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Malawi Medical Journal

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Establishing a children’s orthopaedic hospital for Malawi: A review after 10 years

SL Dorman, SM Graham, J Paniker, S Phalira, WJ Harrison

Abstract


Background
BEIT CURE International Hospital (BCIH) opened in 2002 providing
orthopaedic surgical services to children in Malawi. This study reviews the
hospital’s progress 10 years after establishment of operational services. In
addition we assess the impact of the hospital’s Malawi national clubfoot
programme (MNCP) and influence on orthopaedic training.
Methods
All operative paediatric procedures performed by BCIH services in the
10th operative year were included. Data on clubfoot clinic locations and
number of patients treated were obtained from the MNCP. BCIH records
were reviewed to identify the number of healthcare professionals who
have received training at the BCIH.
Results
609 new patients were operated on in the 10th year of hospital service.
Patients were treated from all regions; however 60% came from
Southern regions compared with the 48% in the 5th year. Clubfoot,
burn contracture and angular lower limb deformities were the three most
common pathologies treated surgically. In total BCIH managed 9,842
patients surgically over a 10-year period. BCIH helped to establish and
co-ordinate the MNCP since 2007. At present the program has a total
of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has
overseen the full or partial training of 5 orthopaedic surgeons and 82
orthopaedic clinical officers in Malawi.
Conclusion
The BCIH has improved the care of paediatric patients in a country that
prior to its establishment had no dedicated paediatric orthopaedic service,
treating almost 10,000 patients surgically and 6,000 patients in the MNCP.
This service has remained consistent over a 10-year period despite times of global austerity. Whilst the type of training placement offered at BCIH has changed in the last 10 years, the priority placed on training has remained paramount. The strategic impact of long-term training  commitments are now being realised, in particular by the addition of Orthopaedic surgeons serving the nation.



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