AFRICAN NEUROSURGERY - PART II - CURRENT STATE AND FUTURE-PROSPECTS

A survey conducted among African neurosurgeons shows that there are no w 500 neurosurgeons in Africa; that is, one neurosurgeon for 1,350,000 inhabitants, and 70,000 km(2). The distribution of these neurosurgeon s shows a striking regional disparity: North Africa has 354 neurosurge ons for 119 million inhabitants; that is, one neurosurgeon for 338,000 inhabitants; and South Africa has 65 neurosurgeons for 40 million inh abitants; that is, one neurosurgeon for 620,000 inhabitants. Between t hese two areas where neurosurgery is developing quite well, we have th e majority of African countries with a scant density of neurosurgeons (81 neurosurgeons for 515 million inhabitants; that is, one neurosurge on for 6,368,000 inhabitants). The Panafrican Association of Neurologi cal Sciences (PAANS) brings together African neurosurgeons, This conti nental African association represents African neurosurgeons in the Wor ld Federation of Neurosurgical Societies (WFNS). In addition to this c ontinental association, there are national societies of neurosciences, However, there are only six societies of neurosurgery. Two systems of training exist in Africa: (1) local training, and (2) training abroad . These two systems have unequal quality and specific difficulties tha t are pointed out, Among the optimistic elements that make us believe in the development of neurosurgery in Africa, are the existence of a q uite good level of neurosurgery at the two extremities of the continen t (North Africa and South Africa), the development of neurosciences in African universities, and the increasing interest that the internatio nal community bears to Africa in the last years. However, the real fac tor of optimism is the African neurosurgeons who should promote neuros urgery in their continent, at the level of their own countries by deve loping information and health education, setting their speciality in t he education syllabus and health planning, and settling into active an d performing societies. At the continental and international level, Af rican neurosurgeons should institutionalize inter-African cooperation, expedite their continental association (PAANS), and further exchanges with the other continents through the WFNS. The latter, together with other associations such as the European Association of Neurosurgical Societies (EANS) could provide help to the development of neurosurgery in Africa as far as training, exchanges, research, and organization a re concerned. (C) 1998 by Elsevier Science Inc.