A Request in or around Freetown from University of Sierra Leone Teaching Hospitals Complex

Description of Request

Over a five-year period, 2,295 neurosurgical patients were seen at the Connaught Hospital of the University of Sierra Leone Teaching Hospitals Complex. Three hundred and eighty-three of these were pediatric neurosurgical cases. One hundred and eighty-five (48.3%) of them had hydrocephalus. Shunt operations were performed on a small percentage of these patients, and the mortality rate was high, with most deaths due to post-operative infections. At the same time, 1395 non-emergency adult neurosurgical cases were seen in the surgical outpatients. The most common cases were degenerative diseases of the spine. However, there were 101 head injuries, 289 spine deformities, and 30 Pott's diseases. Finally, 517 adult neurosurgical emergency cases were recorded. Patients with traumatic brain injuries were the most common, accounting for 237 (45.8%). There were also 75 (14.5%) Spinal cord injuries. During the same period, the country lacked neurosurgeons. Only one pediatric surgeon was able to perform shunt surgeries on top of the pediatric surgical workload he was already dealing with in the hospital. In addition, there is a general who performs burr hole surgery in a private hospital occasionally. That is the extent of the expertise available to deal with a yearly caseload of 327. Given that this data was collected retrospectively in a hospital with poor medical records, it is clear that the disease burden is much higher.
It is critical to establish a neurosurgical service in the hospital in order to reverse this unfortunate situation. In addition, there is a need to improve research capability to better understand the dynamics of neurosurgical conditions in Sierra Leone. Furthermore, research capabilities must be improved to better understand the dynamics of neurosurgical situations in Sierra Leone.