The challenges and Opportunities of Global Neurosurgery in East Africa

The Neurosurgery Education and Development Model

Andreas Leidinger, MD; Pablo Extremera, MD; Eliana E. Kim, BA; Mahmood M. Qureshi, FRCSEd(SN); Paul H. Young, MD, PhD; José Piquer, MD, PhD


Neurosurg Focus. 2018;45(4):E8 

In This Article


The volunteer was recruited by the NEDF in 2017. He performed as a neurosurgeon coordinator (NC) during an 18-week stay from November 2017 to March 2018 at the NEDI. The selection process consisted of a series of interviews with Dr. José Piquer, the current president of the NEDF.

Objectives of the NC

The main objectives of the NC were as follows: management of patients, reinforcement of weekly academic activities, coordination of international surgical camps (ISCs), and identification of opportunities for improvement. The improvement opportunities were categorized as clinical, administrative, and sociocultural.

Management of patients involved performing scheduled surgical procedures twice per week, daily visitation of admitted patients, and medical management in the neurosurgical ward and intensive care unit (ICU). The NC was available 24/7 for telephonic consultations and emergency surgeries.

The NC served as organizer and field coordinator of several ISCs. The NC also kept in close communication with the ICU and local rehabilitative care teams, with which the NEDF has also established collaboration.

Finally, the NC interviewed local doctors, administrators, and government officials, such as two consecutive health ministers (Mahmoud Kombo Thabit and Hamad Rashid Mohammed). During these interviews, important social and cultural aspects of the current health situation in Zanzibar were discussed and recorded.

The Mnazi Mmoja Hospital and the NEDI

The NEDI is localized within the perimeter of the Mnazi Mmoja Hospital (MMH) in the city of Stonetown, Zanzibar. The MMH is the single tertiary care referral hospital in the Zanzibar archipelago (consisting of two main islands, Unguja and Pemba, and numerous other minor scarcely populated islets), which has 1.8 million inhabitants.[16] Currently, the NEDI acts as the single neurosurgical care provider in Zanzibar. As of April 2018, the NEDI is staffed by one trained local neurosurgeon, one fast-track trained local medical officer, and two other off-site surgeons who are receiving formal neurosurgical training abroad. The NEDI is codirected by Dr. Mohammed A. Haji, a local coordinator, and Dr. José Piquer, the president of the NEDF.

The NEDI has 24 inpatient beds, two outpatient clinic consultation rooms, one administrative office, and two dedicated neurosurgical theaters equipped with flexible beds, air conditioning, anesthesiology ventilators, and cardiac monitors, all provided by the NEDF. The NEDI's surgical storage holds over 30 boxes of surgical material, including all the basic materials to perform neurosurgical procedures.