Journal Mobile

Author(s): 
IM Izzeldin, EA Nagi
Journal Issue: 
Volume 38: Issue 1: 2008

Format

Abstract

 

This  report, compiled  after  a  short  visit  to  Darfur  sponsored  by  the Association of British Neurologists, describes the status of healthcare in Nyala, the capital of southern Dafur. Four hospitals and 19 consultants supervise the care of over three million people. The most common neurological diseases in Darfur are infections of the central nervous system, characterised by meningitis during the dry seasons  and  cerebral  malaria  following  the  short  rainy  autumn. Trauma-related neurological disorders are common. Epilepsy, mostly symptomatic, is largely caused by untreated or poorly treated CNS infection, head injury and neonatal/childhood diseases. Epilepsy  management  is  greatly  hindered  by  the  fact  that  the  disease  is considered to be a social stigma. Uncontrolled hypertension is the leading vascular risk  factor, and  stroke  is  frequently  seen  in  younger  patients  who  are  not  fully investigated. During  his  visit, the  first  author  saw  46  patients  in  whom  the  most common  neurological  problem  was  infection  and  trauma-related  epilepsy. The spectrum  and  presentation  of  neurological  diseases  was  very  different  from  the usual  disease  pattern  seen  by  neurologists  in  the  UK. Most  components  of  a multidisciplinary team for neurological patients are lacking; no physical, occupational or  speech  and  language  therapy. The  medical  and  neurology  services  in  Nyala desperately  need  CT  scanning  to  complement  a  reasonably  equipped  laboratory service. In addition, there is a need for local clinical guidelines to govern the practice of more junior staff and those working in disadvantaged health units.

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