BFIRST in The Gambia: Building Foundations for Plastic & Burns Care (2024–2025)
BFIRST has undertaken two collaborative visits to The Gambia in partnership with GAMMED, and later Interburns, with the shared aim of addressing the significant unmet need for plastic and burns surgery while supporting the development of a sustainable, locally led service.
2024: Scoping, Education, and Identifying Need
In November–December 2024, BFIRST joined GAMMED for a combined clinical and scoping visit. While GAMMED delivered high-volume orthopaedic and reconstructive surgery, BFIRST focused on assessing the state of plastic surgery provision and training in the country, where no formal plastic surgery service currently exists.
BFIRST delivered a four-day introductory plastic surgery teaching programme to 20–30 multidisciplinary participants per day, including surgical trainees, medical officers, nurses, physiotherapists and students. Teaching covered core plastic surgery principles such as wound management, skin grafts, local flaps, hand trauma, lower limb trauma and burns, with a strong emphasis on practical skills. The visit highlighted excellent engagement from trainees, particularly during hands-on sessions, and revealed that for many participants this was their first formal exposure to plastic surgery techniques.
Clinically, the team identified an overwhelming burden of untreated and poorly managed burns injuries—particularly in children—leading to severe scar contractures and lifelong disability. Limited community awareness, lack of first aid knowledge, reliance on traditional treatments, and minimal access to reconstructive surgery were key contributing factors. This visit confirmed a clear opportunity for BFIRST to focus future work on burns prevention, early management and reconstructive training.
2025: Focused Burns Training and Capacity Building
In November 2025, BFIRST returned to The Gambia with GAMMED and Interburns, building directly on the findings from 2024. The focus shifted to burns care, prevention and service development.
Over the week, the team delivered structured Interburns Essential Burn Care (EBC) and Community Burns Care (CBC) courses to 63 participants from across the country, including doctors, surgeons, nurses, physiotherapists and traditional healers. The inclusion of traditional healers was a key step in addressing community-level burns management and fostering dialogue between formal healthcare services and community practitioners.
Alongside education, BFIRST prioritised in-theatre training, with local trainees actively scrubbing in and leading parts of complex burn reconstruction cases under supervision. These included severe paediatric and adolescent burn contractures requiring grafting and release, demonstrating both the clinical need and the potential impact of targeted reconstructive surgery.
Developing a Sustainable Future
Across both visits, BFIRST established strong relationships with Gambian trainees who are now pursuing, or about to commence, specialist plastic surgery training abroad. Together, they represent the foundation of The Gambia’s first plastic surgery service. The visits also
highlighted promising existing nursing and therapy expertise, alongside significant challenges related to equipment, dressings and infrastructure.
Working in partnership with GAMMED and Interburns has enabled BFIRST to deliver context-appropriate education, support local leadership, and lay the groundwork for sustainable service development. Future plans include continued mentorship, focused in-theatre training, burns prevention outreach, and long-term support for the establishment of a dedicated plastic and burns surgery service in The Gambia.