History and Current State of Neurosurgery in the Gambia

Authors

Momodou G. Bah, Michigan State University College of Human Medicine, Lansing, Michigan, USA. Electronic address: bahmomod@msu.edu.
Cyrus Elahi, Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Kerry A. Vaughan, Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Lamin Dampha, Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Ebrima K. Manneh, Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Isaac Jabang, Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Jallow Zainab, Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Seydou B. Badiane, Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal.
Alioune B. Thiam, Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal.
Papa I. Ndiaye, Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal.
Mayguette Gaye-Sakho, Department of Neurosurgery, Grand Yoff Hospital, Dakar, Senegal.
Ousman Nyan, Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Charles A. Roberts, Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Rosseau Gail, Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Seattle, Washington, USA.
Ellegala Dilan, Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Sakho Youssoupha, Department of Neurosurgery, Grand Yoff Hospital, Dakar, Senegal.
John N. Jabang, Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia.

Document Type

Article

Abstract

BACKGROUND: Despite global efforts to improve surgical care access, many low- and middle-income countries, especially in neurosurgery, face significant shortages. The Gambia exemplifies this, with only 1 fully qualified neurosurgeon serving its population of 2.5 million people. This scarcity results in higher morbidity and mortality. OBJECTIVE: We aim to document the history and current state of neurosurgery in the Gambia to raise awareness and promote neurosurgery development. METHODS: The study reviews the Gambia's health care system, infrastructure, neurosurgical history, workforce, disease burden, and progress, with information derived from reference sources as well as author experience and interviews with key partners in Gambian health care. RESULTS: Neurosurgery in the Gambia began in the 1970s, facing constraints due to competing health care demands. Significant progress occurred much later in the early 2010s, marked by the initiation of Banjul Neuro Missions and the establishment of a dedicated neurosurgery unit. We report significant progress with neurosurgical interventions in the past few years showcasing the unit's dedication to advancing neurosurgical care in the Gambia. However, challenges persist, including a lack of trained neurosurgeons, equipment shortages such as ventilators and diagnostic imaging. Financial barriers for patients, particularly related to the costs of computer tomography scans, pose significant hurdles, impacting the timely diagnosis and intervention for neurological conditions. CONCLUSIONS: Neurosurgery in the Gambia is progressing, but challenges like equipment scarcity hinder further progress. We emphasize the need for addressing cost barriers, improving infrastructure, and fostering research. Engaging the government and international collaborations are vital for sustained development in Gambian neurosurgery.

Medical Subject Headings

Gambia; Neurosurgery (history, trends); Humans; History, 20th Century; History, 21st Century; Neurosurgical Procedures (trends); Neurosurgeons; Delivery of Health Care

Publication Date

7-1-2024

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

187

First Page

2

Last Page

10

PubMed ID

38575063

Digital Object Identifier (DOI)

10.1016/j.wneu.2024.03.155

Recommended Citation

Bah, Momodou G.; Elahi, Cyrus; Vaughan, Kerry A.; Dampha, Lamin; Manneh, Ebrima K.; Jabang, Isaac; Zainab, Jallow; Badiane, Seydou B.; Thiam, Alioune B.; Ndiaye, Papa I.; Gaye-Sakho, Mayguette; Nyan, Ousman; Roberts, Charles A.; Gail, Rosseau; Dilan, Ellegala; Lawton, Michael T.; Youssoupha, Sakho; and Jabang, John N., "History and Current State of Neurosurgery in the Gambia" (2024). Neurosurgery. 2003.
https://scholar.barrowneuro.org/neurosurgery/2003