Latest member of The G4 Alliance has joined InterSurgeon too, right before Global Surgery Day, 25th May. Derek Johnson discusses NeuroKids, joining InterSurgeon and what’s next.
NeuroKids: the beginning
In May, InterSurgeon had the pleasure of speaking with Derek Johnson, CEO at NeuroKids. NeuroKids specialises in helping children with hydrocephalus and spina bifida live longer and better lives through comprehensive training, innovative treatments, and dedicated mentorship and support. They specifically train in the Warf procedure, a low-cost alternative to shunt insertion which combines two procedures, endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC). Pioneered in Uganda by Dr Benjamin Warf, dozens of US neurosurgeons travelled to Uganda to be taught the technique; “Dr Warf, the founder of NeuroKids, pioneered this technique over 20 years ago in Uganda. He was getting great success with it- he published his results and was getting a lot of attention. It attracted people like Jim Johnston [InterSurgeon founder] and other surgeons from the States to go to Uganda to learn how to do it.”
“Dr. Warf pioneered this technique in Uganda out of necessity because he knew shunts were going to fail and he knew that kids with shunt failures were in settings where they were probably not going to survive. So he was looking for a way to treat it better and through a series of happenstance and intellect, he combined a couple of therapies: ETV & CPC, and when he combined those two things for children less than one year of age, it doubled the success rate of endoscopic treatment for hydrocephalus. That became known as the Warf procedure. But we had over a dozen U.S. Neurosurgeons, two or three from the UAB, come to Uganda between 2012 and 2013 and they learned how to do it. They were taught by Ugandans and then went back to the U.S. They were now offering this treatment for children in the U.S., which is kind of a nice story about innovation in Africa helping people in America. And the same for the UK. We’ve had several UK surgeons come over and learn how to do this and are now doing it back in the UK.”
“Over the years, dozens of surgeons from around the world, mostly from LMICs, come to Uganda. But all along we knew that that’s a tough model to scale. You’re bringing surgeons out of their home country for two to three months at a time. And in some cases, they may be the only neurosurgeon in the country. And so then you’ve got a country, for example Malawi, without a neurosurgeon for three months. That’s not good. The cost of doing that and just the disruption of the host site, it really slows things down. We were always looking for a better way to scale training.”
Weathering the pandemic
The pandemic shifted things quite considerably once travel was restricted and so face-to-face mentoring became impossible, so they looked to technology to find answers for more sustainable mentoring options; “When COVID happened, [We knew that] Jim Johnson had been using Help Lightning [free to all InterSurgeon members] so we were familiar with it. But all of a sudden, there was this proliferation of these different technologies coming out through the pandemic. And we thought- we could build a scalable training model whereby we still provide hands-on training over a very short, intensive, one-week period, and follow that up with remote mentoring. We felt like the endoscopic procedures are really prone to succeed under this model because everything we’re doing is through a monitor. I remember Dr. Warf telling me years ago, ‘after somebody does this case two or three times (hands-on) then I’m just over their shoulder, kind of advising them and mentoring them. I could do that from anywhere.’ And so, rather than just being over their shoulder, he’s sitting in his office in Boston and being able provide this kind of real-time mentoring support to surgeons anywhere in the world.”
“Now we’re not asking neurosurgeons to leave their home countries. We’re going to them so that we train them with their people, their tools, in their hospitals. That way, there’s not a shift when they go out of a centre, like Uganda or UAB, and go back to their home country which may be nothing like what they were trained in. We’re training them on-site and we do that for a week, and then we follow it up with 6 to 12 months of remote mentorship.”
“So that’s kind of the idea. Honestly, we’re building on the backs of giants like Jim Johnston, who was doing this in Vietnam before we were. But we really wanted to scale the Warf procedure. We thought how do we train the most surgeons in the shortest, most effective and efficient amount of time? And that’s why we started NeuroKids.”
A new model
Now, in 2025, NeuroKids is ready to start moving to a more proactive model rather than reactive and use the InterSurgeon platform; “Historically, up until now, we’ve been very reactive, meaning surgeons reach out to us to be trained on the Warf procedure [at their site]. We go through a series of processes to determine if it’s a good site for us and, more often than not, we end up partnering in that location. As an organization, we want to start pivoting to being more proactive and that’s where I think InterSurgeon can really help. If we’re going to places that we don’t have history with or familiarity, like Mali, West Africa and going through InterSurgeon, we can see who’s connected to InterSurgeon in Mali that could really help us on the ground. I know it sounds very basic, but that’s how I’ve envisioned the connection with InterSurgeon.
InterSurgeon and NeuroKids
NeuroKids are new members of InterSurgeon partner, The G4 Alliance, and have also joined The Global Health Council. They are also available to help with equipment and services; “we want to continue to grow and so that more surgeons can take care of more kids, but we also invest in places where we already are so that if, you know, anaesthesia provision is a problem in one of our sites, we ask “Who are the partners?
What are the investments we need to make to help in that location” And so that’s where I also see InterSurgeon helping. Spina bifida is a great example. We’re a group of neurosurgeons and children with spina bifida are going to need urologic care, orthopaedic care, therapy and more. That’s kind of outside of our wheelhouse. Who are the partners in a specific location that can help with those things?
That’s where I also think InterSurgeon can really help us connecting to other specialties.”
To see the NeuroKids profile, click here.
