Neurologists (medical) and neurosurgeons (surgical) are doctors specialising in diseases of the brain, the spinal cord and nerves. Neurologists use medicines and neurosurgeons (brain surgeons) perform operations. Both are supported by other specialist doctors such as neuro-radiologists, neuro-pathologists and neuro-rehabilitation specialists etc., to facilitate effective service delivery as required by patients with diseases of the nervous system.
All of them are in very short supply and you may be forgiven if you did not know they even exist. There are perhaps about 40 neurosurgeons in Nigeria and perhaps about 60 neurologists. As previously calculated, one neurosurgeon is responsible for about 5 million Nigerians and one neurologist; about 3 million. Of course, this is strictly not true since most of these doctors are in urban areas (cities) and not in the rural areas where most Nigerians live. In the case of rural areas where there is no specialist, God is in control, easily supported by dangerous fake pastors and criminal herbalists!
One report in the news highlighted the importance of this group of doctors and behoves on them a responsibility to improve their visibility. As reported, a young man, Nabil complained of a headache on 11th May 2012. His best friend took him to a renowned private hospital on Lagos Island and that day, he slipped into a coma. After tests were conducted, they discovered he had a bleed in his brain. For some reason, there was no qualified neurosurgeon available or they were unable to find one within the time frame that it became imperative he be taken out of the country. He died in transit out of Nigeria.
Stroke, which is what happened to Nabil (May his gentle soul rest in peace) is an emergency and requires immediate action to prevent brain damage and death. Stroke causes injury because vital nutrients are not delivered to the brain; and so brain tissue dies. I do not know the true facts of the case and I will not dwell on it. However, I know there are at least 4 neurosurgeons in Lagos and they should be known to any renowned hospital on Lagos Island. There are also numerous neurologists in Lagos who could have been consulted about this case and who certainly could have given advice.
There are two issues here. One is the visibility of the neurosurgeons and accessibility. The second issue of course, relates to medical tourism and the need for us to develop local health facilities to manage emergencies better. Too many people are dying on their way to India!
I went online while writing this article to find the details of neurologists in Lagos, as an exercise. I simply typed in neurologist in Lagos in Google. There was nothing about neurologists in Lagos.
I did find articles written by Professor Mustapha Danesi on the internet. There was no information about who he is, place of work or how to contact him in an emergency. Apparently, he has been trying to create a health directory for years and progress had been stunted by lack of funds. How many lives could such a directory have saved?
Provide essential information
Our patients deserve timely access to quality services appropriate to their needs. There is need for provision of specialist advice, diagnostic, treatment, rehabilitation and support services. Even when these are available, lack of information about what is available and where could be the difference between life and death.
With the advent of the web, it is easier for a Nigerian in Surulere, to know there is a kidney specialist for his problem in Mumbai, India, than to know about the presence of a similar specialist physician in Ebute Metta.
Nigerian doctors are not allowed to openly advertise their services but, this does not mean that hospitals should not be aware of specialists available to them. Specialists (neurologists and neurosurgeons) must also make it their duty to inform other doctors in their locality, of their particular expertise and availability.
Abuja Healthcare Directory
We have tried to do this in Abuja (FCT) through the Abuja Healthcare Directory. This is a compendium of names of hospitals and specialist doctors in Abuja: for easier communication and delivery of timely advice. The directory is in a booklet and available for doctors, patients and relatives. It is available on the Nigeria Health Journal website and can be made available online through other portals. You should have a copy on your desktop and even on your website!
We need to create a data base of Nigerian specialists and make this data base available to patients for them to choose. We do not want the situation where unqualified doctors continue to make decisions on cases they are not trained to manage. So many people are dabbling into the management of epilepsy, stroke, head injury, movement disorders and spine problems because the real specialists remain virtually unknown.
Remember the case of former President Ibrahim Babangida and his radiculopathy? He was flown to Paris to have surgery. This was something that could have been done at Lagos University Teaching Hospital (LUTH) or at any other hospital staffed by a neurosurgeon.
He probably did not even know we exist.
The Nigerian Society of Neurological Scientists
It is important that the society deliberates on ways and means of contributing actively, in this day and age, to the problems of access to its specialist services in Nigeria. The society should also be conscious of the acute need for more neurologists and neurosurgeons in Nigeria. Working to bring back home, many of these doctors in the diaspora will have both short and long term benefits for all.
Finally, Building Strengths Network: coming to a hospital near you!