With its intricate network of nerves and blood vessels, the human brain is a universe unto itself.
But sometimes, surgeons have to remove tumours that spread irregularly around the brain.
A little oversight may mean some bits of the tumour are not removed and they may regenerate.
Dr Sylvia Shitsama, Kenya’s first female neurosurgeon, says they are increasingly adopting the use of microscopy and endoscopy to access problems in the brain.
“The goal is to make this the standard practice,” she told the Star at a training session at the University of Nairobi’s Chiromo campus, during the 4th Annual Continental Association of African Neurosurgical Societies.
Dr Shitsama is a consultant neurosurgeon and a lecturer at Jomo Kenyatta University of Agriculture and Technology school of medicine.
“The microscope and endoscope allow us to visualise the tumour better,” she said.
The patient also has smaller incisions.
Endoscopy is a procedure in which a doctor uses an endoscope—a flexible tube with a camera—to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.
This procedure can be used to examine problems in the brain and in the spinal cord.
The more experienced neurosurgeons attending the five-day congress have been training the younger doctors to apply this procedure, at the sessions being conducted at UoN, the Aga Khan Hospital and at Kempinki Hotel.
“We need to demystify neurosurgery and encourage more women into the practice,” Dr Beverly Cheserem, a neurosurgeon at the Aga Khan University Hospital and one of the conference organisers, said.
Kenya has about 39 neurosurgeons covering the entire population, which is about one neurosurgeon for every 1.4 million people.
“We currently have 35 trainees. The goal is for the trainees to have the additional skills and to increase neurosurgical care,” Dr Shitsama added.
The World Health Organization recommends one neurosurgeon for every 200,000 people. The training takes about six years after the bachelor of medicine and surgery degree.
According to the University of Nairobi’s department of surgery, the practice of modern neurosurgery in Kenya began in 1950s when one Dr J F Jarvis is reported to have performed brain surgeries.
Peter Clifford, an Irish surgeon and ENT specialist, also performed a number of procedures but documentation is scarce.
In 1967, Dr Renato Ruberti joined the staff at Kenyatta National Hospital and later undertook postgraduate training in neurosurgery at the University of Padua Medical School, Italy.
He is accredited with founding neurosurgery in Kenya.
The first indigenous Kenyan neurosurgeon was James Nabwangu, who trained at Johns Hopkins Medical School in early 1970s through the Kennedy Airlift programme.
“He returned to Kenyatta National Hospital as the first indigenous Kenyan neurosurgeon. Unfortunately, he returned soon thereafter to Canada and we did not benefit from his expertise,” the department says.
Gerishom Mudanya was the first locally trained general surgeon to be selected for neurosurgical training in 1976.
The UoN started its Master of Surgery (MMed) in neurosurgery programme in September 2006.
“In 2011, Dr Wekesa Dismus and [Kaguri S Kanja] graduated through this programme as one of two totally locally trained neurosurgeons,” the department says.
“The department has noted with interest the number of top students who, after receiving their primary school examination results (KCPE), seem to express an interest in pursuing a career in neurosurgery.”
“There is still an acute shortage of neurosurgeons in the country.”
Edited by A.N
