CALL FOR BETTER EMERGENCY STROKE TREATMENT
LAST weekend, at the First Malaysia Stroke conference in Penang, the health director-general highlighted that stroke is the No. 3 cause of death in Malaysia. Ten years ago, it was fifth.
In 2016, public hospitals recorded about 90 stroke admissions and 30 stroke related deaths every day. The incidence may be the tip of the iceberg due to under-reporting by hospitals.
The situation was already grim 10 years ago due to diabetes and hypertension epidemics. Even more precarious, many patients who had stroke are those below 60. We are not just losing an economically active population but cutting across generations, someone’s grandparent, father, mother or even child could be a victim of stroke.
Globally, one person dies of stroke every six seconds.
Is the country’s healthcare system adequately positioned to face this epidemic? The health director-general said the public healthcare system lacked neurologists and hospitals that offer emergency stroke service, and that it was looking at ways to extend the service horizontally. I concur that the matter needs to be addressed urgently.
But before that, steps need to be
taken from top strategic planning to operational ground level. Government healthcare policy should be reprioritised and realigned. Manpower and resources have to be redistributed.
Emergency stroke management is time-dependent, labourintensive, cross-disciplined and costly.
Certain basic but important requirements are needed at the local hospital level. Value-based medicine requires investment. In 2016, RM180 million was spent to treat stroke patients in government hospitals.
Perhaps more importantly, the medical fraternity should look at stroke in a different way. The management of stroke, from prevention, emergency treatment to rehabilitation, is not in the realm of neurologists only. It is multidisciplinary, thus requires an institutional or even a community-based effort. A neurologist treats neurological disorders and stroke is one of them.
Also, there are effective treatments and preventive medicines available for stroke. We need to re-look our practice biases, re-examine our knowledge and keep up-to-date on it.
Certain policies, such as limiting the quota for medicine found effective in stroke prevention due to insufficient funding in public hospitals, only compound the problem.
A speaker at the stroke conference said we were 20 years behind in emergency stroke treatment.
We often have meetings and discussions, but no overall policy to move the “needle”. We have to admit the shortcomings and learn to move forward, as we rightly should.
Do we need political will to change ? Humbly, a compassionate one will suffice. CHEAH CHUN FAI Ipoh, Perak