Michael Martin Haglund

Primary Theme: Global Health

While epilepsy affects over 50 million people globally, three of four people in low-resource countries do not get care for this treatable condition. In Uganda, stigma is pervasive: one in five people believes epilepsy is contagious, and there are strong beliefs in supernatural or witchcraft-based causes, treatments and even inoculation. In 2017-18, a Bass Connections project team began work to identify, predict and address the barriers to epilepsy care in Uganda. The team implemented a mixed-methods design to collect data examining cultural and practical barriers to reaching biomedical care. Team members designed a quantitative survey to examine the predictors of care patterns and delays, and collected focus group and interview data among all epilepsy stakeholder groups, including patients and families, traditional healers, pastoral healers, neurologists and psychiatrists. The objective for the 2018-19 Bass Connections project team is to address the question, Given that we now know potent predictors of care-seeking behavior, how will we systematically address the barriers to epilepsy care in Uganda through well designed, culturally relevant and sensitive interventions?

Primary Theme: Brain & Society

Surgery was catapulted into the global health spotlight with the publication of the Lancet Commission on Global Surgery report. The report discusses the importance of projects that not only focus on provision of surgical procedures, but also the need for holistic health systems strengthening. Since 2007, Duke Global Neurosurgery and Neuroscience (DGNN) has been utilizing this concept of health systems strengthening to improve neurosurgical care for patients throughout Uganda. DGNN’s approach consists of provision of neurosurgical services, training, research, twinning and advocacy. The long-term vision includes having 20 Uganda-trained neurosurgeons equitably spread across the country, increasing the number of facilities capable of providing neurosurgical operations, improving the infrastructure for neurosurgical care delivery and developing a Uganda Neuroscience Institute to serve as a center of excellence in East Africa. Within this larger framework, a Bass Connections project will evaluate interventions directed at impacting neurosurgical patient outcomes.