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How Brain Surgery with a Tree Saw Inspired a New Model for Sustainable Healthcare in Tanzania

In the United States there is approximately one neurosurgeon to every 1,000 people. In Tanzania, there are just 3 neurosurgeons for a country of over 50 million people. Exacerbating the shortage of physicians, is the dire lack of equipment to perform essential neurosurgical procedures.

Dr. Dilan Ellegala, an accomplished American neurosurgeon, faced these challenges on medical mission in rural Tanzania. The hospital where he was working in Haydom had no drills or saws, no ventilators or cautery devices. Presented with a patient who needed brain surgery, he diligently began searching for tools. On a walk one afternoon, he saw a man cutting a tree limb with a wire saw. He reached into his pocket, bought the saw, sterilized it and used it to save the patient’s life.

Not content to return to the U.S and leave Haydom without a resident neurosurgeon, Dr. Ellegala began training a medical officer, Emmanuel Mayegga, to perform neurosurgery. Mayegga had no degree, no neurosurgical training. He had, however, what Dr. Ellegala recognized as the key component of a neurosurgeon: confidence and competence. Once trained, Ellegala and Mayegga trained two more health care workers. The hospital in Haydom now has a staff of three neurosurgeons acting as agents of change in their own country.

Dr. Ellegala’s mission in Haydom has been documented by Tony Bartolome in his book “Send Forth the Healing Sun.” Dr. Ellegala’s NGO, Madaktari Aftrica, exists to advance healthcare in Tanzania and beyond through the Train Forward model developed in Haydom.

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