Without Borders

Editor's Blog

  • Global Stuff You Should Know

    Developing a System of Neurologic Care in Zambia
     
    Deanna Saylor, MD, MHS Assistant Professor of Neurology, Johns Hopkins University School of Medicine Director, Johns Hopkins Global Neurology Center Visiting Consultant, University Teaching Hospital Visiting Lecturer, University of Zambia School of Medicine, Department of Internal Medicine Program Director, University of Zambia MMED Neurology Program Program Director, Zambia Ministry of Health Specialist Training Program in Neurology
     
    The Global Burden of Disease study estimates that neurological disorders are the leading cause group of disability-adjusted life years and second leading cause group of mortality globally.1, 2 Neurological disease disproportionately affects low and middle income countries (LMICs) and is expected to increase further in LMIC as life expectancies rise.1
     

    Despite the burden of neurological disease, most LMIC lack trained neurologists.3 In sub-Saharan Africa there are 0.01 neurologists per 100,000 people compared to >5 neurologists per 100,000 people in the United States. Furthermore, few countries in Africa offer post-graduate neurology training programs.4 Physicians who seek neurology training abroad often do not return home to practice, thus contributing to brain drain. Neurology training in developed countries also lacks exposure to common neurological conditions that occur in LMICs, and management of even the most basic conditions is often vastly different between resource-rich and resource-limited settings. Thus, even neurologists who return after training abroad are often inadequately prepared to manage neurological conditions in resource-limited settings. Training neurologists in their home countries provides exposure to the most prevalent conditions and best available methods to manage those conditions within the resource constraints of the local setting while diminishing the possibility that neurologists will choose to practice abroad.

    Continued...

     

    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.

     

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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!

    The World Federation of Neurology - is accepting applications from young neurologists from low and middle income countries to attend an approved international meeting. Applications are due February 15th. Thirty awards will be given!

    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.

    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