Passionate plea for stroke beds and organised care

An individual effort can bring excellence but a collective effort brings efficiency, is how the live-wire behind the ‘National Guidelines for Management of Stroke in Sri Lanka’, Dr. Padma Gunaratne described this “combined and marvellous” piece of work– a roadmap for the next five years.

Two years of extensive discussions with medical administrators and professionals and allied health and nursing professionals had made the National Guidelines a reality.

Dr. Gunaratne reiterated that these National Guidelines would help dispel the thinking among some clinicians and administrators that not much can be done for stroke patients.

The data this Senior Consultant Neurologist gives were revealing – 60% of stroke patients either completely improve or improve with mild disabilities allowing them to live independently in society; only 10% die in hospital; another 10% die of preventable complications after being discharged from hospital and going home; and 20% survive with major disabilities requiring the assistance of another to carry out their activities of daily living.

Underscoring the importance of a better prognosis for stroke patients, if they get proper attention through organized services at hospitals, Dr. Gunaratne earnestly appealed for such services.

She spoke of the “premature discharge” of stroke patients, citing the example of such patients not having adequate dedicated beds at the NHSL, as there is a severe shortage of beds to keep them for the adequate period in hospital. They were prematurely discharged in 3 to 5 days, whereas the duration of stay in a Stroke Unit would be about 21 days.

“We also need to complete the one-stop National Stroke Centre at Mulleriyawa, which was begun in 2013, with about 20% of the work now done,” urged Dr. Gunaratne.

In 2013, the government budget had identified the need to establish 10 Stroke Units in Jaffna, Anuradhapura, Ampara, Polonnaruwa, Kandy, Badulla, Kurunegala, Ratnapura, Karapitiya and Matara. Dr. Gunaratne stressed that this far-thinking project needed to be revisited and completed.

She also focused on the promised 40 stroke beds (20 each for men and women) at the over 3,000-bed NHSL and sent out a fervent plea that if these dedicated beds were available stroke patients could be given a decent service.