Without Borders

Editor's Blog

  • Fumbled Priorities and Lost Perspectives: Epilepsy in LMICs Today
    Gretchen L. Birbeck, MD, MPH

     

    Three cheers for Dr. Mamta Bhushan Singh whose candid editorial in the November issue of Seizure really sums up the problems of epilepsy research and care in the developing world today. 1  Such a maddening paradox—70% of epilepsy cases would respond to basic treatment, if provided. And rather than expending efforts to assure we put systems in place to roll out sustainable care to the masses, we in the global epilepsy arena continue to focus most of our attention and resources on the 30% of patients with treatment resistant epilepsy. This approach might make sense in developed settings, but certainly not in low and middle income settings where the treatment gap really hasn’t budged in more than two decades.

    Continued...

    November 13, 2018
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  • Global Stuff You Should Know

    Building Research Capacity in Sri Lanka
     
    John Phillips, MD Professor and Director of Child Neurology Medical Director, The Mind Research Network University of New Mexico Health Science Center USA
    JIthangi Wanigasinghe, MBBS Senior Lecturer & Specialist Pediatric Neurology University of Colombo, Faculty of Medicine Sri Lanka
     

    The numbers paint a stark picture. Sri Lanka is one of the world’s most rural countries.1 Eight child neurologists serve the entire population of ~ 5 million children who are under 14 years of age. Of these children, those with developmental disabilities are particularly vulnerable, because of difficulties with access to care related to shortage of western rehabilitative services. These treatments are often prohibitively expensive and sometimes considered culturally inappropriate. It is an unfortunate fact that while 80% of the world’s children with developmental disabilities live in LMIC such as Sri Lanka,2 most research is conducted in higher income countries, often in the US or Europe. Thus, particularly in the area of developmental disabilities,3 there is a clear need for greater engagement of LMIC in clinical research.

     
     
    Neurology Outreach Clinic for HD in Peru: A Model of Care Provision on Exiting the Capital City
     
    Gretchen Birbeck, MD, MPH, Without Borders Editor, Rochester, NY interviewing Anastasia Vishnevetsky, MD and Mario Cornejo-Olivas, MD, of the Instituto Nacional de Ciencias Neurológicas and Instituto Nacional de Ciencias Neurológicas, Lima, Peru
     
    In this week’s edition of Neurology there is a must read for anyone pondering how one might provide multidisciplinary neurologic care to a population with a substantial burden of disease in an area with very few but some neurologic expertise.1 The impetus for developing the program described by Vishnevetsky and colleagues was the very high burden of Huntington’s Disease (HD) in the area around the Cañete valley about 3 hours outside of Lima. HD occurs at rates ~4 times expected. Through 2 days of clinic and community-based outreach provided every 3 months, they are able to bring specialty care and critical home-based assessments to not only the HD population but the broader group of people in area with chronic neurologic disorders. As I was reading their description of what they are doing and how they are doing it, several questions same to mind. Dr. Anastasia Vishnevetsky and Dr. Mario Cornejo-Olivas have kindly agreed to answer them for us here.
     
     
     

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  • On The Road

    Congress Report: The 23rd World Congress of Neurology, September 16 - 21, 2017, Kyoto, Japan

    Steven L. Lewis, MD, Rush University Medical Center, Chicago, Illinois, USA and Wolfgang Grisold, MD, KFJ hospital, Vienna, Austria

    We are pleased to report on the XXIII Congress of the World Federation of Neurology, which took place from September 16 - 21, 2017 in Kyoto, Japan. This report is based in large part on our report on the World Congress that we recently published in World Neurology (1), the WFN’s official newsletter. Interested readers are also encouraged also to sign up for a free subscription to World Neurology.

    The World Congress of Neurology is the premiere international conference of the World Federation of Neurology (WFN) and occurs every two years, rotating among each of six major regions of the world, and hosted by a national neurological society (2). This rotation among many regions of the world, to quote WFN president Raad Shakir, “ensures its diversity and uniqueness.” (3). The location of each world congress is decided four years in advance by the WFN’s Council of Delegates (who represent the national member neurological societies from around the world [4]), who vote on nominations from the upcoming region. The previous World Congress of Neurology was held in Santiago, Chile in 2015.

    Continued...

  • Podcast Transcripts

    November 5, 2018: Dr. Gretchen L. Birbeck interviews Dr. Benjamin Warf, the Director of Neonatal and Congenital Anomaly Neurosurgery at Boston Children's Hospital where he holds the chair in hydrocephalus and spina bifida. He is Medical Director of the CURE Hydrocephalus program, and Professor of Neurosurgery at Harvard Medical School, Boston, MA  Find the transcript here. 

    Interview Part I

    Interview Part II

     A  R  C  H  I  V  E  S 

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  • Extra! Extra! Read All About It!

    Don’t miss the Joint Congress of the Neurological Association of South Africa (NASA) & concurrent 2nd African Academy of Neurology (AFAN) meeting - in East London ICC, South Africa 26 Feb to 1 March 2019. Registration is open and some bursaries will be available to junior African neurologists! More information here.

    Neurology Humanities - The October 23rd issue includes a piece titled The Forgotten. "Though hardly a recreational drug, phenobarbital has become increasingly unavailable around the globe with disastrous consequences for the world’s poorest people with epilepsy. These are the voiceless. The forgotten. Can you hear them in the excerpts taken from reports filed by the Chikankata Epilepsy Care Team?1"

         1. G Birbeck. The Forgotten. Neurology
             2018;91:800-803

    Neurology: Clinical Practice has just launched their next Practice Current survey on a universally controversial topic - Practice Current: How do you manage patients with a "hot carotid"? Please consider completing the survey to add your own perspective.

    National Institute of Health Opportunity -  The National Institute of Neurological Disorders and Stroke (NINDS) is currently seeking a Health Disparities and Global Health Program Director – Division of Clinical Research. The Program Director position is within the Division of Clinical Research (DCR) at NINDS, located in Bethesda, MD. The Division of Clinical Research (DCR) within NINDS oversees a large program of observational studies, clinical trials, and other clinical research supported by extramural funding mechanisms. Check here for a full description and information on how to apply.

    Resident and Fellow Section: International Issues A Guide to U.S. Academic Global Health Programs in Neurology U.S. trainees interested in undertaking a global health elective should check out this month’s Resident’s and Fellow’s Section. In International Issues: A Guide to U.S. Academic Global Health Programs in Neurology, Samudralwar and colleagues provide pragmatic, insightful advice about how to go about doing this along with a helpful listing of existing opportunities. If you are a health professional in neurology or allied fields working outside of the US who accepts US trainees, please also check out this paper and consider adding your opportunity for neurology trainees to the online directory. 

    The American Academy of Neurology Global Health Section has posted its most recent newsletter - In this issue you'll find information on the Foundation for African Medicine & Education (FAME), Iceland's health care system, observership experiences at the Neuroscience Center of All India Institute of Medical Sciences, and The International AIDS Society Conference on HIV Science in Paris. 

  • Meet the Editor

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    Dr. Gretchen Birbeck, MD, MPH, DTMH, FAAN, Without Borders Editor, Rochester, NY