“Ignorance aggravates serious neuro-diseases” [Archives:1998/47/Health]

November 23 1998

There is no doubt that neuro-diseases are quite common in Yemen. Every year, thousands of victims die because of brain disorders and other neurological problems.
Dr. Yahya Ali Al-Thawr, one of a few specialists in neuro-surgery in Yemen, studied and specialized in neurology in Germany. He worked there for 13 years as a senior consultant. Today he is the head of the neuro-surgical center in a private hospital in Yemen. In addition, he pursues his career as a surgeon in Germany.
Ms. Nadwa Al-Dawsari of Yemen Times met Dr. Al-Thawr and filed this interview:
Q: Coming home after a long time of practicing surgery in Germany, what have you found?
A: There are no opportunities available for practicing neuro-surgery in Yemen. Coming back home in 1994, I brought the proposal for a huge project with me; a hospital for internal and neuro-surgery. The EC agreed to give me a loan to start the project here in Yemen.
Although it was a personal loan, the government refused to give me permission to implement the project. The loan was totally refused and the project was never implemented.
Imagine that US $700 million goes every year for treating Yemeni people abroad. This of course does not include all Yemenis, but upper-class people. Often those who are sent abroad do not usually suffer from serious diseases.
My project would have offered much less costly treatment inside Yemen. I studied the project carefully with some German specialists. It cost me about DM 70,000 preparing the feasibility study of the project. I talked to the Prime Minister and the Minister of Finance then. I approached the relevant authorities, but they said that no permission can be given for implementing private projects. We asked them to take the loan and implement the project as a public institution, but they also refused.
Q: What are the reasons that cause neuro-problems and diseases in Yemen?
A: Neuro problems are divided into two parts:
1. Neuro-diseases.
2. Accident-related neuro-problems (backbone and skull fractures, internal bleeding, etc.).
In Yemen, there are many patients who develop neuro-problems like palsy because of shooting accidents. This unfortunately happens because of social practices like revenge and land dispute fighting.
Other neuro-diseases prevalent in Yemen are engiums, eneuresma, hypophuse tumors, posterior-fossa tumors, meningo-encephalitis, meningocele, and spinal tumors.
What is really sorrowful is that there are many neuro cases among children. There are about one million disabled children in Yemen; of whom, unfortunately, 80% belong to the lower classes. People in Yemen are unaware of how important taking care of women and children is.
Most Yemeni women deliver their babies at home. In complicated pregnancy cases, lack of oxygen causes serious neuro-problems to babies. About 70% of disability cases among children are caused by this. After birth, some children get meningo-encephalitis. Most often, they are not quickly taken to hospitals, leading to brain atrophy and eventually to palsy.
Another reason is that some women go to doctors for treatment and do not say that they are pregnant. I’m very sad to say that some doctors also prescribe wrong medicines for pregnant women which causes congenital deformities.
Another reason behind neuro-problems in Yemen is that marriage among relatives is so common here. This causes different hereditary diseases, including serious neuro-diseases like meningocele and hydrocephalus. Those patients may live after treatment but, unfortunately, as disabled.
Q: What difficulties do you face as a neuro-surgeon?
A: Lack of medical equipment! The magnetic resonance machine (MRI) is a diagnostic piece of equipment which costs US $800,000. This machine is capable of detecting diseases at their early stages, making treatment more effective. MRI is not available in Yemen. It is available in many countries like Djibouti and Ethiopia, but not in Yemen. In Jordan an MRI became available 18 years ago.
We also need blood-vessels diagnostic equipment. This is usually a check-up piece of equipment that discovers engiums and eneuresma diseases at early stages. Such a device is also not available in Yemen. After removing malignant tumors, we need to administer radiotherapy to the patient. The necessary equipment for that is also not available here. Anyway, we try to make do with the equipment available.
Another problem is that doctors’ efforts are not appreciated in Yemen. Imagine that a doctor’s monthly salary is around YR 8,000 ($60).
Q: What cases of neuro-diseases exit in Yemen?
A: A common disease among young people in Yemen is multiple-sclerosis (MS). This disease causes pamplegia (total palsy). Young women are likely to be afflicted by the disease 50% more than young men. Another common disease here is partial paralysis caused by blood clots.
So basically, we want a real community health program, especially for children. About 250 out of 1,000 babies die in Yemen. About 40% of the rest are disabled.
About 6% of the government budget is given to the Ministry of Health, of which 1% is allocated for actual medical treatment. I doubt it goes for that purpose. The other 5% is allocated as salaries for officials there.
Q: Are all kinds of treatment and surgery available in Yemen, or do patients have to go abroad for that?
A: I do all kinds of neuro-surgeries. I perform operations like vertebral disk repair, treating sudden hemorrhages, and removing brain tumors. After removing malignant tumors, some patients need to have Radiotherapy treatment. Since this kind of treatment is not available here, or should I say the equipment necessary for that is not available, we send them to Jordan. I’m telling you, if we were well-equipped, I’m sure nobody would need to go abroad for treatment.
Q: Anything you want to add?
A: I hope that the media plays a bigger role in educating people. I see that no real health education programs are published in newspapers or broadcast on radio or televisions. Such programs greatly help avoid many problems.
People should know the basic health principles, which, if we apply, we can avoid many health problems in Yemen. Most health problems are caused by ignorance.
For two years, I have been working to establish a specialized hospital not only for neuro surgery, but also for other fields like heart and internal surgery. In this respect, I’m looking for investors who can support the project.
What I really need in the next step is the government permission to implement the project. There are good surgeons here who are going now to Germany for specialization. They will join hands with me to start the project.