Neurosurgery breakthrough
His Majesty King Mswati III’s vision of a First World Eswatini calls for a country where quality services, infrastructure, expertise and innovation are developed to meet the needs of Emaswati.
In healthcare, that vision increasingly means building the capacity to manage complex medical conditions within the Kingdom, reducing the need for patients to travel beyond the country in search of specialised treatment.
It is within this broader national ambition that The Clinic Group continues to invest in specialised healthcare capabilities. Its vision of “Africa’s Leading Integrated Business Partner” guides its commitment to developing solutions that respond to the changing healthcare needs of the people it serves.
That commitment has now been demonstrated through two significant neurosurgical procedures successfully performed at The Clinic Group’s Manzini Clinic, involving approaches that are understood, according to the clinical team and available records, to be the first of their kind to be performed this way in Eswatini.
The procedures were performed by Dr Mpumelelo Shongwe, Neurosurgeon, together with the medical team. Although the cases involved very different neurological conditions, both demonstrated the ability to assess complex cases, consider specialised surgical options and deliver advanced neurosurgical care within the country.
HYDROCEPHALUS: WHEN THE CONVENTIONAL ROUTE WAS NO LONGER SUITABLE
One of the cases involved hydrocephalus following a motor vehicle accident that resulted in a traumatic subarachnoid haemorrhage.
Hydrocephalus occurs when cerebrospinal fluid builds up in or around the brain, creating pressure that requires medical management. The patient had previously received a ventriculoperitoneal (VP) shunt, a commonly used procedure that diverts excess cerebrospinal fluid from the brain to the abdomen.
However, the patient’s subsequent abdominal surgical history presented a new challenge. The abdomen was no longer considered a suitable route for managing the fluid.
THE CHALLENGE: FINDING AN ALTERNATIVE ROUTE
The medical team therefore had to address a critical question: how could the excess cerebrospinal fluid continue to be diverted when the conventional abdominal route was no longer appropriate?
Rather than relying on the usual approach, the team assessed an alternative route that would allow the patient to continue receiving the necessary treatment.
THE SOLUTION: A VENTRICULO-ATRIAL SHUNT
The team performed a ventriculo-atrial (VA) shunt, allowing cerebrospinal fluid to be diverted from the brain into the heart.
The procedure was successfully completed at The Clinic Group’s Manzini Clinic, and the patient was discharged home in good condition.
The case demonstrated the importance of having more than specialist expertise alone. Complex procedures require the combination of specialist medical knowledge, appropriate surgical facilities, theatre support, nursing care and the wider hospital infrastructure needed to manage the patient throughout the process.
For The Clinic Group, the procedure represents an example of how specialised medical intervention can be adapted to an individual patient’s circumstances and delivered within Eswatini.
BRAIN TUMOUR: A DIFFERENT CHALLENGE, A DIFFERENT APPROACH
The second case demonstrated another aspect of modern neurosurgical capability.
The patient required surgery for a brain tumour, presenting the medical team with the challenge of determining an appropriate route to access the affected area.
In neurosurgery, the surgical pathway is an important part of the procedure. The team must consider the location of the tumour, the safest available access route and how to reach the target while protecting surrounding structures.
THE CHALLENGE: ACCESSING THE TUMOUR THROUGH A TARGETED ROUTE
In this case, the medical team selected an approach that allowed access through a considerably smaller opening than some conventional craniotomy approaches.
The objective was to create an appropriate pathway to the tumour while limiting the size of the surgical opening.
THE SOLUTION: A KEYHOLE TRANSBROW APPROACH
The team performed a supraorbital subfrontal, or keyhole transbrow approach, using a small opening above the left eyebrow to access the affected area.
The opening measured approximately 
by , providing a targeted surgical pathway to the tumour.
The approach requires detailed anatomical planning and specialist neurosurgical expertise, with the surgical team working through a much smaller access point to reach the intended area.
Successfully performing this procedure at The Clinic Group’s Manzini Clinic demonstrates the growing ability to support specialised neurological interventions within Eswatini.
CARE THAT CAN HAPPEN CLOSER TO HOME
For patients and their families, having access to specialised treatment within Eswatini can mean more than avoiding a journey across the border.
It can reduce the financial and emotional burden associated with seeking care elsewhere, allow patients to remain closer to their families during treatment and recovery, and create opportunities for local medical teams to continue building experience in increasingly complex areas of medicine.
It also contributes to a healthcare system in which more conditions can be assessed and treated locally rather than automatically requiring patients to look outside the country.
PART OF A WIDER JOURNEY IN SPECIALISED HEALTHCARE
The neurosurgical procedures are not an isolated development for The Clinic Group. They form part of a wider progression in the Group’s specialised healthcare capabilities.
Over time, The Clinic Group has expanded access to complex services within Eswatini, including pacemaker insertions, interventional cardiology and oncology services, among other specialised areas.
These developments reflect an approach focused on identifying areas where patients have historically had to seek treatment outside the country and working towards building the expertise and infrastructure required to provide more of those services locally.
The latest neurosurgical procedures represent another step in that journey.
“Specialist expertise, appropriate facilities, technology and coordinated medical support brought together to address complex healthcare needs”
BUILDING FOR WHAT COMES NEXT
Managing Director Geinekile Nxumalo has emphasised The Clinic Group’s intention to continue pursuing solutions that bring more specialised healthcare services closer to Emaswati.
The latest neurosurgical procedures provide a practical example of that direction.
They show what can be achieved when specialist expertise, appropriate facilities, technology and coordinated medical support are brought together to address complex healthcare needs.
For The Clinic Group, the focus is therefore not only on what has already been achieved, but also on what these capabilities make possible for the future of healthcare in Eswatini.
WHAT SPECIALISED CARE CAN BE BROUGHT HOME NEXT?
The significance of these procedures ultimately extends beyond the operating theatre.
They contribute to a growing conversation about what is possible when healthcare capacity is deliberately developed within Eswatini.
For patients, families and the wider healthcare sector, every additional specialised service that can be safely delivered locally represents another step towards reducing dependence on treatment outside the country.
As The Clinic Group continues to expand its capabilities, the question increasingly becomes not only what specialised treatment Emaswati need, but what specialised treatment can be brought home next.
That is where the achievement of these two neurosurgical procedures becomes part of something larger: the continued development of specialist-led healthcare in Eswatini and the journey towards a First World Eswatini.
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