The Current State of Neurosurgery in Iceland

Although surgical conditions account for 32% of the global burden of disease, approximately 5 billion people worldwide lack access to timely and affordable surgical and anesthesia services. Disparities in access to surgical care are most evident in low- and middle-income countries, often resulting from a lack of surgical infrastructure. However, the establishment of surgical infrastructure, particularly for specialty surgical services including neurosurgery, is challenging in countries with small populations, irrespective of income classification, due to the distribution of high costs among a lesser number of individuals. One such nation is Iceland. Despite high-income status and high quality of life, literacy, and educational attainment, the population of Iceland has often lacked access to local neurosurgical care, with the establishment of the domestic neurosurgical system in 1971 and continued externalization of complex neurosurgical procedures to neighboring nations and neurosurgeons. This article provides the first-ever examination of neurosurgery in Iceland. We describe the history and social, political, and economic context in Iceland. We examine the history of neurosurgery in Iceland, provide brief biographic sketches of pioneers who have catalyzed the establishment of neurosurgical care and training in Iceland, and characterize the current state of neurosurgery in Iceland. We conclude with recommendations derived from the experiences of Icelandic neurosurgeons to guide the international community in future initiatives