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Report Working Visit Nov- Dec 2015

Bristol 29th December 2015

Main achievements:
1. Three Kathmandu juniors organized to undertake Fellowships in the UK:
a. Bishal Karki, Middle grade Plastic and Hand Surgeon; six weeks Bristol/Bath January to March 2015
b. Mohan Dangol, Hand Therapist; six weeks Bristol/Bath January to March 2015
c. Pramila Shakya, Cleft surgeon; six weeks Oxford/Bristol March to April 2015
2. Delivery of some 300kg of kit and consumables
3. Working trip organized to Kathmandu November/December 2015
4. Fundraising.
5. Change of Trustees – Seamus MacDonald (accountant) has resigned and Nola Mackie has been assumed as Trustee. James Lowther appointed as Charity Accountant

1. Fellowships
Funds were obtained for two Fellowships, one from the BSSH and one from BFIRST, and these were supplemented by funds from Working Hands to enable us to organize three Fellowships.
Suitable candidates were identified by personal contact – the regular work with the team in Kathmandu has provided good first hand information of the needs of the unit and the team members most likely to benefit from such trips.
BSSH Fellows:17th January 2015, for six weeks:
Bishal Karki: Middle Grade Plastic Surgery Trainee
Mohan Dangol: Senior Hand Therapist
Apart from Clinical duties shadowing DS in Bath, and attendance at Southmead Hospital Hand Unit (Bristol) both were awarded places on The Anatomy Dissection Course (Glasgow, February) and The Instructional Course on ‘Tendon transfers and Paralysis’ (Manchester, January)
BFIRST Fellow:8th March 2015 for 6 weeks:
Pramila Shakya: Senior Trainee, Cleft lip and Burns
This surgeon was attached to Marc Swan, Cleft Surgeon, in Oxford and was also awarded a place at the BAPRAS Burns Meeting (Manchester, March) and the Cleft and Craniofacial Meeting (London, April)
Reports and Thanks letters from the BSSH Fellows have been circulated to BSSH Council.

2. Delivery of Kit and Consumables
In the immediate aftermath of the earthquake we were unable to travel to Kathmandu since only recognized relief teams were allowed in. We concentrated on assembling and delivering essential consumables (the Kathmandu team sent a wish list). BSSH Council kindly assigned a one off award of £20000 for purchase of these items, which included microsurgical kit, antibiotics and analgesics and consumables.
Etihad provided generous free cargo allowances and we sent out 100kg of kit with Sarah Tucker, Consultant Hand and Plastic Surgeon In Oxford, in June. A further 200kg was sent out with Mark Cole, a UK based businessman who was travelling to Nepal in October and kindly delivered to Kathmandu.
To date, some £14000 of the allocated 20k have been spent on kit.

3. Working Trip/Surgical programme
The scheduled working trip to Kathmandu and to Lalgadh Leprosy hospital, scheduled for November 2015, was disrupted by a different crisis:
A new proposed constitution was rejected by the southern regions of Nepal which called for a transport strike. This was backed by India, which instituted a blockade to fuel and gas across the India/Nepal border. This has resulted in a relative paralysis of the country, severe shortages of daily goods, gas, fuel and medical equipment and a trebling of prices that coincided with dramatically reduced revenue (This blockade further added to the decline in tourism consequent on the earthquake). The blockade has been in place since early August and is still enforced at time of writing.
We were unable to travel to the south of the country. Janatpur, close to Lalgadh Leprosy hospital, was the focus of some of the worst social paralysis and violence (55 deaths to date). We would have been unable to reach Lalgadh (Internal flights suspended and roads blockaded) and patients would have been unable to come to meet us.
The Lalgadh trip was canceled and instead the team consisted of DS and a Burns Team (Peter Dziewulski and Bruce Anderson). We were able to operate and teach in Kathmandu. The widespread purchase of fuel on the black market, kept in open containers in the combined with obligatory cooking on open fires has resulted in numerous burns.
The civil strife, boycott and blockade are ongoing at time of writing (29th December). This is likely to result in deferment of the next surgical visit until the autumn of 2016.

4. Fundraising activities
Major Income:
The project continues to be supported mainly by Etihad and by the British Society for Surgery of the Hand (BSSH).
BSSH kindly provided the regular sum of £2000 per annum (This is renewed on a three year cycle)
Etihad once again generously provided free flights (which would otherwise represent the biggest expense of such trips).
Aviva Healthcare provided a particularly generous donation.
Nola Lloyd/James Mackie wedding June 2015: Numerous benefactors donated to the Charity in lieu of wedding gifts

Other donors large or small, provided a steady income. Other income came from remuneration for DS artwork, from patients and individual donors and from lecturing in schools and to other Charitable societies.

5. Change of (pro bono) Trustees
As above.

Donald Sammut
29th December 2015

November/December 2013 Trip

22nd November to 12th December 2013

The Hand Surgery team was expanded by the addition of Fiona Ormerod, GP and Ian Pearson, Dental Surgeon. The trip included treatment of patients and teaching in both The Kathmandu Model Hospital, Kathmandu, and Lalgadh Hospital near Janatpur, in South East Nepal. Ian Pearson conducted dental surgeries in Lalgadh, while Fiona Ormerod ran the outpatient clinic, seeing up to 400 patients per day, in collaboration with the Lalgadh team, whom she taught on various techniques.

Donald Sammut and Nola Lloyd operated daily in Lalgadh, teaching the local surgeons and two visitors from the Kathmandu team. They then transferred to Kathmandu and conducted a lecture  and tutorial programme to the team directed by Prof Shankar Rai, in Kathmandu Model Hospital and at Kirtipur Hospital where Prof Rai has established a new unit. This was, as in previous visits, as part of the Hand Surgery  training of the Plastic Surgery programme led by Prof Rai.

 Medical Team: Nov 2014 

Fiona cropped 2

FIONA ORMEROD: General Practitioner in Bristol with an interest in Tropical Diseases. This was her 4th trip to Nepal, providing and teaching Primary Care.

Ian Cropped

IAN PEARSON: In private Dental practice in Cambridge specialising in implant surgery. This was his 3rd trip to Nepal to provide dental welfare.

Lalgadh Hospital

NOLA LLOYD: Junior in Plastic Surgery in London and a Diplomate in Tropical Medicine. Member of the Working Hands team, organiser and fundraiser since 2010


DONALD SAMMUT: Consultant Hand Surgeon in Bath, Reading and London. Founder of the Working Hands project, Surgeon and Project Organiser, since 1999.

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