Plastic surgeon and Operation Smile volunteer Dr (Wg Cdr) Ankur Pandya explains why training local teams in burns care and complex reconstructive surgery is proving so vital in countries like Nepal.

Plastic surgeon Dr (Wg Cdr) Ankur Pandya has been volunteering for Operation Smile since 2006. Based in the UK, he’s an expert in cleft surgery, congenital hand surgery, burns care and complex reconstructive surgery. These skills are in high demand in many of the countries where we work. 

Thanks to their specialist expertise, medical volunteers like Ankur, are having a significant and long-term impact on health services across the globe. An impact that reaches way beyond life-changing cleft surgery and a positive step towards meeting the shortfall of trained surgical specialists in many countries.

Keen to share his skills to benefit as many patients as possible, Ankur’s been involved in training and education programmes in countries like Mozambique, Palestine and Nepal. Training local surgeons to handle more complex surgical cases, improves outcomes for the many young patients currently waiting for specialist reconstructive surgery.   We caught up with Ankur recently after his return from Nepal, where his expertise in treating burns has proved invaluable for the young patients he met during his trip.  

Dr Ankur Pandya during the surgical programme in Nepal
Dr (Wg Cdr) Ankur Pandya during the surgical programme in Nepal. Photo courtesy of Ankur Pandya

Ankur tells us that during the winter months, burns injuries in children increase in frequency and severity due to the prevalence of open fires. Parents are often busy working to make ends meet, and unable to keep a constant watch on their children. He explains:

“I offered to go to Nepal in January, which they were pleased with because it’s the peak of the disaster season in terms of burns. I was joined by a surgical resident and an Australian theatre nurse who I’ve worked with before. As well as Dr Hebah Daradkeh, an Operation Smile global surgery fellow specialising in burns. I was in a position to help them with plastic reconstruction, clefts and paediatric hands. I have been recently appointed as a Visiting Professor.”

The training focused on techniques to manage acute burns and importantly, plastic reconstruction. Ankur recalls a patient he helped during the Nepal visit: 

“One patient we saw was heavily scarred all the way from her neck to her groin – so there was no breast tissue at all.  By the time I had finished operating, she had breasts. They don’t routinely do cosmetic surgery due to the pressures of reconstructive and trauma related work. One patient had a condition called ‘Poland Syndrome’ – an absence of the breast on one side. So I reconstructed that breast and showed the trainees how to do it.”

Although the local team may not be routinely involved in cosmetic surgery, Ankur is impressed by their skills. He calls them a ‘talented group of surgeons’ and has a great deal of respect for how they are handling surgical cases and acute burns. His involvement is not to ‘teach’ but to expand their existing skills by demonstrating new techniques and equipment they may not previously have had access to. 

We ask Ankur to explain what’s involved in treating acute burns and he tells us why these injuries require multiple interventions and are so costly in terms of time and resources:

“From the time a patient gets admitted, they require ventilation and fluid therapy to ensure they are kept alive. Then, they will need repeated operations to remove all the burnt areas, followed by multiple procedures to skin graft those areas. Once that is done, they require intensive therapy, physiotherapy, and occupational therapy to prevent stiffness and contractures. They also require special pressure garments. Now, each pressure garment is extremely expensive.”

Dr Ankur Pandya and other volunteers during the surgical programme in Nepal.
Dr Ankur Pandya and other volunteers during the surgical programme in Nepal.
Photo courtesy of Ankur Pandya

Ankur explains that in addition to ongoing care, patients with acute burns will often need psychological support. The process of adjusting to their appearance after being burned is deeply traumatic and understandably affects their self-esteem and confidence, “Many of them have altered body image, low confidence, and interpersonal problems due to their injuries. This is something I’m studying alongside the department, as they have a psychologist on-site. So, psychological care and support are areas where we can make a difference.” 

One of the patients whose story has really touched Ankur is an eight-year-old girl who has severe burns to her neck, chest, armpit and hand. Ankur explains that she will need multiple further surgeries and breast reconstruction when she’s old enough. He is keen to be there with her at that next stage of her treatment and already making plans for the equipment needed:

Her main surgery will really be when she’s about 12 or 13. When the breast starts developing, that’s when we will need to put a tissue expander create space possible to implant reconstructions. It’s a logistical nightmare, even if she was in this country. But she’s over there. So I’ve already started collecting equipment and everything else for her.

Dr (Wg Cdr) Ankur Pandya

Ankur is passionate about the difference he can make to the lives of these patients, many of whom are overlooked because of the scale and complexity of their treatment. He says: “The problem is that people with burns are the forgotten people. Because they’re not sexy to show before and after photos.” 

This passion drives Ankur to building strong bonds with the local hospital, to ensure future programmes can happen and he can return to help more patients in need:

“The fact that they have seen it fit enough to nominate me as a professor means they would like me to assimilate with them and come for regular teaching, training and working alongside them. I think it’d be very, very useful for me to take Operation Smile residents as well, because it’s a spectrum of work that they will be able to see is unique.”

Dr Ankur Pandya during the surgical programme in Nepal
Dr Ankur Pandya during the surgical programme in Nepal.
Photo courtesy of Ankur Pandya

Change a life today