Easing the Burden

Gift Helps Zambian Man Continue on Path to Becoming a Neurosurgeon

by Stuart Weinberg

Upper Right: Mark Bernstein observing work

Bottom Left to Right: Lashmi Venkatraghavan, Kachinga Sichizya, Boniface Chansa and Mark Bernstein

The first time Mark Bernstein
met Boniface Chansa, Chansa
was sitting in a Zambia hospital room with a gravely ill patient. The short encounter would change Chansa's life and, ultimately, improve the quality of medical care available in Zambia.

It was 7 a.m. The patient needed surgery to remove a brain tumor, but had also had multiple medical problems. Chansa, who worked
as a clinical officer at Beit Cure Hospital in Lusaka, Zambia, had been with the patient all night

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Teaching Awake Craniotomy in Resource-Poor Settings and Implementing it Sustainably.

OBJECTIVE:
Awake craniotomy for brain tumor resection has the benefit of avoiding a general anesthetic and decreasing associated costs (e.g., intensive care unit beds and intravenous line insertion). In low- and middle-income countries, significant resource limitations for the system and individual make awake craniotomy an ideal tool, yet it is infrequently used. We sought to determine if awake craniotomy could be effectively taught and implemented safely and sustainable in low and middle-income countries.

Howe KL, Zhou G, July J, Totimeh T, Malomo A, Mahmud R, Ismail N, Bernstein M

World Neurosurgery 80:171-174, 2013

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Reconnaissance Mission to the Neurosurgical Department in Kijabe Hospital, Kenya: A Call for the Submission of Ideas and Strategies.

During the past 3 years, Dr. Leland Albright has established a

neurosurgical presence in Kijabe, Kenya, providing much-needed

care to much of the regional population (primarily pediatrics).

Neurosurgery residents from the University of Nairobi rotate

continually through Kijabe Hospital and benefit from direct

involvement in a high volume of cases along with formal academic teaching and mentorship by Dr. Albright.

Mansouri A, Okechi H, Albright L, Bernstein M

World Neurosurgery 81:3-4, 2014

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Attitudes Towards Neurosurgery in a Low Income Country: a Qualitative Study.

OBJECTIVE:

The practice of neurosurgery is increasingly common in underdeveloped regions. Few studies, however, have examined the perspectives of neurosurgery patients in resource-poor contexts. The objective of this work was to adapt a study exploring the needs of neurosurgery patients in a tertiary care hospital in Canada to examine, for the first time, the perspective of neurosurgery patients within the context of a low-income country with limited health care resources.

Bramall AN, Djimbaye H, Tolesse C, Abebe M, Biluts H,
Bernstein M

World Neurosurgery 2014 May 14 (Epub ahead of print)

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The World Federation
of Neurosurgical Societies
Educational Course

Harare, Zimbabwe

by Robert Dempsey, MD

Zimbabwe is a country with 13 million people, previously rather prosperous under British rule, but suffered extreme economic decline over the past 10 years associated with decrease in their ability to provide medical care and closing of hospitals. However, Zimbabwe is now on the rebound with increased international investment and a return of some physicians. Based on WHO calculations, with 13 million people, Zimbabwe should have a minimum of 50 neurosurgeons but presently there are only 6.

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Dr. Dempsey (right) assisting staff

Volunteering in Haiti

Treating Hydrocephalus in Children

by David Sandberg, MD

Haiti is the most impoverished country in the western hemisphere. There are no neurosurgeons in the country who treat the many children with hydrocephalus and other neurosurgical conditions. In partnership with Project Medishare (www.projectmedishare.org), John Ragheb, M.D., a pediatric neurosurgeon at Miami Children's Hospital and the University of Miami Miller School of Medicine ,has developed a program to provide neurosurgical care for children in Haiti.

The program involves collaboration between a number of pediatric neurosurgery programs in the United States who rotate and travel to Haiti to provide care for these children, who would otherwise not receive any treatment. The ultimate goal is to create a training program so that appropriate care can be provided by Haitian neurosurgeons.

The following photos are from a trip in December, 2013 led by FIENS Secretary David Sandberg, M.D., who brought a team from Houston. They performed 16 neurosurgical operations, the majority of which were endoscopic third ventriculostomy and choroid plexus coagulation to treat children with hydrocephalus. This team plans an additional trip in December, 2014.

FIENS Haiti volunteer team

Patient with enlarged head from untreated hydrocephalus

Evaluating patients in the clinic preoperatively

David Sandberg, MD performing endoscopic third ventriculostomy with Chief Resident, Yoshua Esquenazi, MD

*FIENS is a 501(c)(3) organization.

Donations are tax-deductible to the extent allowed by law.

Visit our website at www.fiens.org