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AANS Neurosurgeon | Volume 27, Number 4, 2018

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Neurosurgery in the Brazilian Amazon is Possible

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Low- and middle-income countries in remote locations with little access to care can create sustainable neurosurgical programs by recruiting and training young, local doctors, according to a Rutgers study.

The study analyzed the effectiveness over the past 20 years of a successful neurosurgical department, its residency program, an international residency rotation and a medical student exchange program, all in Santarém, a poor, remote region of Brazil in the Amazon rainforest.

Access to care for residents of Brazil’s rural north, where Santarém is located, depends on finding affordable transportation to the region’s only municipal hospital, which serves an area larger than Texas with limited resources.

Specialized care is almost non-existent. Patients whose conditions cannot be treated locally are transferred to larger regional hospitals. Researchers say attracting medical residents and attending physicians to the remote location – where there is one neurosurgeon for every 200,000 to 500,000 people – has been difficult due to low pay and a lack of surgical supplies.

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