Northern Africa

The Northern African region includes 6 countries: Algeria, Morocco, Egypt, Tunisia, Libya, and Sudan. This region counts 187 female certified neurosurgeons, making up 77% of all AWIN (Table 1).

Algeria is leading by a wide margin with 135 WIN. One of the factors that may contribute to this is that the history of WIN in Africa began in Algeria with Professor Faiza Lalam in 1977. She worked as a certified neurosurgeon in 1982 at the surgical department of Tizi Ouzou’s University Hospital. In 2011, she became professor and head of department (HOD). In 2014, Professor Souad Bakhti became the first woman president of a national neurosurgical society in Africa when she became president of the Algerian Society of Neurosurgery (SANC). In 2017, she was appointed as HOD in neurosurgery at the Specialized Hospital Ali Ait Idir in Algiers. At a continental level, she was the only female neurosurgeon present during the creation of the Continental Association of African Neurosurgical Societies (CAANS) in Cape Town in 2012, where she served as treasurer and second vice president for North Africa. She is currently chair of the World Federation of Neurosurgical Societies (WFNS) Women in Neurosurgery Committee⁴ and secretary of the Pan Arab Neurosurgical Society (PANS). Dr. Nabila Tighilt holds a leadership position as the current first vice president of the Algerian Society of Neurosurgery. Algeria has the highest rate of certified WIN (Fig. 1), representing 33% of all Algerian neurosurgeons and 56% of all AWIN, with a rate of 55% of female neurosurgical residents. This was possible because Algeria advocated for education for both genders. This has led to women identifying mentors early in life, and entry into a specialty training like neurosurgery is based purely on academic merit.

Map of Africa demonstrating the number of qualified female neurosurgeons classified according to regions.

Morocco, with 25 female neurosurgeons, ranks as the African country with the second highest number of female neurosurgeons. Professor Najia El Abbadi was the first practicing female neurosurgeon at Ibn Sina Hospital in Rabat. She trained as a fellow in several departments all around the world and became the first African female professor of neurosurgery in 1994. She was nominated as head of the neurosurgical department at Ibn Sina Hospital from 2014 to 2016, then moved to Cheikh Zaid International University Hospital, where she holds the position of HOD in neurosurgery, along with being chair of the Department of Surgery at Abulcasis International University of Health Sciences. She was elected the first female president of the Moroccan Society of Neurosurgery (SMNC) in 2015 and became the first African chair of the WFNS Women in Neurosurgery Committee from 2013 to 2017.⁴ In this position she was able to highlight the social difficulties of African female neurosurgeons around the world. She also served as treasurer of the CAANS in 2016 and has been assistant treasurer of the WFNS from 2018 to date. In 2018, she became the first female president of the Pan Arab Neurosurgical Society. Dr. Mouna Bougrine holds a leadership position as the secretary of the Moroccan Society of Neurosurgery.

Tunisia counts, to the best of our knowledge, 12 certified neurosurgeons. Dr. Faten Abid was the first female neurosurgeon in the country. She graduated from Monastir’s medical school and trained in Monastir and at Pitié-Salpêtrière University Hospital in Paris. She is now practicing as a neurosurgeon in the Hospital Fattouma Bourguiba in Monastir. Tunisia has only 2 associate female professors of neurosurgery and no full professor.

Sudan counts 12 women neurosurgeons with 13 female residents and has done an incredible job in increasing its female representation. Egypt is one of the African countries that has one of the lowest rates of WIN (1.2%) within the region, and contrasts that by having the highest number of male neurosurgeons, exceeding 500. Dr. Djamila Kafoufi Benderbous is the first certified female neurosurgeon in Egypt. She trained as a neurosurgeon in Algeria, then joined the Neurosurgery Department of Necker Hospital in Paris, and then in Egypt. Egypt counts only 3 WIN with 10 female residents.

