Sierra Leone’s First Neurosurgeon Transforms Patient Care

Morie Abibu, a 56-year-old man from Sierra Leone, is fighting for his life. Paralyzed from the neck down, he lies on a hospital bed in Connaught Hospital, where a mass at the base of his skull is pressing against his spinal cord. Without neurosurgery, Abibu faces a grim fate. Fortunately, he is now under the care of Dr. Alieu Kamara, the first and only neurosurgeon in Sierra Leone, who began his practice in January 2025.

Before Kamara’s arrival, patients like Abibu had little hope. According to Dr. Kehinde Oluwadiya, the acting chief medical director at the University of Sierra Leone Teaching Hospital Complex, those without financial means often faced life or death situations. “If you are lucky and rich, you will go to another country and be treated. But if you are not, it’s either you die or you live with a lot of disability,” he stated.

Kamara’s training and establishment of a neurosurgical department at Connaught Hospital mark a pivotal moment in the country’s healthcare landscape. The hospital is now equipped to handle a variety of neurosurgical cases, including traumatic injuries and brain tumors, providing much-needed care to a population of approximately eight million.

Challenges and Triumphs in the Operating Room

On the day of Abibu’s surgery, the operating room buzzes with activity, but challenges are evident. The surgical ward has limited resources, with two operating rooms shared among various specialties. As the team prepares, improvised solutions become necessary. Bolsters made from surgical gowns and masking tape support Abibu, while a nurse swats flies to maintain a sterile environment.

As Kamara begins the surgery, he uses controlled electric currents to dissect the tissue. One and a half hours into the procedure, he removes a chunk of bone that had been affected by the tumor. The surgery is not without its difficulties; multiple power outages occur during the operation, plunging the room into darkness. The team relies on battery-powered surgical headlights to continue their work. After three tense hours, Kamara successfully closes Abibu’s incision with fourteen staples, completing the first spinal surgery in Sierra Leone.

A Lifelong Journey to Neurosurgery

The journey to becoming a neurosurgeon was not easy for Kamara. Born in a small village, his childhood was overshadowed by an eleven-year civil war. During his secondary school years, he resolved to become a doctor after witnessing a friend’s injury and realizing he could not help.

Kamara’s path to medicine was fraught with obstacles, including financial challenges that delayed his studies. After working for two years to save money, he secured a scholarship to study medicine in Jilin, China, where he earned both an MD and a Ph.D. in orthopedic surgery. Upon returning to Sierra Leone in 2020, he operated on patients with broken bones, but the absence of a neurosurgical ward meant he could not treat patients with head or spinal injuries effectively.

Recognizing the urgent need for neurosurgical care, Kamara sought further training. His efforts were supported by a grassroots network of professionals committed to improving healthcare in Sierra Leone.

After a visit from Fatu Conteh, a neurosurgery resident from California who had fled the civil war, a plan was set in motion to bring neurosurgery to the country. Conteh connected with Dr. Sonia Spencer, chairperson of the hospital complex, and together they sought partnerships to develop a neurosurgery program.

Collaboration with organizations like Mission Brain enabled the establishment of training programs and the provision of necessary surgical supplies. The organization, led by April Sabangan, aims to expand neurosurgery access worldwide, and Sierra Leone became a focal point for their efforts.

Kamara’s training included an eighteen-month neurotrauma fellowship offered by Dr. Abdessamad El Ouahabi, a Moroccan neurosurgeon. This partnership, alongside contributions from various donors, resulted in significant advancements in neurosurgical care in Sierra Leone.

The Road Ahead

Just six hours post-surgery, Abibu begins to show signs of recovery. As Kamara checks on him, Abibu manages to move his toes, a remarkable achievement considering his prior condition. “For a patient paralyzed for months to move their toes just six hours after surgery is almost unheard of. It’s a miracle,” noted Dr. Silvia Vaca, one of the assisting surgeons.

Despite these successes, significant challenges remain. Connaught Hospital often faces shortages of essential supplies like IV fluids and bandages, and many patients struggle to afford treatment. Abibu’s family had to borrow $300 to cover his surgery costs, a sum that represents half of a typical family’s annual income in Sierra Leone.

Efforts are underway to improve sustainability in the healthcare system. The government is working to establish a dedicated neurosurgery ward and has purchased a CT scanner for the hospital. With ongoing support from Mission Brain, 24 nurses have been trained in neurotrauma patient management, marking a significant step towards self-sufficiency in neurosurgical care.

Kamara’s vision extends beyond patient treatment; he aims to inspire future generations of medical professionals in Sierra Leone. By providing training and mentorship, he hopes to cultivate a new wave of healthcare leaders who can continue to drive change.

“I work around the clock. I work seven days a week. I have to follow up on patients,” Kamara said, reflecting his commitment to improving healthcare in his country. The journey of neurosurgery in Sierra Leone is still in its infancy, but with dedicated individuals like Kamara at the helm, the future holds promise for many.