Brain surgery in Uganda

Neurosurgeons explain how lack of advanced technology is danger to patients

The symptoms are ordinary enough in the initial stages; usually just headache that appears not to respond to treatment. But this soon advances in slightly more severe symptoms such as double vision, seizures, and difficulty in speech. At this point your doctor might give you some really bad news; you possibly have a tumor or swelling in your head.

After several tests, you might start hearing words like `meningioma’. This describes a swelling in either the brain or the spinal cords, which together are called the central nervous system and form the complex of nerve tissue that control body activity. The brain and spinal cord are wrapped in three layers of semi-porous sheets called meninges that allow certain things to pass and blocks others. This is where the particular tumor called a meningioma develops.

Dr. Michael Edgar Muhumuza; a senior consultant in neurology and a neurosurgeon, says about 8 in every 100 people suffer from them, making them the commonest kinds of brain tumors.

Some of the meningiomas are cancerous and quite dangerous. Fortunately these comprise only 10% of cases. The other 90% are non-cancerous or benign.

So, depending on the severity of your case, your doctor might recommend varying interventions – including surgery. At this point, the most financially able patients will opt for surgery abroad in USA, UK, India or even South Africa. These are considered to offer higher chances of better outcomes. For patients with limited financial means, local surgeons often step in to give assurance that meningiomas can be successfully removed in Uganda.

Locally, the fees range from anything between Shs7 million and Shs10 million. A similar surgery in India would cost Shs23 million. Therefore, at the level of cost, the decision appears pretty obvious. What about at the level of outcome? That is dicier.