The History and Current State of Neurosurgery in the Republic of Moldova: Celebrating the 25th Anniversary of the Founding of the Department of Neurosurgery

Authors

Grigore Zapuhlîh, Department of Neurosurgery, State Medical and Pharmaceutical University "Nicolae Testemitanu", Chișinău, Republic of Moldova.
Gail Rosseau, Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA; Barrow Global, Barrow Neurological Institute, Phoenix, Arizona, USA.
Nathan A. Shlobin, Department of Neurosurgery, The Neurological Institute of New York, New York Presbyterian Hospital - Columbia University Irving Medical Center, New York, New York, USA. Electronic address: nshlobin@gmail.com.
Marcel Ivanov, Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK.
Valeriu Matcovschi, Institute of Neurology and Neurosurgery "Diomid Gherman", Chișinău, Chișinău, Republic of Moldova.
Vladimir Dolghi, Institute of Neurology and Neurosurgery "Diomid Gherman", Chișinău, Chișinău, Republic of Moldova.
Radu Safta, Werner Forßmann Hospital, Eberswalde, Germany.
Aurel Bodiu, Section of Neurosurgery, Republican Clinical Hospital "Timofei Mosneaga", Chișinău, Republic of Moldova.
Valeriu Vicol, Brasov County Emergency Clinical Hospital, Brasov, Romania.
Victor Andronachi, Department of Neurosurgery, Institute of Emergency Medicine, Chișinău, Republic of Moldova.
Anatol Litovcenco, Department of Neurosurgery, Mother and Child Institute, Chișinău, Republic of Moldova.
Angela Leanca, Section of Neurosurgery, "Valentin Ignatenco" Children's Municipal Clinical Hospital, Chișinău, Republic of Moldova.
Adrian Danu, Section of Neurosurgery, Medpark International Hospital, Chișinău, Republic of Moldova.
Iulian Glavan, Section of Neurosurgery, Ministry of Internal Affairs Republican Hospital, Chișinău, Republic of Moldova.
Vioral Gaina, Section of Neurosurgery, TerraMed Medical Center, Chișinău, Republic of Moldova.
Dan Lisii, Section of Neurosurgery, Novamed Polyvalent Hospital, Chișinău, Republic of Moldova.
Viorel Guranda, Section of Neurosurgery, Balti Clinical Hospital, Balti, Republic of Moldova.
Vasile Postolati, Section of Neurosurgery, Cahul District Hospital, Cahul, Republic of Moldova.
Augustin Zapuhlîh, Department of International Relation and European Integration, State Medical and Pharmaceutical University "Nicolae Testemitanu", Chișinău, Republic of Moldova.
Nicu Ribac, Institute of Neurology and Neurosurgery "Diomid Gherman", Chișinău, Chișinău, Republic of Moldova.
Elena Costru-Tasnic, Institute of Neurology and Neurosurgery "Diomid Gherman", Chișinău, Chișinău, Republic of Moldova.
Oxana Grosu, Institute of Neurology and Neurosurgery "Diomid Gherman", Chișinău, Chișinău, Republic of Moldova.

Document Type

Journal Article

Publication Date

10-28-2024

Journal

World neurosurgery

Volume

193

DOI

10.1016/j.wneu.2024.10.004

Keywords

Global health; Global neurosurgery; Global surgery; International development; Moldova

Abstract

BACKGROUND: Five billion people worldwide lack access to safe, timely, and affordable surgical and anesthesia care. This deficit is greatest in low- and middle-income countries, especially for specialty surgical services including neurosurgery, due to insufficient personnel, resources, and infrastructure. The southeastern European nation of the Republic of Moldova is one such middle-income country. METHODS: Discussions with key individuals involved in neurosurgical care in Moldova were conducted to characterize the history and current state of neurosurgery in Moldova. Via a process of chain referral sampling, all practicing neurosurgeons in Moldova were invited to participate in the execution and authorship of this project. RESULTS: Developing from origins in the Soviet Union, neurosurgery became part of the national health system in the 1940s, with the creation of the first neurosurgery department in 1999. Eleven hospitals, including eight public and 3 private, offer neurosurgical services, with 239 beds and 5330 cases performed in 2023. Most attending neurosurgeons and residents are male, but this is changing as women comprise over one-third of residents in training. There is one neurosurgery residency program and a 2-year fellowship in endovascular neurosurgery in Moldova, with further fellowship training received outside of the country. Computed tomography and magnetic resonance imaging are available at most centers. CONCLUSIONS: This article provides the first-ever description of the history and current state of neurosurgery in Moldova and presents key recommendations to guide the international neurosurgery community in developing neurosurgical care in countries with an unmet need.

Department

Neurological Surgery

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