INTRODUCTION

Neurologic surgery is an advanced subspecialty of surgery, and its expertise is needed in both rural and urban areas, and in rich and poor communities. With an increase in motor vehicle traffic and resulting crashes, frequent injuries, increased recognition and awareness of congenital defects and brain tumors, the need for access to neurologic surgery has increased dramatically. In parallel, with advances in operative equipment, imaging modalities, and sophisticated perioperative care, the ability to diagnose and treat these conditions with minimal risk has improved dramatically. The availability of neurosurgical skill and resources varies between communities, regions, and countries around the world. In this upcoming series of articles, we focus on East Africa and hope to provide a brief overview of several aspects of neurological surgery in the region. From the late 1960s, when the first modern neurosurgical procedures were performed, to the present day—as neurosurgeons are trained locally—the region has undergone great political, economic, and social change. The practice of medicine has also advanced but is severely resource deficient. Although self-sufficiency is closer than ever before, challenges remain; fortunately, governmental and nongovernmental organizations continue to work to overcome them. This article is the first in a series of 3 that seeks to provide readers with an understanding of the current state of neurosurgery in East Africa (Foundations), the challenges that arise in providing surgical care in underdeveloped countries (Challenges), and what is being done to overcome these challenges and to improve healthcare in these areas (Innovations). Despite being distinct, the 3 articles will bridge into each other and offer a full view of the practice of neurosurgery in East Africa. In this article, we review the history and current state of neurosurgical care and the burden of neurosurgical diseases in East Africa.