With only four qualified neurosurgeons, the profession is critically under-staffed for a country of more than 30 million people. FILE PHOTO

Country seeking more students for neurosurgery

Patience Ahimbisibwe
Kampala

Uganda has four qualified neurosurgeons at Mulago National Referral Hospital. Medical experts are calling on the government of Uganda to support the training of more professionals to better cater for the population, which stands at more than 33 million people.

Neurosurgery is a medical treatment that deals with operation of the brain, spine, peripheral nerves and the arteries of the neck. Nixon Niyonzima always wanted to study journalism but never got support from those around him. For many of his friends, there was only one profession. That is how he finally found himself following the medical path.

Under a Duke Global Health Institute (DGHI) scholarship, Mr Niyonzima, a Makerere University Bachelor of Medicine graduate, is now studying a Master of Science in global health and wants to become a neurosurgeon.

If you paused and asked what interests him in the profession, you could get the most unlikely answer. “It is more about service to the people than the financial benefit,” he says.

Never mind that this is a field many people shy away from. With five years of under graduate study, a year on internship and another on up-country hospital attachment, going for another five-year course to master in neurosurgery is not easy.

“I always want to serve. It takes long to see the results when you start working. You have to learn to be patient. Otherwise many look at the time spent on the training and opt to join NGOs,” says Niyonzima, now in his third year. He plans to be an academic, a researcher, once he is done with the course.

The training focuses on chronic and non-communicable diseases and trauma in areas of neurosurgery, orthopaedic and spinal surgery, trauma management, physical therapy and rehabilitation, stroke and stroke prevention and pediatric malnutrition. To improve the situation in the country, the government has introduced a scheme that sponsors any student willing to study neurosurgery to improve on the enrolment.

According to Dr Edgar Muhumuza, a consultant neurosurgeon at Mulago Hospital, the government should support the training offered by the DGHI and Duke University, in order to increase the number of neurosurgeons.

“This work needs a lot of dedication and patience because we deal with emergencies and work long hours. It will be difficult for someone who is not interested to join because it is tedious,” Dr Muhumuza explains, adding: “We see over 100 patients a month and 30 to 40 of these need surgery, yet we can’t admit them because we are overwhelmed on the ward as the workload is too heavy and facilities are limited.”

Seeing the need for more neurosurgeons in the country, Dr Michael Haglund, codirector in the partnership between Mulago National Hospital, Duke University, DGHI and Makerere University, said an East African Neurosurgery Training Programme has been designed to train Ugandan surgeons in neurosurgery, who will then go to regional hospitals to provide neurosurgical care.

“Uganda has laws in place that are not enforced in compliance to helmet use,” Dr Haglund said during the tour of the Duke projects at Mulago Hospital. Dr Haglund hopes the number of neurosurgeons will have increased to 19 in 2020 and spread across the country. He, however, added that the government needs to support the project by providing residence for neurosurgeons and salaries to trainees to attract their service within the country.

Dr Isaac Alidria-Ezati Director of Health Services (planning and development) in the Ministry of Health said while there are challenges with salaries, there are still few students who apply to study neurosurgery.

“In this country, neurosurgery has been left behind yet this is an important area. Because people don’t apply to study it, we have put up a scholarship that binds the students for five years after which they can go and work where they want,” Dr Alidria-Ezati said.

Dr Alidria-Ezati said once the number of neurosurgeons increases, it will reduce the number of patients who seek their service outside the country.