The Importance of Collaboration in Global Neurosurgery


  • Anthony Fuller Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA
  • Michael Haglund Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA




Collaboration, the kind built upon mutual respect, trust, and a shared vision, is the only reasonable approach to the immense challenges faced by the field of global neurosurgery. We must develop collaborations that foster the free flow of knowledge and resources to ensure that all patients, regardless of geographic location, have access to timely, safe, affordable, and effective neurosurgical care. Developing global, multi-institutional collaborations requires that all parties confront the realities of racism, colonialism, paternalism, and many other isms along with the true magnitude of the problem. Over the past two decades, our Duke Global Neurosurgery and Neurology (DGNN) team has strived to live up to these ideals. We are constantly adapting and evolving our collaborative approach. 


DGNN’s initial collaborative work brought together Makerere University College of Health Sciences, Mulago National Referral Hospital, and Duke Health to provide direct neurosurgical care to patients in Uganda. Our shared principles of twinning guided our care delivery (pairing team members for bilateral knowledge exchange), training (developing new neurosurgeons in Uganda), and technology (providing the necessary equipment to perform neurosurgery) (1). This approach has led to 25 neurosurgery camps, over 500 total camp operations, over 5 tons of donated medical equipment and consumables, the establishment of neurosurgery residency programs, three neurosurgery units, and has more than tripled the number of neurosurgeons in Uganda, to date (2,3). Building, maintaining, and strengthening trust is the most important factor that underpins our collaboration’s success. Trust has been built through open and honest conversations, shared decision-making responsibilities, consistency over the years, and the shared vision of improving access to neurosurgery for all Ugandans.