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Examples of Patients and Problems

-- donated by Miss Hillary Robinson --

A 10yr.old girl presenting at an isolated mission hospital, where there is no orthopaedic surgeon, with a completely rigid upper spine from a form of juvenile rheumatoid. Prof.Jellis has considerable experience of operating on spinal TB and spinal trauma but would not attempt surgery on this case. The FlySpec Major Operations Fund would send her to a spinal specialist in South Africa but lacks the resources at present and is seeking donations.

A girl of about 11 yrs. presented with multiple skeletal dysplasias; NO nasal bone, NO tibia, deformity of the hands and multiple other deformities. Prof.Jellis has "Cattle-trucked" heh fibular and "put about half her pelvis into her leg". This girl typifies patients treated under the FlySpec Major Operations Programme which was established to treat those patients too lod to come under the Cheshire Homes Childrens' Programme and too complex to be treated in the out-reach hospitals. Patients are treated free of charge at ZIOH (Zambia Italian Orthopaedic Hospital), the Fund pays the hospital expenses ie. Hotel costs, drugs & dressings and theatre costs. The surgeons donate their services; when needed the Fund gives a grant towards the cost of travel to and from Lusaka.

more on Malawi

Aims of the Fellowship
To provide an experience of working within an orthopaedic service of a developing country, and to contribute to undergraduate and postgraduate training programs in orthopaedics and to assist with Orthopaedic Clinical Officer education.

To learn from and experience some of the problems and solutions encountered working in a different cultural and financial setting.
This fellowship would be of particular benefit to any trainee, who:

·       is considering working in a developing country in the future

·       has an interest in training and / or research

·       has a particular interest in paediatric orthopaedics, bone and joint infection, or wishes to gain experience and a better understanding of basic principles of the conservative management of trauma

·       has an interest in global health issues

Schedule Example:

Two six month placements working under each of our UK consultants:

Mr Jim Harrison (Medical Director and Research Coordinator)


·       Bone and Joint Sepsis, Musculo-skeletal sequelae of HIV

·       Lower Limb arthroplasty

·       Adult and paediatric trauma

·       General paediatric orthopaedics

Mr John Cashman (Director of Training)


·       Paediatric Orthopaedics and Traumatology

·       Limb Reconstruction

·       Adult and paediatric trauma

General Duties and Opportunities:

·       attend clinics and theatre sessions (each team has 9 operating sessions per week

·       help with teaching of OCOs both clinical and possibly classroom

·       perform weekly day trip visits to surrounding DGH’s assisting resident OCOs with opd clinic problems and advising, encouraging and teaching them in afternoon theatre sessions.

·       be involved with ongoing research projects

·       accompany the surgical teams on monthly trips to the North and central region of the country for provision of clinics and surgery.

Thereafter possibilities would be dependent on experience, skills and length of stay.


·       Rental of good quality accommodation in Blantyre.

·       Transport will be provided for medical commitments. No guarantee is given that a vehicle would be available for travel and weekend recreation, though sometimes this is possible.

·       Good nearby facilities of Blantyre with Sports club for swimming pool, squash, tennis, golf etc.

·       Good potential for cycling (especially mountain biking - though care needed onroads, climbing, walking and diving.)


This is not to be viewed as a holiday. Although great fun, conditions and work demand appropriate motivation (and often patience together with a sense of humour.  Candidates ideally should be in their last three years of training and have a current UK driving license and be physically fit.  Visas or work permits are not required, as the fellow is not in paid employment or practicing autonomously.

Take at least a 10 day holiday at the end. The country is stunning, as is adjacent Mozambique and Zimbabwe.  Talk to a previous volunteer prior to applying. Also discuss what to and what not to take with you.  Seek early approval of your own hospital consultants, the regional postgraduate dean, the SAC, the Regional Advisor in Orthopaedics, and hospital postgraduate tutor and PMETB.  This chronological order of affirming approval is often the most appropriated. As the process is in constant flux, we suggest you correspond with the incumbent fellow for advice.  Even if there are problems with taking unpaid leave, you may be eligible for up to two months (or even more) of paid study leave and of a further month of salaried annual leave.

Notify World Orthopaedic Concern regarding your application.

Apply early for funding:

·       WOC

·       Furlong Foundation ( )

·       Rotary Club Great Britain  ( )

·       Local charities

·       Drug companies and Orthopaedic manufacturers

Cost Estimates:

·       Airfare BA direct - circa £650 return

·       Accommodation - 400 - 600 US $ / month resident (includes all bills, including washing and ironing)

·       Cheap living expenses - circa 150 - 300 US$ / month


Mr Steve Mannion

The aim of the Fellowship is to improve the quality of care provided by the local Khmer staff. The fellow will therefore assist with the surgical workload and training, independently and under the direct supervision of Dr Gollogly. The complexity of cases will depend on the level of his/her ability and experience, and is suitable for a senior UK surgeon with an interest in paediatric orthopaedics, trauma and limb reconstruction either individually or in combination. Candidates should ideally have had experience in, or are able to adapt to, working in low resource environments.

The successful candidate is expected to work from 0800 -1700, Monday to Friday, with no on call commitments. It is expected that the period of tenure is at least 6 months, and ideally 1 year. The successful candidate is expected to supervise between 2 and 6 international medical students, who are involved in the clinical activity as well as working on research/audit projects aimed at regional publication.

The fellowship is funded through the University of Oxford by the Kadoorie Family and provides a monthly stipend with an additional allowance for flights, accommodation and insurance. The hospital also provides a 4x4 vehicle, for discretionary use. The funding allows for a very reasonable quality of life in an exotic and interesting location.