Underserved Populations in Healthcare

Medical Education and Training Benefiting Underserved Populations Worldwide

Nearly 3.5 billion people worldwide lack access to healthcare–a number expected to soar to 5 billion by 2030, according to the World Health Organization (WHO). The WHO also estimates that one in three people in the world is afflicted by a neurological condition. Although many of these conditions can be treated, of the 14 million patients annually needing neurosurgical interventions, upwards of 5 million don’t receive them due to limited medical resources.

Already recognized as an international leader in the neurosciences, Barrow Neurological Institute has drawn patients around the world to receive lifesaving care for diseases of the spine and brain. Now, Barrow is turning the tides on health disparities worldwide through Barrow Global, a multi-pronged approach to educating neurologists and neurosurgeons in developing nations worldwide.

Advancing Global Neurological Care in Underserved Populations

Barrow Global was established in 2021, inspired by the legacy of world-renowned neurosurgeon Robert Spetzler, MD, who trained countless neurosurgeons worldwide. His vision is now embodied by current Barrow President and CEO Michael Lawton, MD, who, like his predecessor, believes, “Teaching is the great multiplier.’ 

Shortly after Barrow Global was established, Barrow Neurological Foundation received a transformational gift from Bill and Carolyn Franke to expand the Institute’s mission to countries that can benefit the most from its knowledge and innovation. In honor of this gift, Barrow established the Franke Global Neuroscience Education Center, which features programs to educate the next generation of neuroscience professionals worldwide. The Franke Gift is one of the largest gifts in the nation made for the continued development of neuroscience. 

“Carolyn and I believe education is vital to advancing life-saving care for patients with devastating neurological conditions. The Franke Global Neuroscience Education Center will allow Barrow to expand its international and undergraduate educational programs and to develop a legacy of learning that will have a global impact.”

Bill Franke

The Franke Global Neuroscience Education Center is Barrow’s platform for building neuroscience care and clinical education programs to reach, teach, and serve its colleagues in the developing world. Currently, the Center comprises the following programs:

• Franke Global Neurosurgery Fellowship
• Franke Global Neurosurgery Research Fellowship 
• International Sonntag Spine Center Research Fellowship
• Frank Global Undergraduate Internship
• International Visiting Scholars and Clinical Observerships
•  International Mission Trips

Addressing Neurosurgery Challenges in Tanzania, East Africa

Barrow established its first neurosurgical partnership in 2022 with Kilimanjaro Christian Medical Centre (KCMC). KCMC serves more than 11 million people, yet it has never offered neurosurgical training, leaving general surgeons to perform routine and complex neurosurgical cases.

Barrow Global Co-Director and neurosurgeon Dilan Ellegala, MD, has been instrumental in fomenting the KCMC partnership, traveling to Tanzania himself to successfully launch the clinical site and develop an effective training program. This includes hospital-based, regional, and local neurosurgeons applying U.S.-level skills in patient care and Barrow-trained neurosurgical fellows spending a year at KCMC mentoring local partners, furthering the global mission. Additionally, Dr. Ellegala appointed Tanzanian neurosurgeon Happiness Rabiel, MD, as lead neurosurgeon at KCMC.

The partnership between Barrow Global and KCMC has yielded countless accomplishments in a very short time:

• More than 800 patients have received neurosurgical operative care
• Nearly 4,000 patients have undergone non-operative consultations
• 150+ KCMC medical students rotate through the surgical unit each year 
• 100+ medical students from 20 different countries attend clinical and neurosurgical rotations 
• 2 KCMC general surgery graduates now specializing in neurosurgery
• The launch of the Barrow Global Bulletin, the first Global Neuroscience digital news magazine in the U.S.
• More than 15 articles published in peer-reviewed medical journals
• The Neurosurgical Residency Program at KCMC is now under review with the College of Surgeons of East Central and Southern Africa.
• The first Tanzanian Neurosurgical Society Meeting held in conjunction with a surgical training camp at KCMC
• The launch of the Global Neuroradiology Program in partnership with the Barrow Neuroradiology Program

Medical Education and Training in Developing Nations Worldwide

Franke Global Neurosurgery Fellowship

“The Franke Global Neurosurgery Fellowship enables full-time, trained neurosurgeons to teach and work in Tanzania and other African countries,” explains Barrow Chief Medical Director and Co-Director of Barrow Global F. David Barranco, MD. “This is a new concept in providing training and medical expertise in remote locations to upgrade the quality of patient care in financially and medically limited regions.”

Barrow Global welcomed Kerry Vaughan, MD, to campus in January 2023 to begin her first three months of training as the inaugural Franke Global Neurosurgery Fellow. She then spent nine months in Tanzania training neurosurgeons and establishing a sustainable education program modeled after Barrow’s successful neurosurgery programs. 

“My many experiences in global neurosurgery have taught me, through collaboration with local teams, how to do so much more with so much less,” says Dr. Vaughan. “Having the opportunity to travel to so many different countries and be part of their healthcare systems, learning from local teams, has made me realize that we all have the need for compassion, care, and community that brings us together and makes for great healthcare teams.” 

