Technology and neurosurgery in developing countries: Experience and present situation in Morocco

OBJECTIVE: The high cost of technology is considered to be the determining factor slowing the expansion of modern neurosurgery in many developing coun tries. The literature dedicated to this topic rarely proposes internal solu tions whereby affected countries can overcome this economic impediment. Cer tain articles cite inevitable obstacles, and the neurosurgeons of these cou ntries can become disheartened when these articles conclude with calls for foreign help as the only approach to the development of neurosurgery. METHODS: Morocco is presented as an example of a developing country in whic h neurosurgery has become well established in the past 30 years, using a pr ogram based on four guidelines, as follows: 1) encouraging the local traini ng of young neurosurgeons, 2) organizing and promoting neurosurgery, 3) int egrating the development of neurosurgery into the health care pyramid syste m, and 4) stimulating research on local pathological conditions. RESULTS: Because of the internal planning efforts stimulated by the first n ational neurosurgeons, Morocco has progressed from 2 underequipped neurosur gical services and 5 neurosurgeons in 1968 to 12 well-equipped services and 80 neurosurgeons in 1998. The main benefits of this progress are discussed . CONCLUSION: Neurosurgery in developing countries can be promoted if the fir st working neurosurgeons take up their responsibilities as pioneers. This r ole requires that they initiate the training of young neurosurgeons as soon as possible and that they find in the local conditions the necessary facto rs to promote neurosurgery and to integrate it into the health care develop ment of their country.