Americare Neurosurgery International Inc (AMCANI) and The Institute of Neurosciences Kolkata (INK) India

The INK was founded by Ram Sengupta MD. A consultant neurosurgeon (cerebrovascular) and Professor Emeritus at Durham University, Newcastle on the Thames. Dr. Sengupta has worked in the English NHS for over 30 years and wished to return to his native West Bengal and give back to the community that he came from. His radical proposal for a self-funding, private, nonprofit neuroscience institute represents a novel model for health care delivery in India (see below). The institute will provide comprehensive care from an integrated team of MDs neurosurgeons, neurologists, psychiatrists and physiatrists... [Read more]

The Department of Neurosurgery at the University of Hue has four neurosurgical faculty and six residents (all working on M.D. Ph.D. degrees) as well as rotations of general surgery residents. The department is headed by Tran Duc Thai, M.D. Ph.D., Head of the Neurosurgery section and Gamma Knife Center, Dean of the School of Nursing, Hue Medical College. The department is responsible for providing neurosurgical training to central Vietnam with its population of 20 million people, and as a source of leadership for the local neurosurgical groups in Hue and Da Nang. They are one of three academic centers of excellence for neurosurgery in the entire country.

Prior to the collaboration with AMCANI, the department had access only to hand powered instruments for cranial surgery. It had no operative microscope or microsurgical instruments. It did have a 0.5 tesla MRI, single plane CT, and Gamma Knife system all donated by the People's Republic of China. In a typical year prior to starting our relationship in 2004, the Department would perform, on average, 150 cases. Of these, 100 to 110 were surgeries on the spine and 30 to 40 were simple craniotomies (surgeries on the brain) for trauma, very superficial tumors, and blood clots on and in the brain, all done with hand powered instruments.

After four years of engagement and three site visits to install and train the faculty in the use of the new equipment, our mission to the Department of Neurosurgery has yielded significant results. Following the AMCANI missions and donations of a Zeiss OPM-1 operative microscope, titanium microsurgical techniques-instruments, two complete Midas Rex pneumatic cranial drill sets, two complete Hall pneumatic skull base surgery drill sets, a bipolar coagulator with hand pieces and all with supporting disposables, the Department's capabilities have expanded significantly, enabling them to treat complex disease of the brain including, in 2009:

• 118 brain gliomas
• 22 vestibular schwanomas
• 47 posterior fossa tumors
• 33 skull base meningiomas
• 11 craniopharyngiomas
• 3 pituitary adenomas

These complex surgical procedures became possible to safely perform with the modern microsurgical equipment donated by AMCANI. The department can now project surgical therapies into difficult regions of the brain that previously were done only at a few major centers in Vietnam. Furthermore, patients who needed these types of procedures required transport to facilities in Hanoi or to Ho Chi Minh City. Both are approximately 750-1000 miles away. While there, the patient would be without family support, as the majority if patients at Hue Medical College are from the rural areas and are impoverished. In the milieu of Vietnam medical care, families provides the bulk of floor nursing care and the lack of family support can lead to suboptimal outcomes.

We also gave a series of presentations on interventional neuroradiology to help jump start their fledgling interventional neuroradiology group. To date, they are now starting preliminary endovascular therapies.

In addition to AMCANI training, the Hue faculty has sought and received supplemental fellowship training for the junior faculty. AMCANI equipment donations enabled them, upon their returning to Hue, to utilize skills acquired abroad requiring modern technologies. To date Than Duc Tri MD. PhD., successfully completed a one year cerebrovascular fellowship at the University of Antwerp, Belgium and Nguyen Thai Minh MD. PhD., completed an endoscopic/skull-based fellowship at The Centre for Minimally Invasive Surgery, Sydney, Australia.

The faculty neurosurgeons have identified the following needs in their department:

1. An additional microscope with 2 dual head optics, and a brighter light source and longer focus length.
2. Transsphenoidal set to operate on tumors of the pituitary gland.
3. A surgical navigation system, that will allow them to more precisely approach tumors and other lesions with smaller and more refined surgical openings; so called minimally invasive surgery.
4. An upgraded drill system as the disposal bits currently used by the donated drills are difficulty to obtain in Vietnam.

AMCANI's next phase of development with the Department of Neurosurgery, Hue Medical College, will include addressing the needs listed above as well as installation of a stereotactic frame for biopsies and framed based lesional procedures (ie treatment of Parkinson's disease, and intensive training in neuro-rehabilitation. To further this work, we are seeking material and financial support. Funds are needed to cover the shipping cost of materials as well as travel funds for physician and ancillary personal teams to train the department in the use of the donated supplies as well as rehabilitation techniques. All donations are tax deductable as AMCANI has permanent 510.c.3 granted by the US Internal review Service