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Surgical skills training in Malawi and Ghana

Earlier this year a team of surgeons, including three UK consultants, a Zimbabwean consultant and a senior trainee from Ghana, travelled to Malawi and Ghana to teach the vital surgical skill of anastomosis.


Anastomosis is the surgical connection between two body channels, for example between blood vessels or loops of the intestine. In medical practice, it involves safely stitching together these types of channels and is a crucial skill in many surgical procedures. Mastery of anastomosis is essential to avoid life-threatening complications and to ensure successful outcomes in both emergency and elective surgeries.

About the workshops 

In April 2024, a team of surgeons, including three UK consultants (Clive Quick, Paul Gartell, and Lesley Hunt), a Zimbabwean consultant (Matthew Wazara), and a senior trainee from Ghana (Theophilus Anyomih), travelled to Malawi and Ghana to conduct the International Cambridge Anastomosis Workshop (ICAW). 

The ICAW aims to improve the skills of local surgeons by teaching precise hand-stitching techniques for anastomosis and training local trainers for future workshops. The program featured a “Train the Trainers” session with discussions, motivational talks, and breakout sessions on teaching surgical techniques and managing challenging trainees. Additionally, the Basic Surgical Skills (BSS) Course covered instrument handling, stitching techniques, and performing anastomosis. 

“It was good to learn to do things in the right way. This course has curbed the wrong approaches I had to instrument and tissue handling. It has overall built my confidence with the different organ systems handled.” 

Skill sharing and learning 

The workshop participants gained a versatile set of skills that they can apply to different surgical scenarios, particularly those involving abdominal organs like the stomach, bowel, and bladder, as well as the repair of damaged or blocked blood vessels. To ensure the learning was sustainable, local trainers were also trained to conduct future workshops with minimal assistance. 

The workshop was well-received in both Malawi and Ghana, with participants appreciating the comprehensive coverage of anastomosis techniques and hands-on practice. The positive feedback highlighted the lasting impact the workshop had on the medical professionals who attended. 

“Personally, I want to emphasize that I enjoyed the course very much and I am glad that you gave me the opportunity to participate as a trainer! Last week I went to one of the district hospitals to find out if they would be interested in providing some training for the Clinical Officer there. They have asked me to start BSS training, which I will be happy to provide. So, the training will be continued.” 

Dominik von Malsen, visiting Fellow and local trainer

Not only was the ICAW an opportunity for the UK team to share their expertise with trainees in Ghana and Malawi, it also served as a valuable learning experience for them. The team gained insights into working in low-resource settings, highlighting the need for contingency plans and the ability to adapt quickly to unforeseen challenges. This experience emphasized the importance of flexibility and preparedness in such environments. 

“It has increased my awareness of the importance of ongoing peer review and updates of the courses and workshops provided by UK teams in LMICs.” 

Lesley Hunt, Consultant Surgeon, Sheffield Hospitals and part of the UK team

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