off record
Shaukat Ali Jawaid

Stroke units manned
by trained Physicians 


Though exact figures are not available about the incidence and prevalence of stroke in the country but it remains one of the most important cause of morbidity and mortality. We have very few neurologists and no dedicated well equipped and staffed Stroke Units in our healthcare facilities. Hence even if those who survive with disabilities, their quality of life is extremely poor and they are a burden on the family which face lot of difficulties in caring them in view of the almost non-existing proper rehabilitation services in most of the hospitals.

It may not be possible for us to have a qualified trained neurologists to take care of these patients in every hospital but it does not mean that those who suffer from stroke should be abandoned. It calls for a cost effective solution to plan stroke care services in the country. The first and foremost important thing is to create awareness and educate the community on signs and symptoms of stroke so that these patients are immediately taken to the nearest healthcare facility to get emergency treatment.

During the recently concluded annual conference of Pakistan Stroke Society, one of the guest speakers from India Dr. Jeyraj Pandian highlighted the importance of establishing the stroke care units headed by physicians who are trained in stroke care. They along with the trained nurses and other support staff with the help of physiotherapy services offering rehabilitation facilities are doing a commendable job in India. Abut thirty such Stroke units, he pointed out, are functioning in five States of India. He also shared the roadmap for establishing such stroke units in resource limited countries. Our health planners and leadership of professional specialty organizations who are very fond of holding conferences in Five Star Hotels must also learn some lesson and move into the community. According to a well-designed programme, physicians can be trained in acute stroke care who should be supported by well-trained nursing staff in stroke care. Physiotherapy department must also be established at least in every District Hospital staffed by qualified trained physiotherapists. Following the example of India, these physicians can also form a WhatsApp groups and keep in touch with the neurologists to seek their guidance when needed.

Since health is now a provincial subject, provincial government can be approached and persuaded to establish these stroke units. Creating awareness in public and educating the community as well as the healthcare professionals in early identification of stroke, efficient emergency care and timely referral to a stroke care unit can go a long way in improving the ultimate outcome. But all this cannot be done sitting in Five Star Hotels or in teaching hospitals in big cities. If the healthcare professionals are sincere and serious, they will have to move out in the community. A lot can be done if there is a will, there is always a way and healthcare professionals in India has showed that it is doable and practical. Let us hope that all this will not fall on deaf ears and apart from controlling high blood pressure and diabetes, the two most important risk factors for stroke, neurologists in collaboration with health planners in general and Pakistan Stroke Society in particular will take some practical steps in this direction.

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