Dr. Philip Stieg and Dr. Roger Härtl joined forces in June to head up this summer’s neurosurgical mission to Tanzania, where they provided treatment, consultation, and – most importantly – hands-on training to the local physicians who need to perform basic neurosurgical procedures year-round. In addition to patient care and surgeon training, this year’s mission included classroom instruction and practical instruction in neurotrauma, to allow local doctors to better respond to emergency cases.
Dr. Härtl, chief of spinal surgery and neurotrauma at the Weill Cornell Brain and Spine Center, makes an annual trip to Bugando Hospital in Mwanza in northern Tanzania, a regional center that serves a population of 14 million people. He led the faculty of this year’s Neurotrauma Course, co-hosted by Bugando Medical Centre, the Canadian Network for International Surgery (CNIS), and the Weill Cornell Department of Neurological Surgery. The course provided training to dozens of local surgeons and other health professionals who treat patients for accidents and injury, providing them with the skills they need for successful outcomes.
Dr. Stieg, chairman of the Department of Neurological Surgery at Weill Cornell Medical College and neurosurgeon-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, visited Muhimbili Orthopedic Hospital in Dar es Salaam, south of Mwanza. Dr. Stieg consulted on a variety of cases and personally performed some of the more complicated surgeries, including several large skull base tumors. (These complex procedures cannot be done in Bugando, which lacks the equipment needed for them.)
The annual mission is critical for doctors in East Africa, where neurosurgical training, and therefore neurosurgical care, is almost non-existent. Many patients suffer needlessly from traumatic brain and spine injuries, hydrocephalus, and birth defects, many of which could be successfully treated by trained physicians. Each year, Dr. Härtl and his team train local surgeons to perform basic neurosurgical procedures using locally available equipment and resources. The training also improves all other aspects of care — nursing, anesthesia, intensive care treatment, and general ward care.
This year, the Neurotrauma Course covered basic neuroanatomy and neuroimaging, treatment and management of traumatic brain injury, proper operating room hygiene, the use of surgical spinal instruments, portable neuroendoscopy, and more. In addition to classroom instruction, Dr. Härtl’s team selected 10 cases for surgery during their stay, including:
- A laminectomy with rod and screw stabilization on a young man with an incomplete vertebral fracture at T12.
- Trauma surgery on a teenager with a severe head wound. Skull fragments and necrotic tissue were removed and the wound disinfected, debrided, and closed.
- Several ventriculostomies for the treatment of hydrocephalus.
These cases illustrate the importance of basic neurosurgical training in these parts of the world. At least one life was saved, and many others were improved, despite challenging operative conditions and the lack of up-to-date equipment and resources. With proper training, local physicians can acquire the skills they need to treat these cases even in under-resourced facilities.
The relationship between Weill Cornell and our Tanzanian colleagues does not end when the annual mission comes to a conclusion. Throughout the year, conference calls and Skype sessions allow the Cornell team and their colleagues at Bugando and Muhimbili to discuss challenging cases and patient management. Promising surgeons from Tanzania are selected for short-term observational fellowships in New York, which not only provides African surgeons firsthand exposure to high-level neurosurgical care but also fosters collaboration and communication between the Cornell and Tanzanian teams once the fellow has returned home.
Download the final summary report (PDF)
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Photos courtesy Dr. Roger Härtl and Dr. Philip Stieg