Stroke Centre, a place of hope

or Israfil Mia is a 65-year-old man from Shingiar upazila of Manikganj. At present, he is undergoing treatment at government’s National Institute of Neurosciences and Hospitals (NINS)’s ‘Hyper Acute Stroke Care Centre’. This centre is commonly known as the Stroke Centre.

Israfil Mia’s son Mohammad Sumon talked to Prothom Alo on the afternoon of 29 June. Sumon said, his father returned home from the bazar at around 11.00am on 14 June. He placed the the shopping bag down on the porch and suddenly fainted.

First Israfil Mia was taken to Shingiar upazila hospital but physicians referred him to the Neurosciences Institute in the capital’s Agargaon area. However, he couldn’t be admitted there as there was no vacant bed there on that day, he said.

Sumon further added, being unable to admit his father into Shaheed Suhrawardy Medical College and Hospital and later in National Institute of Cardiovascular Diseases, their relatives then admitted him into Enam Medical College and Hospital, a private hospital in Savar.

On 15 June, the next day physicians at the Enam Medical College and Hospital said, they cannot provide him with the treatment he requires. Then their relatives again took him to the Neurosciences Institute. Since then he has been undergoing treatment at the Stroke Centre of the institute, Sumon said.

Israfil Mia is staying in bed 11 in the male ward of the Stroke Centre. Physicians on duty there have said that Israfil Mia suffered from a stroke. That means blood had clotted inside the veins of his brain.

There are 50 beds in that ward. There was no vacant bed there on 29 June. The female ward is on the same floor, just opposite of the male ward. That too contains 50 beds. There was no empty bed there either.

Professor Badrul Alam, joint director of the institute said to Prothom Alo, “We have collected and using the latest equipment and tools required in administering emergency treatment to the stroke patients. Alongside, we have recruited trained physicians, nurses and associated manpower as well.”

There is no other centre so large for the treatment of the stroke patients anywhere else in the country. Physicians claim they are not aware of any such centres in the region.

Physicians say there are three types of strokes. When blood coagulates inside the veins of the brain, it is called ischemic stroke.

Meanwhile, when blood escapes through a ruptured blood vessel, it is called hemorrhage. Apart from that, there can be a rift in the vessels above the brain. These types of strokes are called arachnoid hemorrhage.

However, there are certain misconceptions among common people regarding strokes and heart attacks. Physicians say, symptoms of heart attack includes chest pain, a feeling of pressure and sweating.

Meanwhile, stroke symptoms include slurred speech and drooping face. A person suffering from stroke cannot move his hands or legs. These symptoms indicate whether the patient has to be taken to a cardiologist or a neurologist.

Going to 10th floor of the institute it was seen that there are strict regulations about patient’s relatives entering the ward.. Only one relative can visit the patient at a time for a brief while, that too within fixed visiting hours. There’s no need for the relatives to stay with the patient.

All sorts of attention including feeding, using the toilet, turning the patient over, is taken care of by the physicians, nurses and other health workers.

Visiting both wards of the stroke centre twice in the past week, no relatives were noticed beside any of the patient’s bed.

There are 20 physicians working at this 100-bed stroke centre. All of them are stroke specialists with post graduate degrees on this subject. Besides, there are 80 nurses who have special trainings too.

Apart from them, there are 80 other associate health worker including caregivers. There are seven professors above them. And, there are arrangements for physiotherapy in both of the wards.

According to physicians, most of the stroke patients can be fully treated if they are taken to the hospital within four and a half hours of the stroke. The more is the treatment delayed, the less is the possibility of full recovery.

Both the wards are neat and clean. The complaint there is regarding uncleanliness at government hospitals, cannot be used against the Stroke Centre. The cleaning staff here is active round the clock.

The nurses themselves have made a list of 10 'right' tasks for providing proper care. It says on that list, right patient, right treatment, right medicine, right dosage of medicine, application of medicine on right spot, right time, right documentation, right advice, right refusal, right verification and right evaluation. The list can be noticed in the wards. Nurses try to follow this list in case of every patient.

Yet, it is common for people to make mistakes. Such as, stroke patients cannot turn over by themselves and need to be turned over by others. But, it’s hard to track which patient has been lying on which side for how long.

To avoid this issue, nurses have been instructed to keep all patients lying on one side for a certain period of time and then turned over on the other side after that time.

For example, all patients are kept lying on their right side from 9.00am to 12.00pm every day. From 12.00pm to 3.00pm they are propped on their left. The whole day is mapped in this way.

Because of this, none of the patients have to lie down on one side for a long period of time. Entering the ward, one can notice most of the patients lying on the same side.

There are arrangements for consultation on a regular basis. There are two separate rooms to update the patient’s families about the patient’s conditions or possible result of treatment.

Patient’s relatives are called by the name of the patient and bed number and briefed on the patient’s condition. If there is risk that the patient may not survive, the relatives are properly informed of that too. These tasks are carried out by trained physicians.

The Stroke Centre was launched on 6 January 2020. That year, 4,019 critical patients took treatment at the centre. The next year, 7,362 people were treated there. Among the patients who underwent treatment there, 90 per cent have recovered. The risk of a patient suffering from paralysis is reduced by 70 per cent, after taking treatment at the centre.

On the condition of Israfil Mia, physician in-charge Shahin Mahmud said, patients like Israfil Mia are discharged with guidelines to follow at home, before they make full recovery.

They are somewhat forced to release the patients since the queue of critical patients keeps growing if there’s a delay in discharging the current patients.