Enabling treatments for brain tumors in Tanzania

In October 2025, a team from the Medical University of Lausitz – Carl Thiem (MUL – CT) and the University Hospital Augsburg traveled to the Bugando Medical Center (BMC) in Mwanza (Northwest Tanzania). Their goal: to provide treatment for people suffering from malignant and unusually large brain tumors. The medical team led by Dr. Ehab Shiban, Dr. Maria Kipele, and Dr. Henning Kahl was able to utilize advanced technologies such as neuronavigated tumor resection, intraoperative radiotherapy, and neuromonitoring for the planned medical procedures. Among their equipment were the ZEISS INTRABEAM 600 and the ZEISS CONVIVO.* Together with the medical team at BMC, they enabled the very first intraoperative radiotherapy on the brain on the African continent.

Despite interruptions due to protests related to elections in Tanzania, which led to a temporary curfew, the medical team successfully completed several operations daily in two operating rooms. It was not a one-time mission but the beginning of a partnership to establish a neurosurgical clinic at BMC. This project is supported in the long term by the Neurosurgical Clinic of MUL – CT, the Ministry of Health of Tanzania, and through the provision of mobile medical technology by industry partners like ZEISS. In the below interview, the head of the medical procedures, Dr. Ehab Shiban, and his colleague Dr. Maria Kipele discuss the preparation for the trip, long-term goals, and what the impetus was for the project.

Why did you choose the region and the Bugando Medical Centre (BMC) in Mwanza for this mission?

Dr. Maria Kipele: I completed part of my medical school at BMC in Mwanza and knew that there is a high demand for surgeons, especially in neurosurgery. I remember we had a lot of neurosurgical patients, especially children, but BMC didn’t have a neurosurgical department. Today, the situation is different, as BMC is well-staffed with Dr. Gerald Mayaya, head of the neurosurgical department, and neurosurgeons Dr. James Lubuulwa and Dr. Misso Mpeji. The team is fully trained, but not for complex surgical procedures involving brain tumors.

How many patients can be treated weekly in the neurosurgical department at BMC?

Dr. Maria Kipele: In general, the situation in Tanzania is precarious for people with severe brain tumors, as access to medical care and the possibility of early diagnosis followed by adequate therapy are challenging. BMC serves a very large catchment area of roughly 20 million people across the Lake and West Zone of Tanzania. The neurosurgical department performs around 600 basic neurosurgical procedures per year, weekly case numbers vary depending on emergency load, theatre capacity, and staffing. The nearest neurosurgical clinic in the country is approximately 1,100 km away in Dar es Salaam.

How did the idea for the project come about? Were you more focused on treating rare brain tumors, or did the technical equipment you brought to Tanzania offer a promising opportunity for BMC?

Prof. Dr. Ehab Shiban: In June, Dr. Kipele told me about her dream of returning home and supporting her country in 10,15 years. I replied, “Why wait that long? We can start right away.” Shortly afterwards, we contacted ZEISS and quickly got positive feedback.

In our luggage, we had the ZEISS CONVIVO for the histopathological examination of cell structures. This allows the cell structures to be checked in real-time directly in the operating room after tumor resection, and possible malignant tumor remnants can be detected. During the same procedure, the tumor bed can be treated with intraoperative radiotherapy (IORT). Through this type of radiation, any potentially undetected residual tumor tissue and the walls of the tumor cavity can be sterilized. For IORT, we had the ZEISS INTRABEAM 600 available. For the tumor patients at BMC, this was a promising option, and in line with our mission based on Dr. Kipele's desire to enhance medical support in her homeland.

While in Tanzania, there were political unrests, and consequently, no internet – a crucial requirement for planned digital collaboration. Part of the surgical plan was to send tissue samples from the operating room in Mwanza in real-time to Germany and immediately evaluated by a pathologist in Munich. What opportunities does such a histopathological examination offer in a country like Tanzania, where conventional pathological resources are rather limited?

Prof. Dr. Ehab Shiban: It enables faster intraoperative decisions and supports surgical precision. After a tumor resection, the ZEISS CONVIVO can be used to examine cell structures directly in the operating room and in real-time, identifying possible malignant tumor remnants. For our tumor patients in Tanzania, this would allow for more informed decisions and strengthen confidence in the surgical strategy – especially in complex cases where every additional piece of information improves safety. Additionally, it would support the mindset of "right treatment, right extent, right time," which is particularly valuable when follow-up resources and adjuvant therapies are limited.

You introduce a new keyword, as adjuvant therapies in cancer treatment also include conventional external radiotherapy. What opportunities does intraoperative radiotherapy (IORT) offer for neurosurgical patients in Tanzania compared to this?

Prof. Dr. Ehab Shiban: Intraoperative radiotherapy for brain surgery is hardly established and represents a real medical innovation, especially under the challenging conditions in Tanzania. If the suspicion of a malignant tumor is confirmed, IORT allows for a one-time, targeted irradiation of the tumor bed immediately after resection, still in the operating room – without delay and with high precision. This helps to close the gap in oncological care, as postoperative radiotherapy can be a logistical challenge for patients in Tanzania. During our mission in Tanzania, we used intraoperative radiotherapy for the treatment of a brain tumor for the first time in Africa.

This first week in Tanzania is part of a strategic partnership between the University of Leipzig and BMC, aimed at establishing a long-term cooperation network that includes training measures, telemedicine solutions, and joint case discussions. What techniques and procedures have you already been able to teach the BMC medical team, and how are you currently collaborating?

Dr. Maria Kipele: Our long-term goal is a self-sustaining program for cranial tumor surgery with local ownership, encompassing training, standardized procedures, quality controls, and a scalable telemedicine pathway from pre-assessment to postoperative follow-up. Capacity building occurs stepwise and requires sustainable support. During our first mission in October, we focused on practical elements such as microsurgical workflows, structured safety checklists, support through neuronavigation, intraoperative neuromonitoring concepts, and team-based decision-making in complex cases.

The next mission is planned for March 2026, with the scheduled training and treatments building on the measures from October. We will gradually increase the complexity of cases, strengthen perioperative routines, and enhance the independent working methods of the local team.

What support do you need to achieve the goals of the collaboration?

Dr. Maria Kipele: The key requirements are reliability and continuity: a stable infrastructure, regular maintenance of equipment, access to essential consumables, structured training times, and a robust telemedicine setup that ensures connectivity, secure workflows, and comprehensive documentation.

Why is it so important to collaborate across borders and continents nowadays?

Dr. Maria Kipele: Because healthcare challenges don’t stop at borders. Cross-continental collaboration accelerates learning in both directions: it brings advanced care to places where it is urgently needed, and it forces us to innovate – making workflows more efficient, safer, and more resilient. In a globally connected world, shared standards, shared training, and shared responsibility are no longer optional – they are the future.