BFIRST in Zimbabwe

In 2024 BFIRST surgeons were invited to make a first visit to CURE International Children’s Orthopaedic Hospital, Bulawayo, Zimbabwe

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 seek to widen access, particularly to plastic and reconstructive surgery for populations around the world.

Plastic and hand surgeons Jamil Moledina and Drew Fleming, whose expertise is in congenital hand problems, were invited to the CURE hospital by Mr Andrew Hodges FRCS(Plast) and the Hospital Director, Mr Jonathan Simpson.  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 enabling them to help children in the future.

The Cure hospital has spacious, well-staffed wards with accommodation for parents next to the children’s beds. There is a 4 bed High Dependency Unit on the ward and a 20-bed dormitory to accommodate children and parents awaiting surgery. Many of these families had travelled from all over Zimbabwe.

The team first held a day-long clinic together with a Cure hand therapist, a visiting Plastic Surgery Registrar from Harare, and a senior nursing sister. There were 22 children for assessment. There were also three late arrivals over the following two days. Of these 14 were selected as suitable for surgery over the following four days in two operating theatres. Andrew and Jamil in one theatre and Drew and a Registrar in the other. In the latter part of the week, they were joined by Ms Faith Muchemwa, Plastic Surgeon in Harare and another plastic surgery registrar from Harare.

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. The visiting team undertook all 14 planned operations, including burn contracture releases with skin grafting, tendon transfers to improve hand function, and complex congenital hand procedures. They also performed perhaps the first operations in Zimbabwe switching a second finger to provide for a thumb missing at birth (pollicisation) and the microvascular transfer of a second toe to a hand, also for a deficiency present at birth. Despite some minor early hiccoughs, the team have had positive feedback on outcomes for all children since returning.

Feedback from the visit has been enthusiastic and further trips now a possibility. An additional aim would be to teach the Harare registrars some more of the fundamentals of hand surgery which they confess is sadly lacking in their current curriculum due to local theatre and expertise constraints in Harare.

Contributors: Jamil Moledina and Drew Fleming