BFIRST in Tanzania
Dar Es Salaam in Tanzania has been a focal point for BFIRST visits since December 2018.
The British Foundation for International Surgery and Training (BFIRST) is a U.K based charity whose vision and mission is to promote global plastic surgical training, and the development of independent, high quality clinical practice in resource limited countries. Through multidisciplinary collaboration, BFIRST seeks to widen access, particularly to plastic and reconstructive surgery for populations around the world.
Visits to Tanzania have evolved over time to address critical needs and forge meaningful, sustained partnerships. The latest visit in July 2024 comprised three plastic and reconstructive surgeons led by Naveen Cavale, Chairman of BFIRST, two plastic surgery registrars and two advanced plastic surgery nurse practitioners. Having gathered information about what demand there may be for plastic and orthoplastic surgery training at a prior visit, they delivered a pilot training programme. This took place over a week at the Comprehensive Community Based Rehabilitation Tanzania (CCBRT) Hospital, in Dar Es Salaam.
By establishing and nurturing relationships with surgeons, nurses and allied healthcare professionals, they hoped to teach and train independent practice in local teams. This would in turn encourage attendees to go on to lead and teach colleagues, particularly in more remote locations. In Tanzania, as in many similar places, there is particular demand for training in trauma, particularly lower limb, hands and burns, the management of scars and birth anomalies. Training topics included wound care, dressings, and negative pressure therapy, lower limb trauma, scar contracture, local flaps for wound cover, hand surgery and microsurgery. Local medical and paramedical staff also learned to manage specific complications arising from each area.
Classroom based teaching was complimented by supporting the local teams in their outpatient clinics, simulated surgery and in-theatre supervised operating. The hand surgery sessions included injury assessment and tendon repair, whilst the microsurgery covered nerve and blood vessel repair, as well as flap monitoring. This was complimented by the advanced nursing staff teaching chronic wound management techniques and patient monitoring.
Cases managed in theatre included, scar contracture release or revisions, and congenital hand deformities. The local lead plastic surgeon Dr Wayi also had the opportunity to take the visitors through one of the 500 cleft palate repairs he undertakes each year.
There were also opportunities for team building and socialising between the local and visiting teams, further cementing relationships. The visit concluded with the exchange of contacts so that the local clinicians could obtain ongoing general management advice and discuss specific post operative care for the patients operated upon during the week.
BFIRST intends now to conduct regular bi-annual training programs in Dar es Salaam until at least 2029. These will continually improve the skills of Tanzanian plastic surgeons whilst indentifying potential local trainers who may sustain the initiative in the long-term.
Contributor: Naveen Cavale