After completing her fellowship, Dr. Vaughan remained on as Barrow Global faculty. Maria Punchak, MD, a Georgetown University graduate who earned her medical degree from UCLA and completed neurosurgery residency training at Penn Medicine, will join the program as the second Franke Global Neurosurgery Fellow in 2026.

International Sonntag Spine Center Research Fellowship

Barrow selected Temesgen G. Assefa, MD, as the inaugural International Sonntag Spine Center Research Fellow, making him the first-ever Ethiopian neurosurgeon to come to the U.S. for a fellowship program. Born and raised with nine siblings in a small Ethiopian town, he graduated with distinction from the University of Gondar and then joined Addis Ababa University for his neurosurgery residency, performing more than 700 procedures.

At Barrow, Dr. Assefa primarily worked in the Spinal Biomechanics Laboratory, effectively executing sponsored teaching and training laboratories and conducting or participating in numerous research studies. He also received one of Barrow’s highly competitive Fast Track Awards to investigate the biomechanical effects of facet joint violation, which causes extreme pain and stiffness, at the thoracic spine during spinal fixation surgery.

“Dr. Assefa’s academic orientation, strong work ethic, and extensive medical knowledge have significantly contributed to our efforts,” says Brian Kelly, PhD, director of the Barrow Spinal Biomechanics Lab. “He is very actively engaged in resident-led studies, and his surgical skills have been invaluable.”

Following the fellowship, Dr. Assefa returned to Black Lion Hospital in Ethiopia and continues to collaborate with Barrow Global on research projects. “My goal now is to advance spine surgery, especially minimally invasive spine surgery, and research activities back in my home country,” he says. Ethiopian neurosurgeon Fisiha G. Shiferaw, MD, will join as the second International Sonntag Spine Center Research Fellow in 2025.

Franke Global Undergraduate Internship Program

The Franke Global Undergraduate Internship Program enables students from developing countries to come to Barrow for a 10-week summer internship. The Program focuses on familiarizing students with all the different aspects of neuroscience as they work alongside Barrow physicians and scientists conducting hands-on research.

This year, out of the 66 applications from 24 countries, Barrow selected Francisco Javier Gomez Vertiz from Mexico and Vitor Ikeda Ito Silva from Brazil for the program. Francisco interned with Brian Kelly, PhD, in the Spinal Biomechanics Lab, while Vitor interned with Ruchira Jha, MD, pursuing his interest in investigating the molecular mechanisms of neurological disorders.

“I wanted to learn from the best in the world, accepting challenges and taking home what I learned to inspire others, to show them that a limit doesn’t exist,” says Vertiz. Expressing a similar sentiment, Silva says, “In addition to the cutting-edge science, I believe the hospital’s values and working environment helped develop me as a person. I intend to apply these principles wherever I go in my career.”

Balancing Health Equity in Global Neurology

Healthcare leaders worldwide recognize the urgent need to address health inequity issues in underserved populations. In just three short years, several thousand patients in underserved communities worldwide have benefited from the training and skills medical students and physicians have acquired through the Barrow Global program. The power of this progress cannot be understated.

Now, through a bidirectional partnership with the University of the Witwatersrand in Johannesburg, South Africa, the Barrow Department of Neurology is establishing a program to cross-train neurologists from South Africa and the United States. Brad A. Racette, MD, FAAN, Senior Vice President and Chair of Neurology at Barrow, is leading this initiative. For the past 15 years, Dr. Racette has collaborated with researchers in South Africa to study manganese toxicity and other Parkinson’s disease risk factors affecting rural communities.

The program’s initial phase will focus on building epilepsy expertise in South Africa by hosting one neurologist from the University of the Witwatersrand for an epilepsy fellowship at Barrow Neurological Institute. Barrow will also send one of its neurologists to train at Chris Hani Baragwanath Hospital in Soweto, South Africa. Additionally, the program will include biannual visiting clinical observerships by Barrow neurologists, who will participate in examinations, procedures, teaching rounds, and educational conferences.

In 2024, Dr. Racette, along with Barrow Global Neurology assistant director Huiam Mubarak, MD, and Barrow vascular neurologist Daniel Gonzalez, MD, traveled to South Africa for a healthcare mission trip and toured Chris Hani Baragwanath Hospital.

“It’s eye-opening…One of the best things that came from my experience is the person that I was allowed to become after experiencing all the hardships that everyone in South Africa is facing.”

Daniel Gonzalez, MD

Along with treating patients, Barrow Global physicians establish lifelong relationships with peers and mentors while gaining confidence that they can continue inspiring impactful change worldwide. Perhaps most importantly, says Dr. Mubarak, “It changes patients’ lives and our own. Wherever we go, we get way more from patients than we give to them. We are making a huge impact.”

Inspire Global Change with Your Donation

Neuroscience care in the developing world is challenging. Your gift today supports Barrow Global’s mission to improve access to advanced neurosurgery and neurology in the developing world through education and training. Please join us in changing the lives of patients worldwide who are suffering from the most devastating neurological conditions.

Visit us online and make a life-changing gift today!