Three neurosurgeons - for around 19 million people. What is difficult to imagine in Ulm is a reality in the East African country of Malawi - but one that is set to change as soon as possible. Together with his Malawian friend and colleague Dr Patrick Kamalo, Professor Thomas Kapapa, Managing Senior Physician at the Department of Neurosurgery at Ulm University Hospital, has launched the "Malawi-Germany Neurosurgery Project", which aims to establish neurosurgical care at the university hospital in Blantyre/Malawi.
The main causes of death in Africa are respiratory infections, followed by HIV/AIDS and gastrointestinal infections. In fourth place is stroke, including intracranial haemorrhage. Road traffic accidents, including traumatic brain injuries (TBI), take tenth place. However, neurosurgical conditions such as TBI, congenital malformations of the central nervous system, brain tumours and infections of the central nervous system mainly affect children and the more productive members of African societies.
Unfortunately, these negative effects on society and the economic situation in Africa are not yet having such an impact that proactive neurosurgical efforts are being made by healthcare systems, the private healthcare sector and aid organisations. This means that those affected are currently not receiving adequate care. In Malawi, there are only three neurosurgeons for the entire population of the country, i.e. approximately 19 million people.
Despite Malawi's achievements in the field of health care with regard to HIV/AIDS, tuberculosis and malaria as well as the general health of children, mothers, newborns and adults, there are still considerable challenges in terms of technical and financial resources in hospitals, the supply of medicines, norms and standards, medical guidelines and the training of medical professionals. The latter is reflected in the number of neurosurgeons and support staff such as neuroanaesthetists, neuroradiologists and neurophysiotherapists available in Malawi. The question therefore arose as to what can be done to improve neurosurgical services in the case of Malawi. Three neurosurgeons are not able to meet an almost constant demand for treatment throughout the country and at the same time train prospective students and neurosurgeons.
Thanks to the private commitment of Prof Dr Kapapa, Managing Senior Consultant and Specialist in Neurosurgery at Ulm University Hospital (UKU), a cooperation with Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, has been in place since 2007. This commitment has led to ever closer cooperation between the neurosurgery clinics at the UKU and QECH with the overarching aim of improving neurosurgical healthcare in Malawi. This is to be further advanced with the help of this project.
The main objective of the "Malawi-Germany Neurosurgery Project" is to provide training, teaching and practical and therapeutic management in neurosurgical healthcare in Malawi. Further objectives are to increase the number of treatments, diversify the range of treatments and improve the quality of treatment in all professional groups involved in the treatment. Methods for achieving these goals include knowledge transfer, practical and theoretical training for qualification and skills acquisition, networking and cultural exchange.
Initial funding for this project was obtained from the "Clinic Partnerships" programme of the German Federal Ministry for Economic Cooperation and Development (BMZ). The project was launched in February 2020 with an initial visit by the project team (Thomas Kapapa, Kerstin Knoll, Nicole Weber, Florian Pfinder, Tanja Hermann and Natascha Eirich) from Ulm University Hospital to Queen Elizabeth Central Hospital in Blantyre, Malawi.
The project is supported by the German Federal Ministry for Economic Cooperation and Development (BMZ), the Gesellschaft für internationale Zusammenarbeit (GIZ) and the Else Kröner-Fresenius Foundation, among others. So far, around 400,000 euros in funding has been approved, which will be used over the next three years for the individual project stages of training and further training for neurosurgical specialisation for the professional groups of doctors, nurses and physiotherapists.
Else Kröner Fresenius Foundation (EKFZ)
This project promotes the training and further education of students, doctors, nurses and physiotherapists in the field of neurosurgery in order to improve access to neurosurgical care. All professional groups involved in the treatment pathway are supported through modern teaching methods (theoretical and practical instruction, eLearning and virtual reality training).
Gesellschaft für Internationale Zusammenarbeit (GIZ)
The aim of the hospital partnership project is to train neurosurgical specialists and provide further training for nursing and therapy staff by introducing standard operating procedures and standardised surgical techniques for craniocerebral trauma, intracranial haemorrhage, intracranial meningioma and hydrocephalus in children. This should lead to an expansion of the treatment spectrum and better treatment results.
