Abstract
Until 2011 there was no neurosurgical service in Malawi apart from simple shunt surgery. Since then, little by little, a neurosurgical unit has been built up at Queen Elizabeth Central Hospital in Blantyre, with support from Oslo University Hospital.
 Today, the neurosurgical unit has one operating room and a 6-bed high dependency unit for postoperative care. Three neurosurgeons, two young trainees, and a team of dedicated nurses and assistants perform a total of 400 surgeries annually. Three quarters of the patients are children. An increasing proportion of the operations are craniotomies.
 A CT scanner was installed in December 2020 and will probably lead to increased demand for general neurosurgery, in particular for trauma surgery. A second operating room and a 30-bed unit are needed in the near future. Two more trainees will start in 2022.
 The plan is to have a sustainable, self-supporting service in 5-10 years’ time.
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