History and Current State of Global Neurosurgery in Sub-Saharan Africa

Abstract

Archaeological sources reported traces of trepanation in ancient Egypt 3000 years ago, and Papyri of that time already describedtechniques for the treatment of head trauma (1). The history of modern neurosurgery in Sub-Saharan Africa (SSA) is recent, and thereare two significant periods to be considered.The first period can be called the pre-independence period. This period corresponded tothe 1950s, when most African nations were still colonized. During this period, neurosurgical care was delivered by surgeons originallyfrom European countries. For instance, in West Africa, the first neurosurgical operations were carried out in 1957 by a French militarymedical officer at the Hôpital Principal de Dakar. Later, in 1972, the first neurosurgical care delivery was organized in "Côte d'Ivoire"under Drs. B.Courson and C. Cournil. During the same period, neurosurgery service delivery developed in English-speaking West Africancountries. In Ghana and Nigeria, the discipline was introduced by local neurosurgeons who had trained in Europe, namely Dr. JTO.Mustaffa in 1962 (Ghana) and Dr. JL Odeku 1969 (Nigeria) (2,3,5). In Southern and Eastern Africa, the specialty was initiated by Dr. P.Cliffort in Kenya and Dr. I. Bailey in Uganda. In Zimbabwe, Dr. Lawrence Levy was the first neurosurgeon to practice the discipline (2, 3).

Emerging nonpharmacological therapies for epilepsy management in Africa: a review of current trends

“…A randomised controlled trial conducted in Nigeria found that TMS significantly reduced seizure frequency in 40% of patients with refractory epilepsy [16] . Another study conducted in South Africa found that DBS significantly reduced the seizure frequency in patients with refractory epilepsy who had undergone resective surgery [17] . However, these interventions require specialised equipment and trained personnel and may carry risks of adverse events, such as headaches or seizures.…”

Assessing the impact of neurosurgery and neuroanatomy simulation using 3D non-cadaveric models amongst selected African medical students

“…Neurosurgery is a fast-growing medical specialty in Africa ( 1 , 2 ). Africa is disproportionately affected by the high burden of neurosurgical conditions ( 3 ), and the vast majority of African medical students have limited exposure to neurosurgery ( 4 ).…”

“…Neurosurgical anatomy is highly specific to the human brain and does not compare well with animal specimens. Moreover, the management of cadaveric models entails ethical concerns and high maintenance costs, as well as specific and highly equipped structures for their preservation ( 2 ). Moreover, many anatomists believe a medical student-cadaver relationship is essential in developing surgical skills and in developing proper attitudes toward patients ( 8 , 9 ).…”