Good busy

Its been a busy 30 days.? Exactly a month ago today, I was meeting members of the Global Brain Initiative as we took our first tour of the hospitals that were to be used for the GBI 2024 mission in Accra.? This was the first time that brain surgery of such complexity was going to be done in 2 private hospitals, with no public hospital involvement.? And we needed to get everything right.

In the months before we had strategised during zoom meetings until we had chosen the cases that we thought would fit with a five day mission with little margin for error.? The last thing that could happen in such an endeavour was to have a patient stuck in the ICU in a private hospital with family having to pay expensive bills out of pocket.? This was going to be difficult, but there was no other way around it.? Vascular neurosurgery is not done in any of the hospitals in Ghana because we have neither the expertise nor the logistics for it.? And yet the top 5 killers of young people now include hemorrhagic stroke and traumatic brain injury.? The neurosurgical care spectrum over the last 30 years has grown significantly in Ghana, but continues to have a big lacuna, when it comes to blood vessel surgery .

The Global Brain Initiative is a group of vascular and skull base surgeons who do outreach surgery in the countries that do not have microneursurgical and vascular expertise, to facilitate the transfer of expertise in these delicate fields.? Now we had the patients, we had the hospitals : Accra Medical Centre and St Michael’s Specialist Hospital, and we also had eager staff who were going to make everything possible. We were good to go.? The team brought along some neurosurgical goodies, and we sorted out our own local readiness and talked to the first clients.? Consents were signed and then we were good to go.

The next 5 days were intense, with surgeries being done back to back in 2 operating rooms, equipment going back and forth between two rooms and sometimes between 2 hospitals. The evenings were spent going over cases in the conference room with didactic lectures on topical issues in neurosurgery.? By 6pm Friday, 11 procedures had been done on 9 clients, and only one of them remained in ICU. By 11pm the team was aloft in a Delta flight back to the US, and the local team was following up on all the clients on the ward and in the ICU.? By the end of the next week everyone had been discharged. 5 aneurysms had been clipped.? 5 people who had ticking time bombs in their heads prior to this mission, could look forward to normal life ahead of them, never having to worry about the possibility of the aneurysm rupturing in their heads. And 2 Ghanaian neurosurgeons had made history by clipping their first aneurysms.

The intracranial aneurysm is a type of brain vessel anomaly in which the vessel wall forms a blister either during baby development or from trauma.? This blister is a perpetual weak point in the vessel and it is only a matter of time before it breaks down (ruptures) and blood spills into the brain. Only 6 out of 10 people will survive a first aneurysm rupture, and if nothing is done about it, a second rupture is virtually impossible to survive.All of these 5 people had ruptured once before, so they basically have had lifesaving surgery.

In the 3 weeks following I have been on an academic pilgrimage, updating knowledge on paediatric neurosurgery at ISPN2024, and on brain and spine tumours at EANO 2024.? In the coming days, as I join my friend Dzidzo Dei Tutu to raise money to do further work in Ghana, I am grateful for strength and good health. There is still so much to do.

Aluta continua.