Global Neurosurgery

NED Mnazi Mmoja Institute: Zanzibar’s first neurosurgery centre

The NED Institute is the only neurosurgical care and training centre in Zanzibar. Established in 2014 at the Mnazi Mmoja Hospital in Zanzibar, it has been recognised as a model of collaborative healthcare in Africa for the development of neurosurgery in low-resource health systems.

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courses at the NED Institute

Building and opening of the NED Institute

Funded and co-directed by the Foundation, the NED Institute serves all patients (adult and paediatric) with neurosurgical needs in Zanzibar. It is also accredited by the College of Surgeons of East, Central and Southern Africa (COSECSA) to train neurosurgical registrars.

The NED Institute was born out of a belief that everyone in need should have access to dignified neurosurgical care. However, millions of people in sub-Saharan Africa do not have this opportunity.

The NED Institute develops initiatives to improve medical and surgical care for the population. Our interventions aim to Equip, Treat and Educate (ETE) simultaneously. The foundation co-manages the centre, finances the purchase and maintenance of medical infrastructure, furniture and equipment, assists in patient care through surgical missions, and trains local health professionals through educational initiatives.

Vision: Neurosurgery can transform healthcare provision

Our vision is that neurosurgery should be one of the first surgical subspecialties to be developed, rather than one of the last, as is often the case. If a medical centre can successfully treat patients with neuropathies and perform complex neurosurgical operations, other specialties, such as ICU, anaesthesiology, nursing, orthopaedics, and trauma, will benefit.

The catalytic effect has been observed in practice. After nearly a decade of developing neurosurgery, the diagnostic and clinical capacity of health systems has improved. The infrastructure necessary for caring for neurosurgical patients, including diagnostic tools such as CT scans, clinical laboratories and advanced operating theatre instruments contributes to improving the quality of care and the technical quality of the centres.

The development of surgical services necessitates investment in all components of the healthcare system. Anaesthesiologists, operating theatre staff, biomechanical technicians, critical care services, and nursing staff must work closely with specialist surgeons to ensure smooth surgical activity. Therefore, it is crucial that the rest of the system is functioning properly.

Empower so that they no longer need you

The NED Institute stands out from other initiatives because practitioners have been involved in the project from the start. We collaborate by establishing work routines, creating protocols, and providing tools for professionals to acquire the skills and abilities needed to provide neurosurgical services independently.

The success of the project depends on each of the members of the local team (cleaners, assistants, nurses and doctors). Each one is indispensable, and they all carry out their work with a willingness to face any complication, an interest in learning and the motivation to keep going.

Hundreds of volunteers have set an example for professionals at Zanzibar to achieve good healthcare practices. This starts with cleaning, hygiene, and sterilisation, and progresses to more complex milestones such as practicing complex surgery and managing patients post-surgery. This working philosophy brings us closer to achieving autonomy for the centre in the provision, management, and financing of services.

Nursing: an essential pillar

The work of nurse coordinators is crucial in achieving this goal. During their long stays, volunteers have implemented systems to manage the centre’s resources in an orderly manner. They have established care and team coordination protocols in collaboration with the local staff of the NED Institute.

An excellent example of their impact is the organisation of the sterilisation centre. The milestone has enabled the surgical activity at the centre to be carried out continuously and safely, resulting in reduced infection rates compared to the beginning. The nursing coordinator, Hadiya Mmadi Nahoda, communicates constantly with the foundation’s staff in Spain to organise the warehouses, inventories of material and medication for control and replenishment, and review of expiry dates. This ensures that the supply and replenishment of material is organised whenever needed.

Future

We are thrilled to be collaborating with the Zanzibar Ministry of Health to enhance healthcare and train local professionals. Our foundation is committed to ensuring the project’s quality and sustainability in the long run by aligning our objectives and timelines with the Ministry of Health’s Strategic Plan. We will continue to prioritize the needs of patients and local professionals in all our activities and funding efforts.

This project is the result of hundreds of thousands of selfless volunteer hours. It represents over ten years of dedication to the patients whose stories have touched us. We are motivated to continue by the smiles of each person we have helped. Unfortunately, we have lost some volunteers, patients, and friends in tragic ways.

Toni Gómez left the biggest void among them all. He was there from the beginning but did not see the completion of the NED Institute. Toni always shared and appreciated the importance of an African proverb.