In Uganda, thousands of children suffer from life-threatening neurological conditions such as brain tumours and hydrocephalus, many of whom require urgent surgical intervention from paediatric neurosurgeons. It’s estimated that over 4,000 children each year need brain surgery to treat these conditions, with hydrocephalus alone accounting for 1,500 to 2,000 new cases annually.
Ugandan paediatric neurosurgeons
Brain tumours, although less common, remain a significant cause of childhood illness and mortality due to delayed diagnosis and limited access to specialised neurosurgical care.
Unfortunately, Uganda faces a severe shortage of paediatric neurosurgeons and medical resources, leaving many children without the life-saving treatment they desperately need. Addressing this crisis requires improved healthcare infrastructure, increased surgical capacity, and greater awareness to ensure that more children have access to timely and effective treatment. Dr Ssenyonjo, neurosurgeon, is just one of twelve neurosurgeons for a population of 45 million.
Traditional Beliefs and Superstitions
Many communities attribute neurological conditions to supernatural causes. Some believe epilepsy or behavioural changes result from people practicing juju or that a child is possessed by demons. Unfortunately many think they can go to somewhere like Shine and get it sorted or others try religious prayers to see if they can cast the demons out.
Unfortunately, by the time they get to have a diagnosis the pathology is way bigger sometimes and in terms of functional recovery it becomes a problem or the risk of death is increased because of the volume of the pathology that may be needing to be operated.
Poverty and Limited Access to Specialists
Poverty plays a big part in peoples ability to get treatment. 100% off specialists are within the cities so once they’ve seen their local doctor they’ll have to get transport for a further diagnosis and treatment. Many struggle to find transport that leads the to either the right doctor who can access imaging to help make the diagnosis. With 70% of the population living in poverty many families have to balance feeding or educating their children and often affording transport isn’t an option.
Limited Bed Space
For a population of 45 million the number of beds allocated in government hospitals to the growing demand of neurological services is actually wanting even for the major hospital in the city centre. Because of issues with our roads most of the beds are taken up by trauma patients so non-trauma neurological conditions unfortunately end up being neglected because they’re not super urgent. Unfortunately, the more we wait the pathology is growing and by the time the patient gets seen, they may have lost the ability to walk or talk and even when we operate the outcome is not as good or comparable to other hospitals around the world.
Lack of Equipment and Technology
The world is advancing very fast in the field of neurosurgery and we are finding ourselves left behind. For example, we lack state of art microscopes that would help minimise functional arrangements during an operation, especially when operating on pathology in the eloquent areas of the brain so at times we find ourselves interfering with patient function some temporary, unfortunately others permanently.
We also can’t do standard neuro electrophysiological monitoring – which plays an important part the morbidity rates. I know in some cases we try, but if we compare ourselves to some of the centres around us, we find ourselves lacking behind.
Most theatre space is taken up by trauma patients so unfortunately patients awaiting an elective procedure, will always be squeezed off the operating list. We also don’t have a designated neuro ICU with appropriate equipment, enough beds or trained staff. There’s always a scramble for space as a result and this unfortunately bring in the delays In care especially of the non-emergency neurosurgical cases.
Advanced neurosurgical procedures require sophisticated equipment, including high-resolution microscopes and neuro-electrophysiological monitoring. Due to financial constraints, many hospitals lack these essential tools, increasing the risk of functional impairments post-surgery. Additionally, operating theatres are often overbooked with trauma cases, leaving little room for elective neurosurgeries.
Absence of Dedicated Neuro-ICUs and Rehabilitation Units
Proper post-operative care is critical for neurosurgical patients, but limited ICU space and a shortage of trained personnel hinder recovery. Furthermore, the lack of neuro-rehabilitation units forces many patients to remain in general neurosurgical wards, delaying their rehabilitation progress.
Humanity Direct is working hard with its network of surgeons to fund as many operations as possible. To find out more about the patients we help and how you can donate to fund an operation please visit: https://www.humanitydirect.org/patients/