Rwanda Needs More Neurosurgeons to save hundreds of patients on waiting list

By Elias Hakizimana.

A big number of patients who suffer from neuro diseases are waiting for insufficient neurosurgeon specialists every year to get treatment in Rwanda, yet this health condition can kill as it takes long without medical action.

Currently, 400 patients who were prescribed for neurosurgery at Kigali Teaching University Hospital (CHUK) a couple of years ago, are still on the waiting list.

This lack of enough specialized neurosurgeons is coupled with insufficient capacity and equipment in this medical domain, which most of the times delays the treatment procedure because the disease can remain unknown while a patient is suffering.

Josephine Mukangenzi, a patient from Nyabihu district, Bigogwe sector used to suffer from a non-stop headache and once at CHUK, medical doctors revealed she had brain tumor. She was referred for neurosurgery to remove a part of the tumor.

“They gave me an opportunity to proceed for a neurosurgery operation to remove a part of the tumor because it was too big and impossible to remove it at once, but, due to the holiness of the Almighty God, they have managed to remove the entire tumor and I am now safe and happy, may God bless the doctors,” Mukangenzi says.

This brain tumor survivor has spent a year sitting at home because of the severity of the pain.

Venantie Mukabera from Nyarugenge District, Kigali Sector is another tumor survivor who spent twelve months in hospitals without revealing the illness. She passed all possible medical checkups including CT SCAN but the illness was not uncovered.

“But they could give me some medications despite the illness was not known, since a month ago after revealing my illness, I got emergency help,” she says. 

“The doctor told me he has a very long waiting list of patients and what next was to wait, I was likely to forget the appointment, but he later called me to come for treatment. I received neurosurgery treatment unless this eye is not functioning, but there is a hope to recover according to my doctor.” Mukaremera adds.

Mukabera could feel some of the brain tumor’s symptoms which are headache and vision impairment in the right eye.

Dr. Sévérien Muneza Chief Consultant Neurosurgeon in Kigali Teaching University Hospital (CHUK) explains the journey of neurosurgery healthcare service in this hospital since 2005, saying that patients’ number keeps increasing day after another.

He commends the efforts of Rwanda Legacy of Hope (RLH) to invite medical experts from United Kingdom (UK) to support Neurosurgeons team at CHUK so that they manage to help at least 10 out of 400 patients who are on the waiting list since a couple of years.

“We expect significant interventions from these medical experts to reduce the number of patients who are waiting, we expected to treat 10 patients from Monday to Friday, these patients have severe brain problems and have been on the waiting list for a long time. It takes a time to operate them, and we currently have around 400 patients with similar cases. 10 operated cases are a milestone for us, because the waiting time is reduced for other patients,” Dr. Muneza says.

He explains that it can take up to 24 hours to operate one patient as most of the cases operated are very tough, like when tumors have reached the bottom of the brain. 

Only one (1) neurosurgeon is in Rwanda to treat over 2 million patients who need neurosurgery treatment every year, according to Dr. Muneza. 

“There is a need for 1 neurosurgeon specialist to treat at least 100,000 patients per year so that the waiting list becomes shorter. To date, 1 neurosurgeon is still attending to 2,000,000 patients,” Dr. Muneza says.

The Brain tumors that begin in the brain start as a growth of cells in the brain are called primary brain tumors. They might start right in the brain or in the tissue nearby and they can attack everybody according to medical experts.

Dr. Muneza suggests two possible solutions to curb the trending number of patients, including many temporary annual campaigns that involve foreign experts, and a long-term solution to train enough local neurosurgeons, to buy equipment and expand working environment. 

Lack of enough experts in the domain

However much the problem is reported as a burden, lack of enough neurosurgeons is not only for Rwanda, but also in other developing countries where neurosurgery is still an emerging healthcare service.

“But there is a progress in terms of mindset change between the last 10 to 15 years where the number of neurosurgeons was doubled and even tripled in developing countries. In Rwanda, many medical specialties especially surgery started few years ago, but there is a hope that many positive changes will happen in the next 10 to 20 years,” Dr. Muneza says, calling young students to join the domain.

Dr. Nyundo Martin, Head of Clinical Services Division in CHUK and Associate Professor of Surgery reiterates lack of capacity to treat many patients on time, making neuro diseases to remain a burden in the hospital.

“This service is available only in three hospitals in Rwanda namely CHUK, Rwanda Military Hospital (RMH) and King Faisal Hospital (KFH), a big number of patients come here to CHUK as a very known hospital, then the waiting list keeps increasing,” Dr. Nyundo says.

He says that the country needs to increase the number of specialists-surgeons, noting that there is a step made so far to train University Students, but the graduates remain few because of lack of materials and capacity.

 Neurosurgery Expert speaks out

“This is my first time in Rwanda, I am here for the last 6 days, and it has been wonderful to work with Rwanda’s Neurosurgeons, we have been doing several teachings and trainings on neurosurgery and we had complex cases of patients that need huge skills and knowledge,” says Dr. Sam Muquit,   Consultant Neurosurgery, UK.

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