A Collaborative Neurosurgical Mission: Enhancing Patient Care and Training at EGH
From November 3-7, 2019, a dedicated team from Birmingham Hospital, UK, embarked on a five-day mission to the Neurosurgery (NS) Unit at EGH, with the primary goal of strengthening local neurosurgical services. The collaboration between the UK and local teams focused on complex cases, surgeries, educational symposiums, and laying the groundwork for future partnerships.
Mission Objectives
The mission had several key objectives:
- Support the Local Team: Provide ongoing assistance to improve NS services at EGH.
- Clinical Collaboration: Work alongside local staff in outpatient clinics to evaluate complex cases, with a focus on cervical spine issues, brain tumors, and pituitary tumors.
- Surgical Expertise: Conduct surgeries on the most complex cases, sharing best practices with the local team.
- Symposium Participation: Facilitate knowledge-sharing through a symposium, offering educational sessions and engaging discussions.
- Future Planning: Establish a sustainable communication plan between the UK and local teams for continuous improvement.
The UK Team
The mission was led by a multidisciplinary team from Birmingham Hospital, with the support of Medical Aid for Palestine, including:
- Amy Shapiro: Neuro Nurse Specialist
- Ismail Ughratdar: Consultant Neurosurgeon
- Georgios Tsermoulas: Consultant Neurosurgeon
- Claire Lynch: Clinical Nurse Educator
- Attyah Ghuari: Neuroscience Technician
Their work focused on supporting the neurosurgery staff and cases at EGH and Shifa Hospital.
Patient Care and Surgical Cases
Throughout the week, a total of 38 patients were examined—29 from EGH and 9 from Shifa Hospital. The patients presented with various neurosurgical conditions, including cervical spine pathology, brain tumors, and pituitary cysts. Of the patients examined, 9 were selected for surgery, though one later declined, resulting in 8 surgeries over three days.
Surgical Highlights:
- Day 1: 38 patients evaluated in the outpatient clinic to determine clinical needs and treatment plans
- Day 2: Surgeons performed complex surgeries, including a redo craniotomy for a recurrent sphenoid meningioma and a cervical laminectomy for myelopathy.
- Day 3: Further surgeries included a craniotomy and resection for a parietal intraparenchymal tumor in a 14-year-old, as well as a biopsy for a challenging “butterfly” tumor.
- Day 4: The team performed the first-ever Endoscopic Third Ventriculostomy in Gaza, a critical procedure for a child with obstructive hydrocephalus. The day concluded with a successful craniotomy for parasagittal meningioma and cervical laminectomy for myelopathy.
A Focus on Knowledge Sharing: The Symposium
On the evening of Day 4, a symposium brought together 34 medical professionals from EGH, Shifa, and MAP. Case presentations, educational sessions, and a rich Q&A session between residents and consultants made the symposium a success. Feedback from the participants highlighted the need for continued focus on resident training and engagement in future missions.
Nursing and Rehabilitation Efforts
Parallel to the surgical activities, the nursing and physiotherapy teams from the UK worked closely with their EGH counterparts. Amy Shapiro and Claire Lynch provided support in patient care and physiotherapy, while Attyah Ghuari assisted with sorting and organizing medical equipment. A visit to Hamad Rehabilitation Hospital highlighted the hospital’s focus on neuro-rehabilitation, and discussions were initiated for future collaborations in pediatric rehabilitation and staff training.
Future Collaboration and Recommendations
The mission concluded with a post-operative review and strategic meetings to outline the future of this partnership. Key recommendations included:
- Increased Missions: Agreement on six missions per year starting in 2020, with a focus on neurosurgical education and expanding the team to include anesthetists, radiologists, and dietitians.
- Resident Training: Continued investment in resident education through online communication, wet labs, and observerships.
- Equipment and Procurement: Support for MAP in identifying and procuring necessary equipment from the UK.
- Ongoing Communication: Establishment of regular weekly Skype meetings for case discussions and mission preparation.
Looking Ahead
The mission demonstrated the strong potential of collaboration between the UK and local teams in Gaza, paving the way for continued improvement in neurosurgical services. With the plans for future missions and educational initiatives in place, both teams are committed to ensuring that local healthcare providers have the skills and confidence needed to provide world-class care.
This mission was a significant step forward in strengthening neurosurgical services at EGH, and its outcomes are a testament to the power of collaboration and shared expertise in improving patient care.
