Innovation from unexpected places: How Uganda is pioneering hydrocephalus treatment surgery

Global health is a field characterized by innovation. While new advancements are happening everywhere, we seem to hear mainly about those occurring in resource-rich countries. However, the reality is that innovation is not limited by geographical or economical boundaries.

In recent years, sparks of innovation have emerged from unexpected places. Brewing in the rainforests of South America and communities in sub-Saharan Africa, these interesting ideas carry great potential for improving the field of global health. In particular, these breakthroughs can have marked advantages for underserved and disadvantaged communities all over the world.

For example, despite Uganda being a low-income country, it’s the birthplace of a very interesting and pioneering technology that can save the lives of tens of thousands of babies.


Hydrocephalus, or literally “water in the brain” is a condition that develops in about 180,000 babies every year in sub-Saharan Africa. It is a horrid ailment that is characterized by the build-up of spinal fluid inside the brain, causing it to swell up under increased pressure. If the fluid is not successfully drained, half of the children affected by the condition will develop complications and disabilities, while the other half will die.

The conventional treatment for hydrocephalus involves the surgical insertion of a shunt, a type of drainage system, which directs the fluid towards another part of the body. This is usually the stomach. Unfortunately, for children in rural, poor settings, having this intervention does not guarantee an improved life. In a third of the cases, these traditional shunts fail within the first couple of years. In resource-rich countries, where children can largely obtain emergency surgery, the failure rate is much more tolerable. However, shunt malfunctions are a more significant and lethal problem in places like Uganda.

Innovation at the CURE Hospital

Doctors at the CURE hospital in Mbale, Uganda have developed an innovative intervention that when successfully completed, can fix hydrocephalus in babies permanently. The technology, called endoscopic third ventriculostomy with choroid plexus cauterization, or ETV/CPC, combines 2 existing treatments.

The treatment involves the creation of a small hole in the child’s brain ventricle and the subsequent burning of the region in the brain responsible for the creation of cerebrospinal fluid.

Studies have successfully indicated that ETV/CPC prevents the need for a shunt and results in fewer emergency hospital trips. Similarly, research comparing the conventional and new treatments also indicates that there is no difference between children’s’ brain volume or cognitive functioning a year after the procedures.

Today, doctors are increasingly using ETV/CP across the globe and the CURE hospital in Mbale has become a pioneer for hydrocephalus treatment in children. In fact, neurosurgeons and health professionals from all over the world come to Mbale to learn the new intervention from seasoned Ugandan doctors.

Overcoming preconceived notions, Uganda is proving that low- and middle-income countries have great potential for contributing to advancements in global health.

Want to discover more innovative medical organizations?

In addition to the great work CURE is doing in Uganda, there are many organizations working in medicine to help individuals in underserved areas.

These include Bridge to Health, a group of passionate medical professionals that provide medical and dental care to those in tremendous need, as well as Partners in Health (PIH) Canada, an organization that works to provide life-saving care to marginalized communities.


March 1, 2019


Tanya Tewari