Stroke is one of the cardiovascular diseases caused by modifiable factors like high blood pressure, obesity, diabetes and raised blood lipids which are caused by unhealthy diets, tobacco use, physical inactivity and harmful use of alcohol. Stroke has now become one of the global concerns where the attention is urgently required. The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain (the stroke) is found to be the second leading cause of death and the third leading cause of disability including dementia and depression in the world. According to World Stroke Organization (WSO), 17 million people suffer stroke worldwide every year. Out of these, nearly 6 million die and 5 million are permanently disabled. According to Venketasubramanian N., et al (2017) a majority of stroke burden was observed in developing countries due to limited access to the Computed Tomography (CT) scan services that is a must to diagnose stroke. This hampers clinical decisions like whether to anti-coagulate patients or not, and to what level the patients have to control their blood pressure.
Developing countries are facing a double burden of communicable and NCDs. In Bhutan, as per the Annual Health Bulletin 2017, Stroke was the 6th highest cause of death. With the increasing life expectancy of Bhutanese population, and the upwards trend of incidence of Hypertension and Diabetes, stroke burden is only going to increase. For instance, it is reported that diabetes and hypertension have increased to 12,120 and 30,260 in 2016 from 4,097 and 27,023 cases in 2012 respectively (Annual Health Bulletin, 2017). There is hardly any studies on stroke in Bhutan. And there is no dedicated Stroke Care Unit within the hospitals in the country, even at the national referral hospital.
Records maintained with JDWNRH show 2 new stroke cases being admitted daily. The numbers could certainly be more now.
The Ministry of Health (MoH) develops health policy and organizes the provision of quality and comprehensive health-care services, including health promotion, disease prevention, curative and rehabilitative services. In line with this, JDWNRH has designated six bedded ward for stroke patients and provide therapeutic services. MoH also joins rest of the world in observing the World Stroke Day.
However, there is a need for individuals, societies and communities to share the responsibilities of the MoH. The proposed Bhutan Stroke Foundation is aimed at complimenting the efforts of the MoH.