The History and Current State of Neurosurgery in Albania

Abstract

Up to one-third of the global burden of disease involves surgical conditions; however, 5 in 7 people across the world do not have access to timely, affordable surgical care. Low- and middle-income countries account for the majority of the inequities in access to timely surgical care, where the availability of specialty surgical services such as neurosurgery is limited or unavailable. Albania, situated in the Western Balkan region, was once one of the poorest countries in Europe. It is now an upper-middle-income country, and an example of the impact of democratic regime changes in Europe after 1990. This article provides the first-ever examination of the history and current state of neurosurgery in this country. We set the stage with a brief historical background on Albania, including its neurosurgical history. Then, we describe the current state of neurosurgical activity and infrastructure in Albania. Finally, we conclude with suggestions on future neurosurgical efforts for the development of neurosurgery in small countries with variable economic resources.

Keywords: Albania; Global health; Global neurosurgery; Global surgery; International development; Public health.

FIGURE 1.

Indo-European Language Tree. © Jack Lynch. Used with permission.

FIGURE 2.

The inauguration of King Zog I Hospital, September 1st 1932 (photograph courtesy of M. Petrela; any identifiable individuals in the photograph consented to publication of their image).

FIGURE 3.

Staff of King Zog I Hospital in 1935; sitting: Prof. Wilhelm Schlesinger (left), Dr Sabri Tefiku (center), and Prof. Walter Lehmann (right); standing: Hospital staff including 2 women—Dr Quastler, pediatrician (right) and Dr Schlesinger, biologist (left) (photograph courtesy of M. Petrela; any identifiable individuals in the photograph consented to publication of their image).

FIGURE 4.

Walter Lehmann's book—The Surgery of Peripheral Nerve Injuries, 1921 (photograph from the personal library of M. Petrela; book in public domain).

FIGURE 5.

Staff of the University Clinic of Neurosurgery in 1964; back row: Prof. Arian Xhumari (left), Prof. Xhelal Kurti (center), and Prof. Adrian Osmanlliu (right); front row: head nursing staff (photograph courtesy of M. Petrela; any identifiable individuals in the photograph consented to publication of their image).

FIGURE 6.

Staff of the Department of Neurosurgery, UHC “Mother Teresa” after its inauguration in 1996 (photograph courtesy of M. Petrela; any identifiable individuals in the photograph consented to publication of their image).

FIGURE 7.

Henry Marsh lecturing in 2022 at the Faculty of Medicine of Tirana (photograph courtesy of M. Petrela; any identifiable individuals in the photograph consented to publication of their image).

FIGURE 8.

Neurosurgical workforce density (neurosurgeons per 100 000 population density according to World Federation of Neurosurgical Societies 2016 data) and neurosurgical publications in the top 5 most quoted neurosurgical journals (data taken from PubMed and Google Scholar) in the Balkan countries.