Western Africa

Nigeria. Neurosurgery in West Africa started in October 1962, after Dr. E. Latunde Odeku became the first neurosurgeon in West Africa when he relocated to the University of Ibadan, Nigeria.^5,6 It took another 52 years before Nigeria had its first female neurosurgeon: Dr. Salamat Ahuoiza Aliu-Ibrahim, who was admitted as a fellow in neurosurgey of the West African College of Surgeons in 2015. Dr. Salamat Ahuoiza Aliu-Ibrahim completed her residency training at the National Hospital in Abuja. She then continued her training by pursuing a fellowship in pediatric neurosurgery at Boston Children’s Hospital, which she completed in 2019. She is currently practicing at the University of Ilorin Teaching Hospital in Nigeria. As a pioneer she set the path for female neurosurgeons in Nigeria—to date another 4 women have qualified, 3 of whom hold academic positions as faculty in teaching hospitals in the country. There are 2 women who are currently enrolled in the residency program. Nigeria has 80 registered neurosurgeons at last count, and only 5 (6.2%) are female.

Ivory Coast. In 2006, Dr. Espérance Maman You Broalet became the first woman in neurosurgery in West Africa when she graduated from Abidjan. She then practiced at the Yopougon CHU in Abidjan until 2015, after which she relocated to the Université de Bouaké in the center of Ivory Coast, 350 km from Abidjan. In October 2019 she transferred to the St. Joseph Moscati Catholic Hospital in Yamoussoukro, where she was assigned the important task of setting up a neurosurgical department, where she is currently the HOD. Dr. Broalet is an academic and leader within the field of neurosurgery; her accolades include being the first female associate lecturer in anatomy and neurosurgery at the African and Malagasy Council for Higher Education (CAMES). In 2013 she founded “Espérance’s Hope,” which is an Ivorian association that aims to combat hydrocephalus and neural tube defects in the region. She has served as treasurer of the Ivorian Society of Neurosurgery (SINC) in 2017 and 2019.

Ivory Coast currently has 5 female residents from Ivory Coast and Cameroon who are enrolled in various neurosurgical training programs across the country.

Senegal. Senegal has trained the highest number of female neurosurgeons within the West African region—since 1997 a total of 10 women qualified from within not only Senegal but also Cameroon, Gabon, Democratic Republic of the Congo (DRC), and Niger. To date, Senegal counts 4 female Senegalese certified neurosurgeons, and 13 of 37 neurosurgical trainees are women. They set an example that other countries can aspire to. This is a true representation of how a secure pipeline in mentorship can increase female representation within a specialty. Dr. Mame Salimata Diene became a pioneer as the first woman in neurosurgery. Currently, she is the assistant head of clinic in the Neurosurgery Department of Fann Teaching Hospital. Following her, Dr. Magatte Gaye Sakho started her training in neurosurgery in 2002. After 4 years of training in Dakar, she continued her training at La Timone in Marseille from 2006 to 2007, then qualified in 2010. She became the first woman associate professor in this discipline in Senegal. Currently, she is the head of the Neurosurgery Department at the General Hospital Idrissa Pouye. Dr. Mame Salimata Diene also holds a leadership position as assistant head of clinical services at the Department of Neurosurgery at Fann Teaching Hospital. Both of these women are among the few who hold leadership positions within academia.

Central Africa

The region of Central Africa has 9 countries with a population of 180.4 million, but within this region certain countries do not have a single practicing neurosurgeon to date. These countries include Central African Republic, Equatorial Guinea, and São Tomé and Príncipe. In the following countries that currently have no female neurosurgeons, the number of male neurosurgeons are as follows: Chad (n = 3), Republic of Congo (n = 5), Angola (n = 14).

The DRC is the largest country within the region and has a population of 84.07 million, which is served by 11 qualified neurosurgeons. Dr. Sarah Mutomb, who was trained in Senegal and recently qualified in 2019, is the first and currently only female neurosurgeon in DRC. Cameroon has the highest number of female neurosurgeons in Central Africa, with a total of 5, and Dr. Mirelle Moumi was the first to graduate in 2008 after being trained in Dakar, Senegal. Gabon currently has 2 certified female neurosurgeons.

