Dr. Mohammad Ali Aziz-Sultan was 6 when his family left Afghanistan, fleeing the violence of the Russian invasion in 1979. But, in many ways, he never truly left.
The head of vascular and endovascular neurosurgery at Brigham and Women’s Hospital has dedicated much of his career to bringing supplies and his own expertise back home, a charge he feels is his responsibility as a physician.
“[We can] use the same technology politicians use to incinerate villages with drones and bombs to save lives,” he said. “Maybe then we can lead with humanitarian diplomacy as opposed to force.”
To help foster this vision, he co-hosted a two-day symposium earlier this month, bringing together neurosurgeons from around the world to discuss how best to deploy modern technology to broaden global access to neurosurgery. Leading physicians from countries like the Czech Republic, Senegal, and Malaysia joined local experts at the Harvard Club of Boston on Sept. 7 and 8 to discuss the challenges of operating in lower-resource conditions and opportunities for increased international collaboration.
Aziz-Sultan and a group of Brigham colleagues launched the Cerebrovascular and Skull Base Symposium in 2015 to foster honest conversation about how to improve care delivery and build camaraderie among providers. Cerebrovascular diseases refer to conditions that affect blood flow to the brain, including stroke and aneurysms; skull base surgeries treat cranial disorders, including brain tumors, that affect the bottom part of the skull.
Since then, the symposium has grown from a local conference to this year’s global event. This month’s meeting, held in partnership with the World Federation of Neurosurgical Societies, was the group’s first gathering since the COVID-19 pandemic.
Since 2006, Aziz-Sultan has traveled to Afghanistan to bring medical supplies and help treat patients, supporting local providers as increasing political insecurity and international sanctions have caused the near-collapse of the country’s health care system. When the United States withdrew from Afghanistan in 2021, he worked with Afghan-Americans to raise $700,000 in three days to send much-needed head and spine trauma kits back home, he said.
In recent years, he has worked closely with fellow Afghan neurosurgeon Dr. Mohammad Jaweed, who traveled to the conference from Malaysia, where he is based.
Jaweed presented on how he used telemedicine in April to virtually assist surgeons at Ningarhar Regional Hospital in eastern Afghanistan to remove a brain tumor from a 9-year-old child. “I was with them throughout the almost five-hour surgery until the moment they closed,” he said.
Soon, he will be able to do more than just peer through the screen. Recently, he said, Jaweed and Aziz-Sultan sent smart glasses developed by Los Angeles-based company Ohana One to colleagues in Afghanistan. The glasses allow remote helpers to see what their counterparts are seeing and vice versa so they can offer real-time support.
“I can point where to make an incision, for example, and they’ll see that through their pair,” he said.
Experts also presented on the challenges of practicing in countries where there are shortages of neurosurgeons. According to Dr. Mbaye Thioub, professor of neurosurgery at Cheikh Anta Diop University in Senegal, the West African nation only has 28 trained neurosurgeons in a country of nearly 17 million people. As a result, he said, they cannot treat everyone.
Between 2012 and 2013, he said during his presentation, his center received 604 aneurysm cases and could only treat 463, meaning nearly a third left without care.
But, as many doctors noted, there has been progress. In attendance at the conference was Dr. Arnold Bhebhe, a recent graduate of Zambia’s first neurology training program.
Prior to the start of the program in 2018, the country of roughly 19 million people, lacked “a single locally-trained, full-time neurologist,” according to a paper published in Neurology Today. Bhebhe said he is one of six graduates of the program with 12 more in training.
“We’re still very far in terms of what is happening in the rest of the world,” he said. “But, it’s a start.”
Aziz-Sultan aimed for the conference to build kinship among providers, introducing the crowd to five Afghan neurosurgeons during his speech.
“My brothers are stuck at home and I just wanted you to meet them,” he said, flipping the screen of his laptop as he presented the smiling faces of his colleagues, who joined him via Zoom. “These are my teachers, my friends, and your brothers in neurosurgery.”
That goal was achieved, said Dr. Nirav Patel, a fellow Brigham neurosurgeon who was part of the team hosting the conference and an assistant professor of neurosurgery at Harvard Medical School.
“The world is much smaller after this two-day conference,” he said during the closing remarks. “I don’t feel as alone in the endeavors and challenges I’m trying to take on.”