Rutgers study looks to develop neurological programs in rural Brazil
A recent Rutgers study presents a model for creating sustainable neurosurgery programs in poor, remote locations, according to an article on Rutgers Today.
The study found that by recruiting and training young, local doctors, low and middle-income countries in remote locations with limited access to care can create sustainable neurosurgical programs, according to the article.
The study was published in the journal "World Neurosurgery" and analyzed the effectiveness of a successful neurosurgical department, its residency program, an international residency rotation and a medical student exchange program, which are located in Santarém, a remote region of Brazil in the Amazon rainforest over the past 20 years, according to the article.
For the residents of this area, access to care depends on finding affordable transportation to the only municipal hospital in the region, according to the article. This hospital serves an area larger than Texas with limited resources.
Patients with conditions that cannot be treated locally are transferred to larger regional hospitals because specialized care is almost non-existent. Attracting medical residents and attending physicians to the remote location is difficult, due to low pay and a lack of surgical supplies, according to the article.
A five-year neurosurgery residency program was started in 2014, which improved conditions and created more access for patients. The program has led to upgraded facilities and new surgical equipment and expanded partnerships between academic and regional training centers, according to the article.
The program added one new resident who split clinical duties between the municipal and regional hospital, which helped attract surgeons who could work through health care barriers and work with limited resources, according to the article.
“Having worked in the Santarém hospital system, I was fascinated by how it was able to create a sustainable neurosurgical program to care for people in a poor area with limited resources by using doctors who were from the local area,” said lead author Nicole Silva, a medical student at Rutgers New Jersey Medical School.
Researchers also looked at neurological health issues, including those of indigenous people, that are unique to the region, according to the article.
Researchers found that neurological surgeries were performed for brain and spinal injuries from shallow water diving, falls from Amazonian trees and being struck by falling fruit, according to the article. They were also performed for neurological care, like spine surgeries, tumor surgeries and hydrocephalus treatment.
“Understanding the effect the environment has on patients from rural Amazonian communities has distinguished the young neurosurgeons of this region from those who trained in the traditional model in Brazil,” Silva said.
The researchers are encouraging other areas with barriers to neurological care to investigate replicating the program in Brazil, according to the article.
“It would require support from the established medical system of that country, a hospital with surgical suite capabilities, attending physicians and medical residents supported by residency education of their healthcare system and medical education system,” Silva said.
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