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Dr Ncumisa Ji­lata is one of Africa’s youngest neu­ro­sur­geons

Neu­ro­sur­geon Dr Ncumisa Ji­lata rel­ishes the chal­lenges that every new day of­fers, to help

peo­ple on their paths to re­cov­ery.

At 29 Dr Ncumisa Ji­lata is one of Africa's youngest neu­ro­sur­geons. Ji­lata, who is based at the Steve Biko Aca­demic Hos­pi­tal in Pre­to­ria, de­cided on her un­usual ca­reer be­cause she saw a huge need for such skills in South Africa. “The trauma bur­den and the dis­ease pro­file in South Africa is vast, and the ra­tio of neu­ro­sur­geon to pa­tient is still quite scanty.”

She also rel­ished the chal­lenge: “Of course this is a chal­leng­ing field and served as the per­fect plat­form to ex­er­cise [all my] in­tel­lec­tual ca­pa­bil­i­ties.”

Neu­ro­sur­geons in­ves­ti­gate, di­ag­nose and treat med­i­cal and sur­gi­cal neu­ro­log­i­cal struc­tural ab­nor­mal­i­ties in the cen­tral ner­vous sys­tem, she ex­plains.The cen­tral ner­vous sys­tem in­volves the brain, spinal cord and the pe­riph­eral nerves.

“We are also pas­sion­ately in­volved in the re­ha­bil­i­ta­tion process of these pa­tients, which in­volves a mul­ti­dis­ci­plinary team ef­fort.”

She qual­i­fied as a spe­cial­ist in May this year. “It's a lot of re­spon­si­bil­ity but it is equally ex­cit­ing to have qual­i­fied,” Ji­lata says, adding that she feels very priv­i­leged to have been able to qual­ify as the youngest neu­ro­sur­geon.

Ji­lata grew up in Southridge Park, Mthatha, in the Eastern Cape.

The young spe­cial­ist talks of the ad­di­tional chal­lenges of be­ing a woman in a field where sur­geons have tra­di­tion­ally been male. “One needs a thick skin to break through such bar­ri­ers and show the pub­lic that it is nor­mal in 2017 to have a neu­ro­sur­geon who is equally com­pe­tent as [her] male coun­ter­parts.”

As she dis­cusses her be­lief that every pa­tient de­serves dig­nity and care, her pas­sion for and pride in what she does is ob­vi­ous. Ji­lata be­lieves this type of care im­pacts pos­i­tively on her pa­tients' re­cov­ery the im­pact is usu­ally recog­nis­able when pa­tients re­turn to the out­pa­tients clinic and ex­press their grat­i­tude.

Noth­ing typ­i­cal about a day in neu­rol­ogy

There is no such thing as a typ­i­cal day at work, Ji­lata says, be­cause every day is filled with dif­fer­ent ad­ven­tures. “We have a huge

spec­trum of patholo­gies and the day is di­vided be­tween re­view­ing the in­ten­sive care pa­tient unit, which is where the post­op­er­a­tive pa­tients who still need mon­i­tor­ing [are nursed], and the se­vere trau­matic head in­juries.”

The al­lo­ca­tion of pa­tients as well as the as­sign­ment of teach­ing the reg­is­trars and stu­dents is done in con­junc­tion with the head of de­part­ment.

A ward round is fol­lowed by a sched­ule of op­er­a­tions, “where the sur­geons operate on the elec­tive pa­tients”.

The most com­mon con­di­tions Ji­lata comes across in her work are mostly tu­mours in the cra­nial cav­ity or in the spinal canal.

“We also see a lot of vas­cu­lar ab­nor­mal­i­ties [the ves­sels that carry the blood around the body]. These in­clude pa­tients who have had strokes that are re­spon­sive to sur­gi­cal in­ter­ven­tion; some may have bled while oth­ers may have had vas­cu­lar com­pro­mise.”

Some of the tu­mours have a ge­netic cause, while some of the strokes are re­lated to the lifestyle of the pa­tient, she notes.

Prevent­ing brain in­juries

The one neu­ro­log­i­cal condition that can be pre­vented is trau­matic brain in­jury, Ji­lata says. “The most com­mon causes of this are mo­tor ve­hi­cle ac­ci­dents, pedes­trian ve­hi­cle ac­ci­dents and as­sault.”

She be­lieves more at­ten­tion should be drawn to this as such in­juries are an im­por­tant health con­cern and con­trib­ute to the coun­try's health bud­get. “Aware­ness cam­paigns about road safety are def­i­nitely a great way to de­crease the in­ci­dence of trau­matic head in­juries.”

Non-trauma con­di­tions, on the other hand, are “a bit trick­ier, as one is usu­ally not aware of the pres­ence of the dis­ease process un­til it presents it­self clin­i­cally.”

She ad­vises peo­ple to be vig­i­lant and aware of tell-tale signs like sud­den headaches or headaches get­ting worse over time, changes in vi­sion, or vom­it­ing, along with any neu­ro­log­i­cal changes like seizures or weak­ness of any limbs.

If any of these signs are present, her ad­vice is to seek med­i­cal at­ten­tion im­me­di­ately.

Im­pact of neu­ro­surgery to the econ­omy

Neu­ro­surgery has a pos­i­tive im­pact on the econ­omy, and on the coun­try, says Ji­lata.

Neu­ro­sur­gi­cal con­di­tions can be con­gen­i­tal or de­gen­er­a­tive and af­fect peo­ple re­gard­less of age or gen­der. “If these con­di­tions are left un­treated, the re­sults are usu­ally de­bil­i­tat­ing. This of course would im­pact on the eco­nomic pro­duc­tiv­ity of the coun­try.”

Young peo­ple in­ter­ested in a ca­reer in neu­ro­surgery should work hard at get­ting into med­i­cal school, she says. “There are eight med­i­cal schools in the coun­try and any of them is fine.”

As of Au­gust 2017 there were 219 neu­ro­sur­geon reg­is­tered with the Health Pro­fes­sions Coun­cil of South Africa.

To be­come a neu­ro­sur­geon, young peo­ple have to first com­plete an un­der­grad­u­ate de­gree which qual­i­fies them to prac­tice as a doc­tor.

“There­after, one must com­plete a year of com­mu­nity ser­vice. This is fol­lowed by med­i­cal of­fi­cer time and reg­is­trar time, which is the time in train­ing to be­come a spe­cial­ist.”

She sug­gests writ­ing the pri­mary ex­ams in surgery and ap­ply­ing for a post at a teach­ing hos­pi­tal. “Where there is a will there will al­ways be an op­por­tu­nity.”

Steve Biko Hos­pi­tal is one of a kind

Ji­lata loves be­ing part of the Steve Biko Hos­pi­tal fam­ily be­cause it's one-of-a-kind. “The man­age­ment of the hos­pi­tal epit­o­mises the prin­ci­ples that Steve Biko him­self would ap­prove of.”

She adds: “This is the only hos­pi­tal I have worked in where the pa­tient care de­part­ment is re­ally in­volved and does ev­ery­thing pos­si­ble to put the pa­tients first de­spite limited resources.

“This is a great teach­ing hos­pi­tal and I am proud to have trained here.”

Among her plans, Ji­lata wants to spe­cialise fur­ther in in­ter­ven­tional neu­ro­ra­di­ol­ogy, an in­ter­est­ing and del­i­cate spe­cialty that fo­cuses on the vas­cu­lar architecture of the cen­tral ner­vous sys­tem.

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