Eastern Africa

The Eastern African region comprises 15 countries with a population of 537.9 million. Countries such as Comoros, Djibouti, Eritrea, and Seychelles do not have a single practicing neurosurgeon. In addition, Burundi, Djibouti, Malawi, and Somalia do not have a female neurosurgeon. Kenya leads the region with 6 female neurosurgeons. Dr. Sylvia Shitsama and Dr. Susan Karanja both graduated in 2015 from the University of Nairobi and KwaZulu-Natal, respectively, and became pioneers in Kenya. Four other women joined them to make a total of 6 WIN in Kenya. Two hold lectureship positions: Dr. Tracy John is the secretary of the East African Neurosurgery Society, and Dr. Beverly Cheserem sits on the WFNS Young Neurosurgeons Forum (YNF).

Tanzania follows with 4 female neurosurgeons. Drs. Aingaya Kaale and Happiness Rabiel graduated as neurosurgeons in 2018, followed by 2 additions in 2020. Dr. Constansia Bureta recently became the first female neurosurgeon in this region to complete a PhD from Japan. Dr. Rabiel established a neurosurgical department in Arusha, Tanzania, in 2019.

Ethiopia has 2 qualified neurosurgeons, the first being Dr. Yordanos Ashagre (2015). Dr. Juliet Sekabunga is the first female neurosurgeon to graduate from Uganda, and she continued her studies and completed her pediatric fellowship at Toronto’s Hospital for Sick Children (SickKids). Dr. Claire Karekezi graduated from the WFNS Rabat Training Center,^7,8 Morocco, in 2016 and became the first female neurosurgeon in Rwanda. She completed a neuro-oncology and skull base surgery fellowship at the University of Toronto, Toronto Western Hospital, in June 2018, before establishing a new neurosurgical unit at the Rwanda Military Hospital. She also holds several leadership positions, including being the first chair of the AWIN Committee of the CAANS, a representative of WFNS Global Neurosurgery, and a committee member of WFNS YNF.

Southern Africa

Southern Africa is located on the southernmost tip of the continent. It comprises the following 8 countries: Botswana, Lesotho, Mozambique, Namibia, RSA, Swaziland, Zambia, and Zimbabwe. The history of female neurosurgeons within this region started in the early 1990s. Since then, the numbers have grown within this male-dominated specialty. The first female neurosurgeon to qualify in this region was Dr. Minette du Preez, who trained at the University of the Free State. Although initially hesitant to enter the training program because there were no other women in the department, she pressed on after one of her professors encouraged her by mentioning that women all over the world were practicing within the discipline, and she registered as a specialist neurosurgeon in 1994. Shortly thereafter, her Zimbabwean-born colleague Dr. Nozipho Maraire qualified as a neurosurgeon from the Yale School of Medicine. She proceeded to be a trailblazer within the field by completing her subspecialty training in pediatric neurosurgery at the Beth Israel Hospital in New York. Until recently, she was the only woman from this region who had pursued subspeciality training. These women laid a solid foundation for the next generation of Southern Africa’s women to thrive in this discipline and continue their legacy.

Within Southern Africa, the RSA has the highest number of registered female neurosurgeons, a total of 14, and added to this number are 4 women who have just passed their examination, taking the number to 18. The RSA is currently ranked third on the continent when it comes to the number of female neurosurgeons, with 7.4% of AWIN, after Algeria and Morocco. This figure is consistent with other middle-income countries, such as Brazil (5.5%), and higher than in other countries, like India (< 2.5%).^9,10 Five female surgeons are full-time academic staff, the largest number (n = 3) being at the University of Cape Town. With regard to leadership positions, Dr. Coceka Mfundisi became the first woman to qualify as a neurosurgeon from the University of Pretoria in its 100-year history. Today she works as a specialist neurosurgeon at Life Brenthurst and Busamed in Modderfontein, and at Chris Hani Baragwanath Hospital, and she holds a position in the WFNS Global Neurosurgery Committee. Dr. Nqobile Thango, who recently completed her fellowship in pediatric neurosurgery at the Red Cross Children’s Hospital in December 2020, is a committee member of the WFNS YNF, along with the Young African Neurosurgeons Forum education committee.