Professor Christopher Lavy, Consultant Orthopaedic Surgeon, has recently become a patron for Orthopaedic Research UK. Find out about the amazing work Chris has carried out in Malawi, Africa, as well as some other tips and facts you may be interested to learn about him.
What attracted you to leave your job in the NHS in 1996, and go out to work in Malawi?
Purely and simply the need. There were more than 100 orthopaedic consultants in London in 1996, while Malawi with 12 million people had none.
Once there, what was your biggest challenge?
Trauma, for the first few years it just dominated my work. Like UK road accidents are the biggest cause. My challenge was to develop a way of managing it up and down the country with virtually no implants or equipment.
What were you able to achieve?
That is a hard question to answer about 10 years of your life. The three things that have been the most rewarding in that decade were firstly developing a paramedic orthopaedic clinical officer service to deal with all the trauma, secondly building an orthopaedic hospital, and thirdly helping to set up a Central and Southern Africa College of Surgeons to serve not only Malawi but also the other 9 countries in the region.
What advice would you give to someone contemplating going to work in a third world country?
Firstly go for it. It is where the need is, it is rewarding and challenging. Too many people give it some thought but don’t take it any further then get trapped in a rut in the UK. Secondly investigate, visit, meet local surgeons and look at the options. Not all LMIC (Lower and Middle Income Countries) are the same. Talk to others from UK who have worked in the region. There will be different clinical needs, and almost certainly there will be training and research opportunities. Thirdly don’t be in a hurry to operate. When I ran the hospital in Malawi we had a lot of trouble with visitors from the West who just wanted to get started with big operations, sometimes with disastrous consequences because they made assumptions about equipment or facilities that did not exist. We made a rule for short term visitors that on your first visit you did not operate, but just got the lie of the land and an understanding of the pathology and the facilities. Fourthly always remember that you are a visitor and must respect local leadership and local systems.
What are the current routes into gaining orthopaedic practice in undeveloped parts of Africa?
In my opinion working directly with the Ministry of Health in government hospitals is the most beneficial in the long term, but it is a harder option to start with. For surgeons without a lot of international experience it is often better to start by linking up with an NGO or a mission organisation. In orthopaedics there are a number of organisations that will arrange short term working visits. The BOA has an overseas section called World Orthopaedic Concern. This is your first port of call.
Tell us about your exciting new projects?
I am working with the Ministry of Health in Zimbabwe and local colleagues to set up an orthopaedic hospital with an emphasis on training and research.
Here in Oxford we are also working with a partnership of UK and African orthopaedic surgeons and physiotherapists to develop a short course to teach the Ponseti technique of clubfoot treatment to healthcare professionals all over the continent. We are being very thorough and will have four pilots where we test out the course on people who have never treated clubfoot, as well as those with experience.
What attracted you to a career in orthopaedics?
To start with when I was a SHO the first orthopaedic surgeon I worked for was friendly, helpful and encouraging and let me assist in theatre which gave me a taste for the discipline. Later when I had to choose a career it was the fact that orthopaedic surgery was intricate and demanding and has dramatic results. It is also very varied. In my own career I concentrated initially on joint replacements and hand surgery while I was a consultant in London. Then when I was in Malawi I did mainly paediatric surgery, and now am concentrating on spines.
How did you get involved with ORUK?
It was back in the days when ORUK was the Furlong Research Foundation. We had just built the Malawi orthopaedic hospital and were successful in applying for a couple of grants that helped us to set out as a respected research and training centre.
What advice would you give to a young person starting out as an orthopaedic surgeon?
Welcome to the club. You will find orthopaedic surgeons a great bunch of people with enthusiasm drive and humour. We help restore injured and diseased bodies, taking away pain and restoring function. Quite frankly there is no better career. The training system is going through some changes and at the moment it is not fully clear how it is going to look, but whatever the training system remember that the patient is the most important person. Do your best for them and you will get the most out of your training.
Which three orthopod’s would you like to spend an evening with and why?
Art Themen, because I have just started playing the saxophone and need to be inspired.
Steve Mannion because he and I have just bought a London pied a terre and need to get the plumbing sorted.
Hiram Kite, because his method of manipulating the clubfoot has now been superceded by Ponseti and all we ever learn about is Kite’s mistakes. I feel he needs a quiet drink and a bit of sympathy.
What might we be surprised to know about you?
That I started in GP training and am one of a select few orthopaedic surgeons with a family planning certificate – well out of date now so don’t ask me for advice.Back to news
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