Last week I attended a stroke symposium in the Republic of Armenia entitled: Stroke Treatment 2013. This was a joint conference put on by the Yerevan State Medical University (YSMU), the Ministry of Health, the Fund for Armenian Relief (FAR) and the Armenian Medical International Committee (AMIC). It was a collaborative project headed up by Professor Viken Babikian of Boston University and the head of Neurosurgery at YSMU, Professor Rouben Fanardjian. We lectured on a host of topics related to stroke treatment and stroke prevention.
The Republic of Armenia is a developing nation that lacks the presence of a stroke system of care. This is highlighted by the fact that in its history, there has been one known case of acute stroke treatment with thrombolytic. There is one center, at the YSMU, with the capabilities to perform neuroendovascular procedures. In general neurologists are not involved with the care of acute stroke patients, which are attended to by emergency physicians and critical care anesthesiologists.
There are a lot of challenges in developing stroke care in Armenia, as in many developing nations. According to official statistics, the incidence of stroke was 176/100.000 in Armenia in 2012, with 5417 cases, and in-hospital mortality was 20.6%.
We proposed establishing a stroke center at the University Hospital of the YSMU to serve as an acute stroke center for the city of Yerevan and its region, as well as a referral center for all of Armenia. This request was made in writing to the Ministry of Health and we are awaiting their response. We put forth a plan to build the center in stages, over a period of 3 to 5 years.
Our greatest challenge may be in preparing a group of physicians and nurses specially trained in the diagnosis and treatment of stroke. Other challenges include re-organizing the Emergency Medical Services of City of Yerevan, and providing further educational programs to the EMS personnel. These efforts will not yield results without education of the general public about stroke prevention and treatment.
My experiences in Armenia have led me to have a greater appreciation for the work of the World Stroke Organization. I have also come to realize that treating and preventing stroke in the developing world is something we should all support.