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| Friday, 4 June 2004 |
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No organised structure for care of stroke patients - Dr. Jagath Wijesekera by Edward Arambewala Sri Lanka has no organised structure for care of stroke patients even though stroke is on the increase in the country said President of the National Stroke Association Sri Lanka Dr. Jagath Wijesekera at its annual general meeting held in Colombo recently. In Sri Lanka, there is no organised structure for stroke care, and multidisciplinary approaches to stroke rehabilitation are virtually non-existent. Lack of physiotherapists, occupational therapists and speech therapists is a major factor responsible for this. Sri Lanka's first stroke unit was established at the Institute of Neurology of the National Hospital of Sri Lanka (NHSL) in June 1998, aimed at improving the quality of stroke care at the NHSL," Dr. Wijesekera said. 'Stroke is commoner with increasing age, and Sri Lanka has one of the fastest aging populations in the world. The population of over 60 years will increase from 10% to 20% by 2025. Factors that increase the risk of having a stroke such as high blood pressure, diabetes and smoking are increasing with the changes in dietary habits and lifestyles. We are likely to see a large increase in the number of dependent stroke survivors in the near future," he said. "Our experience of treating over 200 stroke patients at the stroke unit of the Institute of Neurology at the National Hospital of Sri Lanka, Colombo have shown that these risk factors are common, and sometimes undetected. Of these patients, 48% had high blood pressure and 26% had diabetes. 15% with high blood pressure and 15% with diabetes were previously undiagnosed,' he observed. Dr. Wijesekara said to improve the quality of stroke care if we are to minimise the burden of stroke. This could be achieved by improving acute management of patients with stroke, improving the rehabilitation services to overcome the functional impairment, and initiating measures aimed at stroke prevention. Stroke prevention is the most cost effective way of reducing the burden of stroke. Public education plays a very important role in this regard. Healthy life-styles should be encouraged. People must be educated on the importance of control of the factors that increase the risk of stroke such as high blood pressure, diabetes and smoking, he said. Dr. Wijesekera called for a comprehensive stroke service aimed at improving all aspects of stroke care. 'This can evolve around a stroke unit, which can serve as a hospital based focal point of services and expertise. If a stroke unit can be established in each province, a stroke service can be developed to serve the entire province. The services should not remain hospital bound, but must reach the community it serves. This is essential if preventive strategies such as educational programmes are to be successful. Community participation is vital in this regard. A stroke association will bring together medical and non-medical people committed to improving stroke care. The managerial skills of the non-medical professionals can be harnessed to take the stroke service to the community, to ensure community participation, and to develop educational campaigns. Creating and improving awareness on stroke, and dispelling the myths regarding stroke are important objectives. The association will also be a meeting point for stroke victims, their families and caregivers, and health care professionals, he said. |
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