Historical Overview of the only Neuro-Psycho-Pathology Center in the Democratic Republic of Congo

Review of epilepsy care in the Democratic Republic of the Congo

Epilepsy imposes a substantial burden on the Democratic Republic of Congo (DRC). These challenges encompass the lack of comprehensive disease surveillance, an unresolved understanding of its pathophysiology, economic barriers limiting access to essential care, the absence of epilepsy surgical capabilities, and deeply ingrained societal stigmas. Notably, the national prevalence of epilepsy remains undetermined, with research primarily concentrating on infectious factors like Onchocerca volvulus, leaving other potential causes underexplored. Most patients lack insurance, incurring out-of-pocket expenses that often lead them to opt for traditional medicine rather than clinical care. Social stigma, perpetuated by common misconceptions, intensifies the social isolation experienced by individuals living with epilepsy. Additionally, surgical interventions are unavailable, and the accessibility of anti-seizure medications and healthcare infrastructure remains inadequate. Effectively tackling these interrelated challenges requires a multifaceted approach, including conducting research into region-specific factors contributing to epilepsy, increasing healthcare funding, subsidizing the costs of treatment, deploying mobile tools for extensive screening, launching awareness campaigns to dispel myths and reduce stigma, and promoting collaborations between traditional healers and medical practitioners to enhance local understanding and epilepsy management. Despite the difficulties, significant progress can be achieved through sustained and compassionate efforts to understand and eliminate the barriers faced by epilepsy patients in the region. This review outlines essential steps for alleviating the epilepsy burden in the DRC. PLAIN LANGUAGE SUMMARY: There are not enough resources to treat epilepsy in the DRC. PWEs struggle with stigma and the lack of money. Many of them still use traditional medicine for treatment and hold wrong beliefs about epilepsy. That is why there is a need for more resources to make the lives of PWEs better in the DRC.

Review of Neurosurgery in the Democratic Republic of Congo: Historical Approach of a Local Context

Neurosurgical practice in the Democratic Republic of Congo (DRC) is challenged by limited resources and infrastructure. The DRC has 16 local residing neurosurgeons for 95 million inhabitants, a ratio of 1 neurosurgeon per 5.9 million Congolese citizens. This is attributable to decades of political unrest and a loosely regulated health care system. Understanding the role of neurosurgery in a historical context is necessary to appreciate and overcome current challenges in the delivery of neurosurgical care. We describe past and present political, social, and economic challenges surrounding the development of neurosurgical practice and training. Highlights of early innovators, current challenges, and a suggested framework to guide future advances in neurosurgical practice are provided. Interviews with Dr. Antoine Beltchika Kalubye, the oldest living neurosurgeon in the DRC, and Dr. Jean-Pierre Kalala Okito, current president of the Congolese Society of Neurosurgery, provide a detailed account of events. Firsthand narrative was supplemented via literature review and collaboration with registrars in the DRC to review current neurosurgery programs. Our discussions revealed that decades of political unrest and inconsistent management of health care resources are responsible for the current state of healthcare, including the dearth of local neurosurgeons. The neurosurgery workforce deficit in the DRC remains substantial. It is essential to understand local neurosurgical history, in its present state and breadth of challenges, to inform future development of neurosurgical care and to secure equitable partnerships between local stakeholders and the international community.