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History

Neurosurgery has been rapidly evolving in Zimbabwe. The practice of Neurosurgery in the earlier years was mainly in the field of head injury, spinal injury, brain abscesses, and hydrocephalus. The only investigations which could be done were plain Xrays, pneumoencephalogram, carotid angiogram and EEG. Most of the earlier work during the colonial years to independence in 1980 was done at Harare Central hospital for the African patients and for the whites was at the then Salisbury Central Hospitals.

Neurosurgery as a discipline was introduced in Zimbabwe by the late Professor Lawrence Fraser Levy who came into Zimbabwe in 1957 having trained under Wilder Penfield in Montreal Canada, Hoen in New York and Douglas Northfield in England. For a long time, he was the only neurosurgeon travelling between Harare and Bulawayo and to several neighboring countries (Malawi, Zambia, Mozambique) while also teaching at the medical school. He was a world class neurosurgeon who travelled far and wide and was awarded the World Federation of Neurosurgical Societies (WFNS) medal of honour in 2007 for his contribution towards development of Neurosurgery in Africa and the world at large. Before his arrival, there is no documentary proof of any neurosurgical work that was being done. Early morden medical care concentrated on the treatment of hookworms, syphilis, Malaria, bilharzia, yaws, measles, influenza, dysentery, roundworm, chickenpox, pneumonia, tuberculosis and black water fever.

He was joined by a young neurosurgeon from Scotland named Dr. Carol Auchterlonie and the 2 of them shared the responsibilities for a long time.

With time, he started training young surgeons by apprenticeship in the field of Neurosurgery. Professor Levy’s aim in training focused on training professionals for the region rather than for his country. He trained a total of 12 Neurosurgeons comprising of candidates from countries that include Mozambique, Zambia and Uganda ; with many of them becoming eminent people in their countries of origin.

Dr. Makarawo was the first Zimbabwean Neurosurgeon to be trained by Professor Levy before he went to complete his training in England.

He remains as one of the pillars of Neurosurgery in Zimbabwe’s health system as well as the training of young Neurosurgeons at the University of Zimbabwe College of Health Sciences.

In 1987, Professor Levy was joined by a young Neurosurgeon from Belgium by the name Professor Kazadi Kalangu. He was initialy recruited by the ministry of health and went to Bulawayo in 1989 to establish a succesful neurosurgical unit. He closely worked with Professor Levy as a part time lecturer at the University of Zimbabwe(UZ) where he introduced microsurgery and some new techniques for the operation of aneurysms, the posterior fossa and intraventricular tumours.

In 1992, Professor Kalangu joined the UZ as a full time senior lecturer with the idea to introduce a formal academic course structured training program in Neurosurgery, inspired by his Belgian training.

In 1994 Prof Levy and Prof Kalangu introduced a Masters programme in Neurosurgery. Due to the unfavourable economic environment and initial wrong perceptions and unfounded fears about joining a local training programme, it was difficult to attract trainees who could stay for long. The qualification with excellent proficiency of the first graduates of the programme, and the assumption of international offices in various institutions by Prof Kalangu including the general secretary of the Pan African Association of Neurological sciences (PAANS), the presidency of the Association of Neurosurgical Societies of Africa (ANSA) and the vice presidency of the World Federation of Neurosurgical Societies (WFNS) helped bolster confidence in the training programme which is now training for a number of its neighbouring countries.

The first graduate of the programme was Dr.Mawera who qualified in 2008. Soon after, Dr. Aaron Musara qualified from the same programme in 2009.

Dr Nozipo Maraire came into Zimbabwe in 2012 having trained in the United states. She becomes the first female Neurosurgeon in Zimbabwe.

Due to the dedication and interest in the program by both Prof. Kalangu and Dr. Musara, the programme has attracted many new trainees and is now well established with 15 trainees in the program as of 2015, spread over several years.

Currently, all neurosurgical operations are being performed in Zimbabwe except functional and stereotactic neurosurgery. Modern investigations such as CTscan (11units available ) and MRI (5 Units available), EEG, Isotope scan, SPECT scan, Ultrasound scan, EMG and Evoked Potential, are available. The operating theatres are equipped with adequate instruments, including but not limited to microsurgical sets, microscopes, and endoscope. Patients are anesthetized by fully trained specialist anesthetists who are very familiar with neuro-anesthesia.

Neurosurgery is now practiced in three government hospitals and in four private hospitals.
References

  1. Adelola Adeloye, The Rahima Dawood Memorial Guest Lecture – December 2006 – Malawi. Pattern, Practice and Problems of Neurological`Surgery in East And Central Africa, East and Central African Journal of Surgery, Vol. 12, No. 2, November/December 2006, pp. 4-16.
  2.  Kalangu KK, Surg Neurol. 1996 Oct;46(4):317-21. Neurosurgery in Zimbabwe.
  3.  C.J. Zvobgo, Medical Missions: A Neglected Theme In Zimbabwe’s History,1893-1957, Zambezia (1986) , Xiii(ii)