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Resident Fontana’s Eye-Opening Experience Treating Kids in Africa

Fifth-year resident, Dr. Elizabeth Fontana had an eye opening experience this summer in Africa.

Through the Foundation for International Education in Neurosurgery (FIEN), she had an opportunity to work with full-time neurosurgeon, Dr. John Mugamba, treating children at the  CURE Children’s Hospital of Uganda (CCHU) in Mbale, Uganda.

CCHU is a 35 bed teaching hospital that was started ten years ago and remains the only pediatric hospital dedicated to neurosurgical disease in all of East Africa.

Fontana says, “It was started because there is such a high incidence of infectious hydrocephalus and spina bifida throughout much of East Africa.”

Treating patients in this hospital contrasted severely with what she was used to in the US.  In particular, she says, “In the types of pathology I was seeing, which are unique to underdeveloped countries.  Also, the severity and frequency of the diseases is very different.  People come in very late so the progression of the disease is already way past when we would normally treat it in the US.  For example, we see myelomeningoceles in the US but they present very differently.  In the US they are usually treated within the first 48 hours after birth but in Africa they would come in a week or month after birth, and they would already be infected by the time they arrived at the hospital.”

Making things worse were the limited medical resources.  Fontanta says, “That was frustrating at times. For example, there is only one MRI machine in the whole country- and it is very low resolution.  It was also frequently difficult to obtain critical medications, including certain antibiotics and anticonvulsants.  After surgery, the children and parents would often have to travel hundreds of miles by moped or minivan to extremely poor living conditions, and this poses a real challenge for post-operative care.  They didn’t necessarily have good access to clean water or good nutrition, and certainly they didn’t have access to services like physical therapy that we would normally provide.”

Dr. Fontana highly recommends the experience to other physicians and says, “In addition to being another set of hands, what we really bring is a different perspective.  We are bringing dialogue to people who are practicing in isolation.  The vast majority of surgeons in Africa are there by themselves. There is a lot of benefit to discussing challenging cases with other surgeons, and I found that even as a resident, my thoughts were very much appreciated”

Dr. Fontana says she hopes one day to go back and she says, “A month was not long enough. I felt like I got more than I gave back.  Next time, I’d like to stay longer.”

To learn more and to find out how you can help see http://www.projectcure.org

patient journey

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