Roger Härtl, MD, in partnership with the Tanzania Neurosurgery Project and Muhimbili Orthopaedic Institute published a paper in Neurosurgical Focus tracking traumatic spinal cord injury patients in East Africa.
Their study of 466 patients led to successful follow-ups in 40.6% of them, and almost 85% of them experienced post-discharge complications. The findings highlight the need for rehabilitation and support following discharge from spine surgery.
Dr. Härtl discussed the study and how groups can bolster the outcomes for international patients.
Note: Responses were lightly edited.
Question: This study underscores the impact of traumatic spinal injuries and the need for postoperative services for patients in Tanzania. How has the MOI Tanzania Group addressed these?
Dr. Roger Härtl: The MOI Tanzania Group has addressed healthcare challenges through strategic international collaborations. Their partnership with Weill Cornell Medicine has strengthened clinical capabilities and has led to a recent initiative that unites MOI, Weill Cornell Medicine, UCSF and SIGN Fracture International — a humanitarian organization building sustainable orthopedic capacity in developing countries through surgeon education and essential implant donations. Together, they’ve developed a comprehensive longitudinal spine trauma database that tracks patient outcomes with the goal of creating sustainable pathways for implant availability in resource-limited settings. Preliminary findings from these collaborative efforts show significantly improved follow-up rates compared to historical data. These partnerships demonstrate how combining local expertise with international support enhances both acute surgical care and long-term patient outcomes in challenging healthcare environments.
Q: What can surgeons and other volunteers do to improve care beyond the operating room?
RH: Keeping patients in the system is key. Many are lost after discharge due to poor follow-up, so better record-keeping, multiple contact numbers, and SMS reminders can help. Patients also need education — on the importance of follow-up care, preventing pressure ulcers, infections, and contractures before discharge can make a big difference. Rehab access is another challenge. Hospitals can train staff in basic therapy techniques, even teaching family members simple mobility exercises. Telehealth or community-based check-ins can help bridge the gap when in-person visits aren’t possible.
Short-term missions provide valuable surgical care, but their impact can extend further. Visiting surgeons can train local teams during their stay, ensuring skills are passed on. They can also set up simple patient tracking systems, helping hospitals follow up with discharged patients more effectively. Donating essential recovery equipment like wheelchairs, braces, and pressure relief cushions can prevent complications. Also, ensuring the presence of means of maintaining these equipment and recovery tools. Even small changes — like providing educational materials or helping establish a basic rehab protocol — can make a lasting difference for patients.
Q: How can surgeon volunteers and medical volunteer organizations bolster support to hospitals abroad beyond their stays in the region?
RH: Surgical missions are important, but real change happens when volunteers invest in building long-term capacity. Our seven-point sustainable initiative serves as a model for centers aiming to establish similar programs. This initiative includes yearly teaching and training visits to Tanzania, an annual Neurosurgery Symposium, a three-month observational fellowship at Weill Cornell for Tanzanian healthcare professionals, a one-year Global Neurosurgery Fellowship for a fully trained North American or European neurosurgeon to teach in Tanzania, ongoing clinical research collaboration, weekly Zoom conferences, and joint academic publications. Finally, volunteers can push for policy changes and funding support, helping to expand rehab access, insurance coverage, and post-op care programs. The goal isn’t just to bring surgical expertise for a week — it’s to leave behind knowledge, resources, and systems that last.
Q: What other volunteer work are you planning for this year?
RH: This year has been an exciting one for global neurosurgery. We had the privilege of participating in the 11th Global Neurosurgery Course at the Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, where faculty worldwide gathered to teach and collaborate. The course covered various topics, including spine surgery, scoliosis, endoscopy, pediatrics, epilepsy, and neurotrauma, alongside a dedicated nursing education track.
Beyond the course, we hosted specialized endoscopy and scoliosis courses and surgical camps, providing hands-on training and expanding access to advanced spine care. Our commitment to global collaboration continued through ongoing research initiatives to improve neurosurgical outcomes in low-resource settings. Additionally, we facilitated exchange opportunities for Tanzanian neurosurgeons to visit New York, strengthening international partnerships and mentorship. This year’s work has been a testament to the power of education, research, and collaboration in advancing neurosurgery worldwide.