​In a landmark initiative, Mr Pranai Buddhdev, consultant paediatric orthopaedic surgeon from the UK partnered with the paediatric orthopaedic team at Muhimbili Orthopaedic Institute to transform the management of children’s femoral fractures in Tanzania. Supported generously by the I’m a HIPpy Foundation, this project has already made a significant impact on the care of children across the country, setting the stage for improved healthcare outcomes in the East African country.

Tanzania, with a population exceeding 70 million, faces substantial challenges in managing paediatric femoral fractures, especially with the high volumes that result from road traffic accidents involving motorcycles. Approximately 1,500 such cases are reported annually, many in rural areas lacking specialised medical care. Traditionally, these injuries have been managed by non-fellowship trained surgeons who favour open surgery including the use of solid intramedullary femoral nails, even in very young children aged 1 to 3 years. This practice, unfortunately, carries a high risk of complications such as avascular necrosis of the hip, infection, fracture healing failure, and places significant financial and emotional burdens on families.

To address these issues, our team organised a comprehensive two-day training course at the Muhimbili Orthopaedic Institute, Tanzania’s sole tertiary paediatric orthopaedic centre. The first day focused on lectures, providing theoretical knowledge and best practices, followed by a second day of hands-on surgical training in the operating theatre with six such patients with femoral fractures who presented over the previous 48 hours. This practical session emphasised the use of walking hip spica casts, a technique we have successfully popularised in the UK. This approach allows children to bear weight on their unaffected limb, facilitating early mobilisation and significantly reducing the need for prolonged hospital stays. The method not only alleviates the economic burden on families but also accelerates recovery, with casts typically remaining in place for only four weeks.

The training was well-attended, drawing 25 surgeons from eight different cities across Tanzania. This broad representation underscores the widespread interest and need for advanced paediatric orthopaedic techniques in the country. Each participant received a specially designed hip spica table, generously donated by the I’m a HIPpy Foundation. These tables, essential for the proper application of the casts, were obtained at a remarkably reduced cost of $100 each, thanks to the support and contributions of Dr. Maulin Shah and his team at OrthoKids Clinic in Gujarat, India.

Looking forward, we hope to utilise the Muhimbili Orthopaedic Institute’s facilities to continue training surgeons who were unable to attend this initial course. We aim to extend this valuable knowledge to medical professionals in places such as Zanzibar, Arusha, and Moshi and surrounding countries  ensuring that the benefits of advanced paediatric fracture management reach and benefit even more children throughout Sub-Saharan Africa.

We owe a deep debt of gratitude to several key supporters who made this project possible. The I’m a HIPpy Foundation’s Ms Regina Wilken, Dr Kishore Mulpuri & Mr Joel Sloan whose unwavering dedication to improving global hip health in children has been instrumental in bringing this initiative to fruition. Their financial and moral support has been crucial, and we look forward to continued collaboration to benefit even more children in the future.

Special thanks also go to Dr. Maulin Shah and his team at OrthoKids Clinic in Gujarat, India, for their vital role in manufacturing the spica tables at a discounted rate. Dr. Shah’s expertise and commitment have significantly contributed to the feasibility and scope of this project.

We are deeply appreciative of the warm welcome and collaboration from the team at the Muhimbili Orthopaedic Institute. Their dedication to advancing paediatric orthopaedic care in Tanzania has been truly inspiring, and it has been a privilege to work alongside such committed professionals.

Finally, the success of this project would not have been possible without the unwavering support of my team and family. Their encouragement and logistical support ensured the smooth execution of this ambitious endeavor, and their belief in the mission has been a source of strength throughout this journey.

The positive response to the training and the adoption of the walking hip spica technique indicate a promising future for paediatric orthopaedic care in Tanzania. We are confident that the skills and knowledge shared during this initiative will empower local surgeons to offer better, more effective care to children suffering from femoral fractures, significantly improving their quality of life.

As we look ahead, we are excited about the potential for expanding this program and continuing to collaborate with partners like the I’m a HIPpy Foundation and healthcare professionals across the region. Together, we can make a lasting impact, transforming paediatric orthopaedic care and providing hope to countless families.