GLOBAL NEUROSURGERY PROGRAM
UAB Neurosurgery Resident Researches and Treats
Hydrocephalus Abroad
After spending nearly six months training in Vietnam’s
Ho Chi Minh City, UAB Department of Neurosurgery
resident Jacob Lepard, MD, returned to UAB in the
summer of 2018 with a renewed sense of purpose and
reverence for global neurosurgery.
In mid-2018, Dr. Lepard completed the Paul Farmer
Global Surgery Fellowship. The program, sponsored by
Harvard Medical School’s Program for Global Surgery
and Social Change, allowed Dr. Lepard to practice and
conduct clinical research in both Uganda and Vietnam,
where many still lack access to safe surgery.
Dr. Lepard’s fellowship has provided him with
opportunities to learn from a number of Ugandan
and Vietnamese surgeons and to continue his
international training in the endoscopic management of
hydrocephalus, a neurological disorder caused by fluid
building within the brain.
UAB Department of Neurosurgery resident Jacob Lepard, MD, visited
the Cure Children’s Hospital of Uganda as part of a global surgery
fellowship hosted by UAB and the Program in Global Surgery and
Social Change at Harvard Medical School.
“There’s really no amount of U.S. residency training that’s going to fully prepare you for what you see in Africa and
Vietnam and other places, because they just see things that we don’t see here,” Dr. Lepard says.
A MORAL IMPERATIVE
Dr. Lepard spent two months at Cure Children’s Hospital of Uganda (CCHU) as part of the global surgery
fellowship. CCHU created an approach of meeting the needs of this disease in sub-Saharan Africa (SSA) by
sponsoring a fellowship focused on educating neurosurgeons from low- and middle-income countries in
the surgical treatment of hydrocephalus. Dr. Lepard’s role at CCHU included assisting in data collection on
the effectiveness of their fellowship program and surgical outcomes to improve understanding of pediatric
hydrocephalus in SSA.
The prevalence of hydrocephalus and other similar conditions within low- or lower-middle-income countries,
such as Uganda and Vietnam, and the lack of available medical care for patients living with those conditions
necessitate global health initiatives such as the Program for Global Surgery and Social Change.
“I think the fact that the vast majority of our population on Earth, 5 billion people, doesn’t have access to safe
surgery really makes it a moral imperative to solve this problem,” Dr. Lepard says.
Research published in The Lancet in 2015 reported that 143 million additional surgical procedures are still needed
each year in low-income and lower-middle-income countries in order to meet the medical needs of people who
live there.
“That number is kind of unfathomable to think of,” Dr. Lepard says. “In the U.S., if you have appendicitis, you go to
the hospital, and you get your appendix taken out. If you get in a car wreck and you have an epidural hemorrhage,
you go to UAB or somewhere else, and a neurosurgeon takes care of you. In other places, you simply don’t have
access to that, so the alternative is that you don’t survive.”
Because Vietnam and other low-income or lower-middle-income countries continue to face a lack of access to
safe surgery, many surgeons and neurosurgeons throughout the world have developed a global response to this
crisis.
28
UAB Neurosurgery Annual Report 2020