Dr. Benjamin Warf thought the prospects were poor that Ugandan children with hydrocephalus, an excess of water on the brain, could be successfully treated by implanting a drainage tube. Families he cared for at a Mbale hospital had limited access to health care. A blockage in the tube, called a shunt, could be disastrous.
In the early 2000s, Warf devised an alternative that reduced the number of infants who needed brain shunts by about two-thirds. It became the standard of care at Boston Children’s Hospital, where he directs the Neonatal and Congenital Anomaly Neurosurgery Program. Now Warf is unraveling the causes of hydrocephalus, work he hopes could lead to prevention.
The 54-year-old from Lexington has been named a 2012 MacArthur Foundation Fellow, one of four Boston-area recipients of the “genius grant.” The award comes with a $500,000 stipend, and, for Warf, visibility for a global health problem that he said has been “way under the radar.”
Warf grew up in the Appalachian Mountains of Eastern Kentucky, the son of a Baptist pastor with an interest in science. He graduated from Harvard Medical School in 1984 and was drawn to pediatric neurosurgery in part by his love of children. He and his wife, Cindy, have six of their own.
The pair decided in early 2000 to act on Warf’s dream of being a medical missionary. He had made some short trips to Kenya with CURE International, a Christian group that provides surgical care in developing nations, and in March of that year the couple moved their family to Uganda, where he would help to open a hospital specializing in neurosurgery.
Warf was unhappy with placing shunts in Ugandan patients. In the United States, about half of shunts fail within two years, and some children endure scores of operations.
Warf tested a combination of techniques that alone had been mostly ineffective in treating infants with hydrocephalus. He cauterized tissues in the brain to slow the production of fluid and made small openings in the base of the brain to allow fluid to drain into the cavity around it. Warf and colleagues followed patients over time and found the method was effective.
When researchers overlaid data Warf had collected with weather patterns, they found the incidence of infection rose and fell with rainfall, pointing to an environmental pathogen.
Now Warf and colleagues are partnering with a hospital and medical school in Uganda to follow mothers and babies from birth to six months of age to learn more about those who develop hydrocephalus.