Doctor helping to make history in Ghana
Neurosurgeon trains and mentors counterparts in West African country
A top Lehigh Valley surgeon stood beside Ghanaian neurosurgeons last month as a 21-yearold woman’s life was saved from a brain aneurysm.
It was a historic moment for the West African nation. Doctors used an operating microscope to clip the woman’s aneurysm. The procedure and the technology has existed for half a century, but for Ghana, this was a first.
That’s why Dr. Walter Jean, chief of neurological surgery at Lehigh Valley Health Network, and two other American neurosurgeons were in Accra, the country’s capital, to show the Ghanaian doctors how these procedures are done so they can save lives on their own.
While Jean and his colleagues in the Global Brainsurgery Initiative were in the country, seven Ghanaian patients were saved, including a little girl with a tumor in her spinal cord.
Jean founded the Global Brainsurgery Initiative along with two neurosurgeon colleagues, Dr. Daniel Felbaum of MedStar Health’s Georgetown University Hospital and Dr. Hasan Syed of the University of Virginia Children’s Hospital, both of whom traveled with him to Ghana.
Jean said the country in which you are born and live shouldn’t be a barrier to getting even basic neurosurgical care, yet this is the reality for many. The group’s goal is to provide training and mentorship to surgeons and residents in underserved countries. The group previously sent doctors to Vietnam and Panama.
“The idea of going to these countries and clearing their list so to speak on surgical needs is ludicrous. I mean, we’re talking about hundreds of thousands of cases that need to be done and no one to do them,” Jean said. “We’ve discov
ered our utility is to open up the eyes and minds of local neurosurgeons as to what neurosurgery really ought to look like.”
Though Ghana has a population of roughly 35 million, it has just 22 neurosurgeons. There are about 16 times more neurosurgeons in the U.S. than in Ghana when adjusted for population.
Dr. Teddy Totimeh, consultant neurosurgeon at the University of Ghana Medical Center, said the visit was significant for Ghana; it’s the first time the country ever had experts in vascular and endovascular neurosurgery come to a public hospital ready to do this kind of work. He said just being able to watch how Jean prepared for surgery and interacted with fellow surgeons during procedures was instructive.
“To have them in my hospital and to have them do these cases with the residents watching, it was really an educational experience, but also just proof of concept that really this could be done and it was not so mysterious,” Totimeh said.
Totimeh said the lack of neurosurgeons, advanced training and material resources for neurosurgery in Ghana is because for the last several decades there was little to no investment by the country in neurosurgery.
“A lot of people would view neurosurgery as high end, high falluting, one of those things that you don’t have to deal with until
you’ve sorted out the basic needs of the country, the basic infectious diseases and stuff like that,” Totimeh said.
However, Totimeh said, neurosurgery is a basic necessity. In sub-Saharan Africa, traumatic brain injuries are the top killer of people ages 15- 45.
Ghana only has two operating microscopes like the one used in the aneurysm surgery in the entire country. Neither is at the two teaching hospitals in Ghana with neurosurgical residency programs.
With the exception of those who trained or studied in places like Europe or the U.S., most surgeons in Ghana don’t have any practical experience using operating microscopes.
Jean said another problem plagues countries like Ghana: The brain drain of talented medical professionals.
It is common for doctors born in these countries to leave for better-paying jobs and better overall standards of living in places like the U.S., Canada and Europe.
Totimeh said the next step for him is to return to America for training in vascular surgery, so that he can teach other doctors the advanced procedures.
He said the goal is to have several other neurosurgeons acquire similar skills and share this practical knowledge with surgeons throughout Ghana and possibly neighboring countries.
Jean said the Global Brainsurgery Initiative’s work to help Ghana is far from over.
He and his colleagues are going to try to persuade microscope companies to at least donate microscopes, even if they’re third- or fourth-hand ones.
“Microscope companies and the medical technology industry needs to step up and say, ‘OK, we need to … right this wrong,’ “Jean said.
Jean added that he, Felbaum and Syed will provide professional assistance and mentorship to the surgeons they met in Ghana, including assistance in writing research papers and getting those papers published in academic journals.
Jean said he and his colleagues will also work on improving the Global Brainsurgery Initiative. He said they want to expand the number of teams in the initiative, allowing them to visit more countries. They are also setting up a more consistent and modern fundraising structure.
For now they are asking anyone who wishes to financially support them to donate to the Foundation of International Education of Neurological Surgery, which has provided funding and support for their trips.
Though these trips are eye-opening for the surgeons and surgical residents in the countries they visit, they are also eye-opening for Jean and his comrades.
“My goodness, we waste so much here, we take so much for granted. Not that we can’t improve our access locally for the American population, but it inspires us to stop whining about so many things in our day-today lives,” Jean said.