Monday, August 27, 2012

Measuring Head Trauma Outcomes and Neurosurgical Capacity Building in Mbarara, Uganda

Patrick Codd, M.D.
Neurosurgery, MGH

Site: Mbarara University of Science and Technology, Mbarara, Uganda

As part of an ongoing effort to build a collaboration between the neurosurgery departments of MGH and MUST, I have been working with Dr. David Kitya to improve neurosurgical capabilities within this hospital.  Dr. Kitya was recently hired to assist with care of the extrodinary number of head trauma patients witnessed by the MUST hospital as the result of bodaboda (motorcycle) and car accidents, as well as care for the general neurosurgical needs of the community.  He has been exceptionally welcoming, and we have worked for the last week on several issues.

First, the neurosurgical drill (including cranial perforator and craniotome) generously donated by Stryker and deliered to MUST by several of my resident colleagues over prior visits, appears to have broken.  This has left Dr. Kitya using Gigli saws and Hudson brace perforators to perform craniotomies, with variable success.  I spent last week trouble shooting these devices, and we determined that several of the components may have been improperly cleaned resulting in electrical shorts and instrument failure.  We have devised a plan to 1.  return the broken components to the US for repairs prior to them being delivered back to MUST, and 2.  to create simplified and readily available instructions for proper cleaning and handling procedures to help prevent the issue in the future. 

Also, we have been working to fine tune the record keeping for head trauma patients presenting to the hospital in order to quantify not only patient outcomes, but to objectively track the benefit or lack therof in introducing the electrical surgical drill and other instrumentation into the the equipment list of this hospital.  Dr. Juliet, an extremely capable senior surgical resident at MUST has taken on the task to tracking these data and we will continue to support her work.

It is anticipated that this coming week will bring several operative cases that have been awaiting the completion of the new operating theaters.  Updates and pictures will be pending.

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