Deutsche Apotheker- und Ärztebank (apoBank)
Student exchange to Malawi to carry out scientific-epidemiological studies on neurosurgical diseases is supported.
German Academic Exchange Service (DAAD)
The "German-Arab Transformation Partnership" project on patient safety for students from Germany, Tunisia and Malawi, for example, is funded by the DAAD and the German Federal Foreign Office. The aim is to create a network to improve neurosurgical care structures.
B. Braun Foundation
Promotes training events in Germany as part of the Malawi project. The first training event was organised to clarify the objectives and the resources used in this project. Further activities and starting points for other projects were discussed.
Right.Brain Foundation
The Right.Brain Foundation provides medical technology to selected hospitals and public institutions in South East Asia, Africa, Central and South America.
Other supporters and sponsors
- Dr Heide Kieninger
- Mrs Hilde Scheible
- The Bosch family
- Angelika Witt, Krefeld (NRW)
Partner organisations in Malawi
Queen Elizabeth Central Hospital
Queen Elizabeth Central Hospital in Blantyre, Malawi is an integral part of the country's centrally structured state healthcare system with a larger, country-specific maximum care hospital in the three regions (Northern, Central, Southern Region) and 23 district hospitals. These provide basic care in the three regions. In the case of illnesses that exceed the care structure of the district hospitals, transfer to the respective central hospital is possible. Queen Elisabteh Central Hospital has 1,300 hospital beds and treats around 95,000 inpatients and around 450,000 outpatients every year. Around 1300 employees are available for this purpose.
Kachere Rehabilitation Centre
The Kachere Rehabilitation Centre is Malawi's only medical facility for intensive medical rehabilitation of people with disabilities caused by strokes, traffic accidents, work accidents, tumours and other illnesses. The rehabilitation centre is part of the Malawi Against Physical Disabilities (MAP) organisation. MAP is a charitable organisation that provides medical rehabilitation services for people with physical disabilities in Malawi.
College of Medicine University of Malawi in Blantyre
The College of Medicine (COM) is a college of the University of Malawi (UNIMA) that was established in 1991 with the three main missions of education, research and service. Over the years, COM has evolved from a single faculty to three faculties that train not only medical practitioners but also other health professionals such as pharmacists, physiotherapists, laboratory technologists and the like, offering over 30 undergraduate and postgraduate programmes.
Partner institutions in Germany
- Physio GmbH(https://www.physio-gmbh.de/)
- UlmKolleg(https://www.ulmkolleg.de/index.php?ausbildung-physiotherapie-massage-podologie)
- Neresheim Specialist Hospital(https://www.fachkrankenhaus-neresheim.de/)
- German Society for Physiotherapy Sciences DGPTW(http://www.dgptw.org/)
If you as a student are interested in study visits, work shadowing etc. at the Queen Elizabeth Central Hospital or would like to exchange ideas with other students in a project group "Malawi Project", you are welcome to contact us at the e-mail address malawiexchange@uni-ulm.de.
The Malawi Project Group is a student-led project with the aim of establishing a bilateral exchange programme between the University of Ulm and the University of Malawi, College of Medicine. The group was initiated in spring 2019 by Prof Thomas Kapapa and Prof Rainer Wirtz (Medical Director), neurosurgeons at Ulm University Hospital.
Further project applications have been submitted or are in preparation, e.g:
- Renovation of the operating theatre of the intensive care unit and the paediatric ward at Queen Elizabeth Central Hospital
- Use of virtual reality in neurosurgery
- Training in Europe as internships for students from Malawi
If you would like to find out more about our projects or are interested in participating, please feel free to contact us.
Donation account
Account holder: Ulm University Hospital
Sparkasse Ulm, BLZ: 630 500 00
Account number: 106 478
Swift Code (BIC): SOLADES1ULM
IBAN: DE16630500000000106478
Purpose: D.6337 Donation Malawi Prof. Kapapa
