Dr Paul releases a whitepaper on mechanical thrombectomy highlighting gaps and opportunities for making stroke-ready infrastructure in India
Noting that an overwhelming 60 per cent of people suffering stroke in India face various degrees of disability, some lifelong, lawmakers, policymakers, and medical experts have highlighted the lack of enough specialists and availability of treatment, especially in the interior parts of the country to reduce such cases. Speaking at the third edition of Stroke Summit organised by Integrated Health & Wellbeing (IHW) Council on the occasion of World Stroke Day, they also emphasised on the need to promote interventions such as mechanical thrombectomy (MT) to save patients beyond golden hour.
“We need to prevent disability caused by stroke by making treatment available to the affected. To that end, tehsil and district level hospitals with stroke care capability are being established. The Ministry will consider proposals to prevent or help people who suffered disability due to stroke. I will also write to the Union Health Minister to ensure stroke treatment is available everywhere,” says Ramdas Athawale, Minister of State, Ministry of Social Justice and Empowerment
Releasing a whitepaper on building thrombectomy (treatment) systems of care in the region, prepared by the Society of Vascular and Interventional Neurology (SVIN), Dr VK Paul, Member, NITI Aayog, says, “Neurological diseases are complex and their number in India is on rise. Since 2014, we have established 167 medical colleges and increased undergraduate seats by 53 per cent. Yet, it will take us 23 years to come up with the required number of neurologists to care for the number of stroke-affected people. I urge your support for the National Board of Examination if we need more trained neurologists in India. Also, I urge you to pass down training to general physicians to expand the capability of treating stroke.”
“In India, about 30 per cent of people suffering stroke die and a whopping 60-70 per cent people suffer various degrees of disability. The number of disabled people is more as we move into the interiors where hospitals do not even have a CT scan machine. We need to ensure they get treatment,” says Prof. M V Padma Srivastava, Head, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi.
The whitepaper carries key recommendations for policymakers to build a stroke-ready India, including, a) creating a task force including neurologists, neurointerventionalists, EMS personnel, community physicians, stroke-trained nurses, stroke coordinators and administrators of hospitals who deal with a high volume of stroke cases; b) assessing the stroke disease and economic burden of stroke, the efficacy of the existing systems in place for stroke management and identify key gaps, the cost and therapeutic effectiveness of existing public and private health systems and conduct a detailed analysis of clinical and cost benefits to the patients and overall population in the region; c) establishing local or regional certification programs for stroke hospitals; d) creating government-supported funding mechanisms for patients in resource-constrained settings who will benefit from MT; and e) establishing specialized regional thrombectomy systems of care equipped to carry out MT and increasing the number of training programs for neurointerventionalists with an aim to create adequate talent for stroke management.
“Stroke patients who get help from paramedics are more likely to reach hospital for care – in India that number is only 1.8 per cent. We need uniform emergency medical services (EMS) system and certification of stroke ready hospitals across the country so that people know where to go when they recognise the signs of stroke,” says Dr P.N Sylaja, Professor and HoD, Neurology, In-Charge, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
“To say that a medical emergency like a stroke requires attention and importance is an understatement. Stroke affects as many as 18 lakh Indians every year, which means one Indian suffers stroke every 40 seconds. One-fourth of these people are aged less than 50 and increasingly, a large proportion of stroke patients are found in the age group of 19 to 30 years. The burden of stroke on the most productive sections of society not only affects the person and their family but leaves a cascading effect on the country’s socio-economic condition,” says Kamal Narayan, CEO, Integrated Health and Wellbeing (IHW) Council.