History and Current State of Global Neurosurgery in Sub-Saharan Africa

Abstract

Archaeological sources reported traces of trepanation in ancient Egypt 3000 years ago, and Papyri of that time already described techniques for the treatment of head trauma (1).  The history of modern neurosurgery in Sub-Saharan Africa (SSA) is recent, and there are two significant periods to be considered.

The first period can be called the pre-independence period. This period corresponded to the 1950s, when most African nations were still colonized. During this period, neurosurgical care was delivered by surgeons originally from European countries. For instance, in West Africa, the first neurosurgical operations were carried out in 1957 by a French military medical officer at the Hôpital Principal de Dakar. Later on, in 1972, the first neurosurgical care delivery was organized in "Côte d'Ivoire" under Drs. Courson and Cournil. During the same period, neurosurgery service delivery developed in English-speaking West African countries. In Ghana and Nigeria, the discipline was introduced by local neurosurgeons who had trained in Europe, namely Dr. Mustaffa in 1962 (Ghana) and Dr. Odeku 1969 (Nigeria) (2,3,5). In Southern and Eastern Africa, the specialty was initiated by  Dr. P. Cliffort in Kenya and Dr. I. Bailey in Uganda. In Zimbabwe, Dr. Lawrence Levy was the first neurosurgeon to practice the discipline (2, 3).

The second period of Sub-saharan African neurosurgery started after the independence and showed greater involvement of African neurosurgeons. This period began in the 1970s, and among the local neurosurgeons, Drs. Mélaine Kouamé Kangah, Vincent Ba Zézé, and G Dechambenoit contributed significantly to the growth of neurosurgery in Ivory Coast. Similarly, Drs. Mamadou Guèye, Seydou B Badiane, and Y Sakho were pioneers in Senegal. Dr. Kazadi Kalangu did the same in Zimbabwe, while Dr. S Sanoussi and Dr. Wandja pioneered neurosurgery in Niger and Cameroon (2,3). In Burkina Faso, Dr. Abel Kabre, after his training in Dakar in the 80s, has successfully developed its specialty.