Celtic Meeting 2025, Dundee (11-12 September, 2025): Strengthened my insight into cleft care quality assurance and international collaboration, reinforcing the importance of structured cleft service delivery.
At the BAPRAS celtic meeting in Dundee
Royal College of Surgeons’ Women at the Cutting Edge, Birmingham (17 October, 2025): An empowering meeting with talks on resilience, innovations, work life balance and leveraging social media for awareness campaigns. Meeting Miss Georgette Oni, who has long been an inspiration to me, was an honour.
It was an honour to meet Miss Georgette Oni at the Royal College of Surgeons’ Women at the Cutting Edge in Birmingham
SIGHTSEEING AND SOCIAL EVENTS
 
At Blackpool tower At Madame Tussauds’ Blackpool
I enjoyed the cultural richness of the UK, visiting the V&A Dundee, Discovery Point, River Tay, Newcastle United Stadium, Blackpool Zoo, Tower and Madame Tussauds. I had privilege of attending the retirement dinner in honour of Mr Peter Hodgkinson, one of UK’s leading Cleft and Craniofacial Surgeon and dining with the BFIRST Co-ordinator, Miss Kate Radcliffe.
With Kate Radcliffe
IMPLEMENTATION OF MY FELLOWSHIP EXPERIENCE
I intend to leverage partnerships with BFIRST, my UK and Nigerian mentors, the management of my
institution, NAPRAS, other stakeholders and policy makers to implement the following strategies in
Nigeria:
- Increase community awareness of Oncoplastic and Reconstructive breast surgery through outreaches and social media campaigns
- Establishment of an Oncoplastic and Reconstructive breast surgery service/centre in my institution especially microsurgical breast reconstruction
- Constitution of a soft tissue tumour MDT in my institution
- Implementation of comprehensive cleft care one-stop clinic similar to the RVI model in my institution
- Organisationn of annual skin cancer screening programmes for high-risk individuals using clinical examinations supported by dermatoscopy
- Establishment of a laser suite for scar management and treatment of benigh skin conditions in my institution
- Advocacy for the integration of comprehensive longitudinal cleft care and
- Oncoplastic/Reconstructive breast surgery into Nigeria’s National Health Insurance Scheme.
CONCLUSION
I achieved all my fellowship objectives and gained far more in mentorship and professional growth. I express my profound gratitude to BFIRST, the BFIRST Co-ordinator, my supervising consultants, all other consultants, colleagues and team members who contributed to my training. I also appreciate my fellowship buddies, whose support made my stay enjoyable and productive. I am grateful to my trainers at the University College Hospital, Ibadan; my senior colleagues and hospital management at my institution; my family and friends for the support. Finally, I thank BFIRST for the surgical loupes, which are now a valuable part of my surgical armamentarium.
With profound gratitude,
Dr Ebere Osinachi Ugwu
Consultant Plastic Surgeon
National Orthopaedic Hospital, Enugu, Nigeria
BFIRST Fellow in Taiwan
University Zaria, Nigeria is undertaking a one year fellowship in Taiwan, in microsurgery, at the E-Da Hospital in Kaohsiung, with Professor Seng-Feng Jeng. Dr Tobi Abass, from the Ahmadu Bello
Here he is raising his first independent ALT free flap!
We look forward to seeing more of his progress!
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Other
BFIRST BAPRAS Conference Pub Night
We will be at the BAPRAS congress in Belfast in December 2026. This year we will be hosting a pub night on the Wednesday at the Fountain Lane, kindly sponsored by Silimed!
This year we will be selling re-usable BFIRST surgical scrub hats! These will be debuted at BAPRAS. There will be limited numbers so make sure to come to the BFIRST stand to get yours as soon as possible!
Funds raised will help us educate and train surgeons in resource limited countries.
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!
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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.
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