The government is set to establish a permanent, sustainable clinical system for epilepsy surgery, a move that will reduce reliance on foreign medical missions and overseas referrals for complex brain procedures. The initiative, the first of its kind in Rwanda and the wider Great Lakes region aims to integrate advanced epilepsy surgery into the country’s public health system, allowing patients to access specialised care locally. According to Dr Paulin Munyemana, a neurosurgeon at Rwanda Military Hospital (RMTH) and the University Teaching Hospital of Kigali (CHUK), the system will provide comprehensive patient tracking across the entire clinical pathway, from initial consultation to final surgical decision-making. ALSO READ: Shedding light on epilepsy: A closer look at its prevalence in Rwanda By strengthening local infrastructure, the Ministry of Health seeks to end the practice of sending patients to Europe or the United States for life-saving neurosurgical procedures. Dr Munyemana said the programme will officially launch on Monday, February 9, to coincide with International Epilepsy Day. Unlike past short-term medical missions, the initiative marks the beginning of a long-term training and treatment framework embedded within Rwanda’s national hospitals and universities. “We are not just looking to treat a few individuals; we are building a sustainable clinical system,” Dr Munyemana said. “This includes standardised protocols and a multidisciplinary network where neurologists and neurosurgeons work together in structured cycles.” The programme will initially collaborate with European experts to help establish and refine local protocols, with the long-term goal of complete self-sufficiency. “Once this system is fully established, we will no longer need to send doctors abroad for training or depend on visiting teams. We will train our specialists right here in Rwanda,” he added. A critical treatment gap For many people living with epilepsy in Rwanda, medication remains the first line of treatment. However, Dr Munyemana noted that drugs have their limits. When a patient has tried multiple medications without success, the condition is classified as drug-resistant epilepsy. “Neurosurgical intervention has a success rate of about 70 per cent,” he said. “From a clinical standpoint, we simply cannot afford to ignore such an effective treatment option.” While South Africa remains the regional leader in epilepsy surgery within Sub-Saharan Africa, most countries continue to struggle with limited capacity. Rwanda’s investment in this infrastructure, he said, positions the country as a potential regional hub for advanced neurological care. ALSO READ: Scientists to investigate high prevalence of epilepsy in Southern Rwanda Cutting costs, saving lives Beyond health outcomes, the economic case for local epilepsy surgery is compelling. Dr Munyemana said referring a single patient abroad for specialised brain surgery places a heavy financial burden on the healthcare system. “The cost difference is staggering,” he said. “Sending one patient abroad can cost upwards of $300,000. If we perform the same surgery locally, using national health insurance, we could treat up to ten patients at a fraction of that cost.” The initiative also seeks to confront the deep-rooted social challenges surrounding epilepsy. In Sub-Saharan Africa, epilepsy prevalence is estimated at about 50 per 1,000 people, yet many cases remain unreported due to stigma and discrimination. “Epilepsy carries a heavy social stigma, which often prevents people from seeking help,” Dr Munyemana said, adding that the condition frequently affects entire households by limiting productivity and economic stability. He described epilepsy as a public health issue requiring a holistic response, noting that many cases currently treated at Ndera Neuropsychiatric Hospital are not adequately captured in national data systems. Prevention and the road ahead As diagnostic capacity improves, health officials expect reported epilepsy cases to rise. While some cases are genetic, Dr Munyemana said many causes in Rwanda are preventable. He cited brain infections such as meningitis and parasitic diseases as major contributors, alongside traumatic brain injuries resulting from road traffic accidents. By strengthening road safety, infection control and surgical care simultaneously, Rwanda aims not only to treat existing patients but also to reduce future incidence. “In the past, our system for identifying and selecting surgical candidates was not as effective as it should have been,” Dr Munyemana said. “By building this capacity locally, we are offering Rwandans the same level of care they would receive in Europe or the United States.”
