Cure Hospital - Uganda

Since being in Uganda, a few of us have had the fortune of visiting a hospital for pediatric neurosurgery in Mbale called Cure Hospital (http://cure.org/hospitals/uganda/). The hospital was founded by an American neurosurgeon, but is now almost completely Ugandan run and staffed. They specialize in hydrocephalus, which they treat often with a groundbreaking new procedure called endoscopic third ventriculostomy (ETV), and spina bifida.

Carolina and I had the fortune of observing surgeries yesterday and today. We saw ETVs, traditional shunt placements, as well as a spina bifida procedure today. This last procedure was really remarkable. 

Picture a 7 day old child, tiny lungs receiving air through a tube in her mouth, little monitors all over her body, laying on her stomach as she is draped with sterile sheets for surgery. The myelomeningocele is the mass protruding from her lower back, the sign that her spinal cord did not correctly form and is bulging out. It means she may be at risk for paralysis, absent bladder control, chronic constipation, and other problems. 

Picture taken with permission - myelomeningocele on the lower back of a 7-day-old infant

Everyone in the room closed their eyes to say words of protection for the child, then scalpel is handed to the surgeon, and to the tune of gospel music, he makes the first cut. We watched in awe as the a small fountain of fluid splashed out, and was quickly sucked up by the scrub tech's syringe. The mass that had looked so solid quickly deflated before our eyes, and skin was further opened up to tackle the damaged spinal cord, that quarter-sized piece of nervous tissue that would dictate so much of this child's future. 

Over the next 45 minutes, he separated out the cord, all the while explaining the procedure to us. He expertly wrapped it in the dura, as if swaddling it, and sutured it closed, after which he finished up by closing the skin. 

It's true that these problems are rare, far less common than malnutrition, malaria, or diarrhea in a child. However, there was something so profound in seeing this procedure, in seeing a small child get a chance she may have otherwise not have received. My experience at Cure really stimulated my thoughts regarding access to medical care in low resource settings. I have no answers, but only thoughts on more questions. Where should resources be funneled? Does every child have a right to a cure, if it exists? If so, what impact does this have on low-resource, high-need care? 

That seems to be the theme of this trip: so many questions, and few answers! 

Another update soon to come,

~ Monika