Article
Challenges and difficulties in setting up a pediatric neurosurgery service at the borders of Europe
Herausforderungen und Schwierigkeiten bei der Schaffung eines pädiatrischen Neurochirurgiedienstes an den Grenzen Europas
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Authors
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Ioannis Mavridis
- Democritus University of Thrace, Department of Neurosurgery, Alexandroupolis, Griechenland
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George Tokas
- Democritus University of Thrace, Department of Neurosurgery, Alexandroupolis, Griechenland
| Published: | May 25, 2022 |
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Outline
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Objective: The availability of pediatric neurosurgery services is limited in many European areas. With this study we aimed to describe difficulties and challenges we faced while trying to set up such a service in our institution (at the eastern European borders) and how we managed them.
Methods: Following the addition of a pediatric neurosurgeon to our staff, we have been trying to set up a pediatric neurosurgery service in our Hospital (a tertiary reference center covering a population of around 600,000) over the last 15 months. We retrospectively analyzed the numerous difficulties and challenges we have confronted during this ongoing effort so far and our particular care to deal with them.
Results: The major difficulties included: 1) absence of pediatric intesivists, 2) absence of a dedicated pediatric neurosurgery outpatient clinic, and 3) limited available equipment for pediatric neurosurgery procedures. We therefore initially avoided extensive surgeries that would require intensive care, we established the first dedicated pediatric neurosurgery clinic in our region, and we achieved to increase the existing equipment (an ongoing effort). The main challenges included: 1) multicultural populations and minorities from various areas often with limited access to medical care and communication problems, 2) refugee flows crossing the borders to reach Europe in various dangerous ways with frequent accidents, 3) unfamiliarity of the regional population with the opportunity to receive such specialized care at our institution and, of course, 4) the ongoing covid-19 pandemic. Dealing with these challenges, we carefully managed children from different cultural backgrounds using translators were necessary, we adapted to the pandemic protocols, and publicized our Hospital’s new service via the local media.
Conclusion: Setting up a pediatric neurosurgery service is a challenge itself. In the context of a European border area with multicultural populations, frequent refugee flows and during a pandemic period, the goal seemed elusive. However we proved it wasn’t. Sharing difficulties and challenges during such efforts, and the ways to manage them, can help neurosurgeons all around the globe who want to try similar endeavors, particularly in geographically and culturally sensitive regions.
