NeuroAccess, Mozambique, July 2014. 

Drs Benedict Michael and Sam Nightingale visited Beira Public Hospital in Mozambique between 16-27th June, 2014.

The hospital

Beira Hospital is the second biggest hospital in Mozambique. The hospital facilities are very basic, for most of their time at the hospital there was no running water. The supply of medications is limited, and the hospital only has regular access to a single anti-epileptic medication. Infectious diseases, including Encephalitis and meningitis are a major problem. Around 20-30% of the local population is HIV positive; in the hospital around 80% have HIV. Multi-drug resistant TB is prevalent - most of the doctors and students wear protective masks on the medical wards. 

Beira Hospital is staffed mostly by local doctors, but there are also doctors from Cuba, the USA and Europe. The hospital has a single neurologist from Cuba, however he is on a temporary contract and does not do any clinical teaching. The medical students and junior doctors are taught neurology by non-specialist residents. The level of theoretical knowledge of neurology amongst students is good, but their practical skills need some improvement.

Although the public hospital in Beira is extremely basic, the medical school is well set up. The first doctor has just completed a PhD, supported by a University in Germany. Her project was investigating using urine dipsticks on CSF to diagnose brain infections. As laboratory facilities are very basic this simple bedside test is very useful clinically. 


Ben and Sam taught medical students and junior doctors a daily morning session on the theory of neurological examination and diagnosis. They followed this with 4 small group bedside teaching sessions. 

On the Saturday they ran an additional session at the medical school. It started with interactive cases of Encephalitis and other neurological infections. The session was completed with a neurology quiz - the winner of which received an ophthalmoscope.  

The written feedback from these sessions was universally positive. Themes for suggested improvements included a request for more learning resources - eg. handouts, videos etc. 

Future directions

Ben and Sam would like to support the pre-clinical undergraduate neurology teaching at the medical school which happens around April every year. 

Another useful project, would be to provide videos demonstrating neurological clinical signs. On their next visit, Ben and Sam aim to record good quality footage of this and make it publicly available.

Students found the NeuroID e-learning modules useful and Ben and Sam are keen to build on this resource. 

Overall, it was another successful trip. Ben and Sam are keen to continue their work, and have even more ideas for the future on how the project can develop and be more beneficial than ever! 

*NeuroAccess is a project supported by The Encephalitis Society and run by Drs Benedict Michael and Sam Nightingale which aims to improve the care of patients with Encephalitis and other neurological problems in sub-Saharan Africa through improving education in clinical neurology. The project is funded by courses in neurology for UK undergraduate and postgraduate medics, and by grants from The Encephalitis Society and the Association of British Neurologists.