Suzanne Caragianis, Dr Philip Griffin (Plastic and Reconstructive Surgeon), Dr Michael Hayes (Orthopaedic Surgeon) and Megan Fitzgerald (Hand Therapist) visited Bhutan from the 17th February until 2nd March 2013, for two weeks of intensive hand surgery and hand therapy at the JDWNR hospital in the capital, Thimphu, and in the regional hospital in Mongar.

They worked side by side with the local surgeons, therapists and nurses from the Orthopaedic Department and Physiotherapy Department. In preparation of our visit, the Royal Government of Bhutan advertised these 'Hand Camps' on national television asking those with hand and upper limb injuries to register. The goal was to recruit patients from the more remote areas who would benefit from hand and upper limb surgery and who would otherwise not have such an opportunity.

Our successful fundraising efforts over the previous twelve months, allowed us to purchase two sets of Stryker surgical instruments which we donated to the local orthopaedic surgeons in both regions. The Orthopaedic Department in Bhutan was most grateful to all of the individuals and companies in Australia who donated funds for the purchase of this valuable equipment, which will enable more advanced procedures to be done and better outcomes for patients to be achieved.

We also transported large quantities of wound care and dressings, which were donated by St John’s Ambulance Service (SA), as well as five large boxes of donated upper and lower limb splints which were distributed to the hospital.

Dr Hayes and Suzanne took the intrepid 2 day road trip across five mountain passes to Mongar, where Dr Hayes undertook several hand and upper limb surgical cases and Suzanne helped Kuenzang set up a hand therapy room within the physiotherapy department and teach treatment protocols and splinting. We then returned to Thimphu to join Dr Griffin and Megan to undertake further surgery.

Dr Griffin and Dr Hayes undertook over 30 complex hand/upper limb and plastic surgery cases, as well as taught the local orthopaedic surgeons in current surgical techniques. Megan worked tirelessly in the hand therapy clinic in Thimphu with Norbu and the team, undertaking the post-operative splinting and hand therapy.

We also completed ward rounds each morning with the surgeons to role model the collaborative treatment approach between surgeons and therapists that is required to achieve the best outcome for the patients, as this is a new concept for them.

We also had the opportunity to meet with the Minister of Health from the Royal Bhutan Government, to discuss the goals and outcomes of our hand camp and propose strategies to maximise our expertise in future hand camps. These meetings have proved pivotal in building a collaborative relationship, which is essential for the sustainability of the project.

Another achievement from the preparation for this visit was that we successfully obtained funding from the Australian Hand Therapy Association and International Federation of Societies for Hand Therapy along with our charity, Southern Adelaide Health Institute Inc – Bhutan Fund.

This enabled us to sponsor Dr Ugyen Thinley (Orthopaedic Surgeon), Kuenzang, Norbu and Physiotherapy Technicians to attend the Triennial International Hand Surgery and Hand Therapy meeting, which was held in New Delhi in March immediately after our hand surgery visit. This opportunity allowed them to develop further specialist skills and make contact with many experts from around the world.

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