title: Mobile endoscopy: a treatment and training model for childhood hydrocephalus.
abstract: BACKGROUND
  Hydrocephalus, largely a disease of poverty in many developing regions such as Sub-Saharan Africa, becomes even more challenging to treat because of lack of trained neurosurgical personnel, inadequately equipped public health care facilities, meager resource allocation, high rates of neonatal infection, difficulty of access to tertiary care hospitals able to treat hydrocephalus, and high complication rates in patients who are able to access and receive shunting procedures. Furthermore, conventional methods of training of neurosurgeons and nursing staff to become proficient in neuroendoscopic procedures involve a lengthy period of training, often at specialized centers in Western or local Western-style institutions.
  
  
  METHODS
  The novel approach promoted by volunteer neurosurgical teams from Neurosurgery Education Development Foundation is described, and its potential role in successfully providing neuroendoscopic ventriculostomy at hospitals in regional sites away from main referral tertiary hospitals is outlined. The impact on the training of local neurosurgical specialists and residents in training as well as nursing staff is highlighted.
  
  
  RESULTS
  With the use of a single portable neuroendoscopy system and a versatile free-hand, single-operator neuroendoscope, this outreach, mobile, and readily portable model has been successfully used to perform more than 250 procedures in 21 different hospital sites around seven different countries in two continents. The local courses have imparted hands-on training to 62 neurosurgeons and trainee residents and a further 110 operating room nurses at these 21 institutions.
  
  
  CONCLUSIONS
  Neuroendoscopy is not only a priority surgical tool for East Africa. It offers a medical philosophy as an application that serves as an art and a science dedicated to the development of a complex surgical specialty: neurosurgery.
authors.affiliation: Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya. moody_qureshi@yahoo.com
authors.forename: Mubashir Mahmood
authors.initials: MM
authors.lastname: Qureshi
authors.forename: Jose
authors.initials: J
authors.lastname: Piquer
authors.forename: Paul Henry
authors.initials: PH
authors.lastname: Young
mesh_terms: D017954:Africa South of the Sahara; D002648:Child; D004493:Education; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000191:economics / Q000601:surgery*; D007630:Kenya; D008297:Male; D008952:Mobile Health Units / Q000191:economics / Q000458:organization & administration*; D044583:Neuroendoscopy / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D009493:Neurosurgery / Q000191:economics / Q000193:education / Q000458:organization & administration; D019635:Neurosurgical Procedures / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods