Neurochirurgie
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This outline of the history of African Neurosurgery explains the role that North Africa has played in the Middle Ages in the development of Neurosurgery, the origins of the development of the latter in twentieth century, and the delay that African Neurosurgery still shows at the present time in the majority of African countries. On the papyrus of the pharaonic era, we have found the description of some neurosurgical procedures such as trephination and brain aspiration by a transphenoidal approach used before mummification. It is particularly trephination which summarizes the ancient history of African neurosurgery, as it was widely used throughout the continent, practised and taught by healers in African tribes. ⋯ During colonization, neurosurgical practice started and developed in many African countries, together with the development of the health system that the colonial forces initiated in general as soon as they had come to these countries. This neurosurgery practised in the departments of general surgery either by neurosurgeons or general surgeons took part in the birth and development of neurosurgery as an independent specialty, thanks to the combined efforts of some European and African pioneers. Modern neurosurgery was introduced and started to develop in African countries from 1960, and the teaching of this specialty in many African universities began between 1960 and 1970.
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A survey conducted among African neurosurgeons shows that there are nowadays 500 neurosurgeons in Africa, that is one neurosurgeon for 1,350,000 inhabitants, and 70,000 km2. The distribution of these neurosurgeons shows a striking regional disparity: North Africa has 354 neurosurgeons for 119 million inhabitants, that is one neurosurgeon for 338,000 inhabitants, and South Africa has 65 neurosurgeons for 40 million inhabitants, that is one neurosurgeon for 620,000 inhabitants. Between these two areas where neurosurgery is developing quite well, we have the majority of African countries with a scanty density of neurosurgeons (81 neurosurgeons for 515 million inhabitants, that is one neurosurgeon for 6,368,000 inhabitants). ⋯ However, the real factor of optimism is the African neurosurgeons who should promote neurosurgery in their continent, at the level of their own countries by developing information and health education, setting their specialty in the education syllabus and health planning, and settling into active and performing societies. At the continental and international level, African neurosurgeons should institutionalize inter-African cooperation, expedite their continental association (PAANS), and further exchanges with the other continents through the SNCLF (Société de Neurochirurgie de Langue Francaise). The latter, together with other associations such as the EANS (European Association of Neurosurgical Societies) and WFNS (World Federation of Neurosurgical Societies) could provide help to the development of Neurosurgery in Africa as far as training, exchanges, research and organization are concerned.