Developing stroke care in Papua New Guinea

05 Jun 2023 Stroke support

Debbie Meko, Senior Physiotherapist at Port Moresby General Hospital, tells us about important steps in developing stroke care across the continuum in Papua New Guinea.

I work as a senior physiotherapist at Port Moresby General Hospital (PMGH), the major referral hospital for Papua New Guinea. We provide a physiotherapy service including advanced neuro rehabilitation interventions for stroke patients within the physiotherapy outpatient clinic and general medicine wards. As a senior physiotherapist, I also provide clinical supervision for the resident physiotherapist and collaborate as team lead and team player to identify opportunities for capacity building, changes in rehabilitation service, and supervise and participate in research activities for the Physiotherapy Department. In addition to the routine clinical and research work, I volunteer to use my lunch breaks and do home visits for discharged stroke patients on daily rotation basis. I have volunteered to do this because currently there is lack of community-based rehabilitation program within the metropolitan city to follow up on discharged stroke patients from PMGH. The Physiotherapy Department of PMGH has recognized the need to enable the stroke care continuum within the comfort of the stroke survivors’ home, and is actively collaborating with the hospital management to initiate such a program as part of the department’s plan for 2023.

Status of stroke care in PNG

Stroke care in PNG is very basic; PNG does not have a stroke unit, stroke specialists, stroke guideline nor a specific stroke registry for reporting, evaluating and monitoring and to deliver a focused approach to stroke care. Therefore, through the office of PMGH Chief Executive Officer (Dr Paki Molumi) and the Director for Medical Services (Dr Kone Sobi), a working Stroke Management Advisory Committee has been formed to initiate the establishment of the country’s first stroke unit at PMGH. The PMGH Stroke Management Advisory Committee members including Dr Willie Toua, Dr Cassius Maingu, Dr Benjamin Thomas and myself are currently collaborating with Angels Initiative Stroke Care Program Manager (Kim Malkin) and Stroke Care Program Specialist (Samantha Dagasso) to see this project through. In pursuit of that, we’re seizing every opportunity made available for capacity building of our staff, through Angels Academy, World Stroke Academy and ASNEN website. Angels Initiative and WSO are doing an incredible job to assist LMICs to establish and certify stroke units across the globe. My team and I look forward to work together with them to have a stroke unit in place and get certified by WSO, hopefully in the next five years or less.

Goals for service improvement

The purpose of having a stroke unit is to improve hyper-acute management of stroke patients, improve functional outcomes for stroke survivors, reduce financial burden on hospital management due to increase length of hospital stay and reduce socio-economic burden on stroke survivors and their caregivers.

The basis of the idea of having an established stroke unit is embedded in the overarching objectives of PMGH’s Corporate Plan that derived from PNG’s Vision 2050 and the country’s National Health Plan. The plans highlight the need to upgrade and improve the quality of health care provided within the national referral hospital, enabling it to be regarded as a specialist hospital. The emphasis on early detection, proper diagnosis and improved treatment options for the lifestyle diseases are key improvement areas to achieve optimal patient outcomes, and stroke is no exception. More educational sessions for the medical staff to be aware of the early features of stroke and awareness campaigns for both the staff and the general public on the modifiable and non-modifiable risk factors of stroke can be effectively fostered.

This stroke unit project is a work in progress in the hope that one day PMGH will be the voice for stroke in Papua New Guinea through best practice, research and innovation with the purpose of delivering quality stroke care.

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