Over a hundred neurosurgeons descended on Abuja last week for a conference. The 3rd Continental Association of African Neurological Societies (CAANS) Congress took place in Abuja, Nigeria from the 24th – 26th July, 2018. The choice of Abuja as a congress venue was born out of the desire to honor the West African sub region’s contribution to neurosurgery.
Abuja was clearly the obvious choice for this major conference in Nigeria. It is one of the safest cities in the world! The newly transformed Transcorp Hilton hotel also proved to be the obvious choice for a conference of this status.
So, neurosurgeons from Africa and many more from the international community booked flights, collected visas to Nigeria and poured into Abuja. An eclectic mix of the young and old, veteran and inexperienced, reputable and freshly-minted brain surgeons were at the Transcorp Hilton Hotel for the meeting. Indeed, Neurosurgeons from all parts of Africa (East, West, North, South and Central) and other areas committed to the trip to meet the important needs of populations in sub-Saharan Africa as far as neurosurgery was concerned.
This meeting was historical coming after an eventful conference in Cape Town, South Africa in 2016. The very first conference was of course, in Algiers, Algeria in 2014. This 3RD meeting aimed to further strengthen CAANS, since its formation approximately six years ago, and to bring everyone together once again to discuss the challenges and progress made in efforts to train Neurosurgeons for Africa.
Members of the CAANS Executive Committee, Professor BB Shehu, Congress President, Professor Sam Ohaegbulam, Chairman of the Local Organising Committee (LOC) and all Neurosurgeons of Nigeria, ensured that the conference was a massive success. The LOC delivered a great conference that actually spanned over 6 days. The conference had integral to it, training workshops and boot-camps for young neurosurgeons.
Some aspects of the meeting is as detailed below.
The number of neurosurgeons
Currently, there is one neurosurgeon to about 3 million people in Africa. This is wholly inadequate and neurosurgical care must be seen as essential health care, and not a luxury. Neurosurgeons still remain an endangered species, largely found only in the big cities.
Neurosurgical diseases and issues such as head injury, brain infections, hydrocephalus and congenital anomalies affect mostly the young in Africa. The young account for almost 50% of the community in Africa. So, increasing the number of neurosurgeons and having a neurosurgeon close to the people is actually paramount and justifiable for health in many countries.
Of note, the number of neurosurgeons in Africa and especially Nigeria has increased significantly in recent years. Nigeria currently has 81 neurosurgeons. This also includes about 5 female surgeons showing that the specialty has become fashionable despite the rigors of the training. Professor BB Shehu and Dr Ismail Nasiru were specially commended for the training scheme established in the North. This scheme in one of the two dedicated centres of excellence for neurosurgical training in Nigeria has produced a fair number of neurosurgeons, for service in the Northern part of Nigeria.
The other notable centre of excellence in Ibadan is not lagging behind. The University College Hospital, Ibadan has been the foremost training unit in Nigeria, producing the largest numbers of neurosurgeons for Nigeria. The unit led by Professors Temitayo Shokunbi and Adefolarin Malomo has continued to lead from the front, since the days of Dr Odeku. One must also mention the only private sector neurosurgical unit run by Professor Sam Ohaegbulam and accredited to train neurosurgeons in Nigeria (Memphys Neurosurgical unit in Enugu).
There is a need for capacity assessment survey which will aim to estimate the actual number of neurosurgery providers in each African country and to describe their training background, with particular note of public versus private practice, and task shifting/sharing practices. The need for a perspectives survey to learn about the neurosurgical community’s beliefs on the best way to move forward was also highlighted. Specifically, this survey is interested in learning about perspectives on the same issues of care delivery efforts, task-shifting/sharing, and research.
We discussed the need to train other health care workers in neurological support schemes, to compliment the work of the neurosurgeon, as members of a multidisciplinary team. The neurosurgeon is not an island and must work in a team for the benefit of the patient. In some communities, other surgeons such as pediatric surgeons may be trained in simple procedures to complement the number of capable hands available to manage the huge numbers of children with neurological diseases requiring surgery.
Political support was also stressed as a valuable tool for improvements in service delivery. Neurosurgical equipment is expensive and unaffordable for many communities without government support. Though the international communities are donating some materials, the commitment of government to funding the units is paramount and crucial. Government must be involved for this to work for real and to deliver solid dividends to the majority.
The CAANS hierarchy appreciated the presence of the President of the Federal Republic of Nigeria, ably represented by the Minister of Health, at the conference. This is important for ascent of the ideals and high hopes of the conference organisers.
The future is bright for Nigerian neurosurgery and CAANS as a whole!
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