When we came to Manipal Teaching Hospital, we learnt quickly, that Manipal will become the role model to prove that small actions will lead to a huge change!
The workshop with 30 physicians and nurses began with Dr. Raju, President of the Nepal Stroke Association, awakening all participants with some devastating facts about strokes worldwide (“1 in 4”). When we then discussed the current obstacles in stroke care in Manipal Teaching Hospital, our impression was that the participants initially felt, most things were out of their area of influence – even though everyone having the strong desire to treat each stroke patient successfully.
As the awareness of stroke in the population is quite low, it’s only a minority of patients arriving in a time window for recanalization. And once the decision for thrombolysis is made – any door-to-needle-time time is prolonged to infinity by the fact that the family itself must raise the money for thrombolysis – and that before the therapy can be started… Currently, thrombolysis is given about 2-3 times/ month (by neurosurgeons, emergency physicians and neurosurgeons), thrombectomy or referral to another center is not yet possible. Dr Raju encouraged the team that the “fear” of thrombolysis will become less and less the more we do it – we just need to get thrombolysis in our routine.