ICNA Zimbabwe Appealsupport upskilling & capacity building in child neurology
imbabwe is a southern African country and has borders with Zambia, South Africa, Botswana and Mozambique. Zimbabwe’s population is around 15 million with 40% between the age of 0 to 14 years. The country has a rich and proud heritage from the 12th century Munhumutapa kingdom which which was flourishing when Europe was still in the Dark Ages. ‘Great Zimbabwe” created out of hand-cut stone, a vast complex of structure, the ruins of which still stands bears testimony to this and is the country’s second greatest tourist attraction after Victoria Falls.
There is no specialist neurological input in Harare. The incidence of neurological conditions is very high with around 500000 people with epilepsy (by comparison: UK population 65million with 603000 people). Only 15% of people with epilepsy are on anti epileptic drugs. Epilepsy is also associated with high incidence of mortality and morbidity through burns from from falling into cooking fires, and drowning as a result of experiencing a seizure when washing clothes in, or near rivers and water bodies. The incidence of neurological conditions in children are also very high and includes a host of preventable conditions including birth asphyxia, neonatal jaundice, meningitis, malaria, HIV and trauma. Children with neurological disorders are often managed in primary care by nurses and only those with severe conditions are seen in tertiary care.
Investigations available in Zimbabwe include relatively complex blood tests, EEG (eight machines in the country of which four are in Harare) and MRI with good quality imaging (six machines in the country; all in the private sector, five in Harare). However, the costs are high and impose difficult choices. Similarly treatment options are limited. The only widely available antiepileptic medications are carbamazepine, phenobarbital and valproate. Lamotrigine can be bought but the cost is around six times that
of carbamazepine and therefore out of the reach of most. Moreover, given the risks from seizures, people who are rendered seizure free will continue lifelong therapy with all of the potential cumulative side effects associated with the old generation medications.
For the whole of Zimbabwe there are only 39 paediatricians, 1 developmental specialist and no child neurologist. The coordination of child centred neurological services is disjointed resulting in fragmentation of care. There is an urgent need for creating a critical mass of professionals trained in child neurology to further champion the cause. Training is currently being offered in neighbouring South Africa and Zimbabwe desperately needs support for facilitating this. In addition to child neurologists, there is also a need for therapists, neurophysiologists and rehabilitation specialists.
The ICNA is committed to support colleagues in Zimbabwe with their efforts in capacity building and in adapting international protocols for their needs and facilitate collaboration in both clinical and basic science research. Please support the appeal by donating generously, Please visit https://icnapedia.org/donate