In remote villages of Kashmir, cardiac patients get lifeline through WhatsApp

Doctors and cardiologists from the tertiary centres are connected through WhatsApp groups. And doctors posted at government health facilities in remote areas are advised on the line of treatment round the clock.

Written by Adil Akhzer | Srinagar | Updated: June 11, 2018 7:21:16 am
At the sub-district hospital in Tangmarg. Top Srinagar hospitals act as the hub, district and sub-district facilities are spokes.

A FEW WEEKS ago, when 27-year-old Bilal Ahmad Chopan, a labourer from Banihal in J&K, was rushed to the local hospital with severe chest pain, doctors quickly conducted an ECG, which confirmed that the patient had suffered a heart attack.

“Without wasting any time, I uploaded the ECG on our real-time network. Doctors and senior cardiologists advised me to go for thrombolysis (using medication to dissolve clots in the blood vessels). I acted immediately and we saved the life of the patient… In such emergencies, the crucial first hour is the golden hour,” says Dr Auqib Najam from the sub-district hospital in Ramban district.

“After providing basic treatment, Chopan was referred to Srinagar’s Sher-I-Kashmir Institute of Medical Sciences (SKIMS) where stenting was done,” says Najam, referring to the use of a stent to keep the patient’s arteries open.

Chopan is among hundreds of patients whose lives have been saved by doctors posted in remote areas of the valley under Save Hearts Initiative launched by the Directorate of Health Services, Kashmir, last December.

According to officials, the department uses a “hub and spoke model” to provide life-saving treatment to those suffering cardiac emergencies, particularly Myocardial Infarction or heart attack.

“The tertiary care centres in Srinagar — SKIMS and Shri Maharaja Hari Singh (SMHS) Hospital — work as the hub, and the peripheral district and sub-district hospitals function as spokes,” says Dr Saleem-ur-Rehman, Director-General, Health Services, Kashmir.

Doctors and cardiologists from the tertiary centres are connected through WhatsApp groups. And doctors posted at government health facilities in remote areas are advised on the line of treatment round the clock.

“As soon as suspected cardiac emergency patients are brought to peripheral hospitals, they are taken to the emergency room for the ECG. The doctor immediately shares the ECG on a dedicated network, which operates 24×7. The cardiologist from SKIMS and other specialists give their advice,” says Dr Nasir Shams, who is from the Health Department and is actively involved in the programme.

“If required, patients are immediately referred for further treatment, and the cardiology department of SKIMS or SMHS is alerted,” says Shams.

According to official data, more than 1,500 cardiac emergencies have been treated under this initiative, including 120 heart attack cases. Officials say the Health Department is now adding Kashmiri doctors working abroad to the WhatsApp group to take advantage of different time zones.

“One doctor from Australia is currently associated with this programme. When doctors here are not available, he is the one who prescribes medical intervention on the WhatsApp group. We are planning to add doctors based in the US so that patients receive help even in the middle of the night in India,” says an official.

In Banihal, Najam says 5-6 patients have been referred to SKIMS in Srinagar. “The best part is all of them survived, and are coming to us for follow-up treatment. I am among around 200 other medical officers who have been trained by the department for this programme, especially in reading ECGs,” he says.

Chopan, who is recovering, says he felt a pain inside his chest “all of a sudden”. “I am thankful to the doctor at Banihal, he saved my life,” he says.

It’s not just Banihal. Recently, thrombolysis was conducted on a heart attack patient for the first time at the Primary Health Centre at Khaltsi in Leh.

Dr Tsering Angmo, anaesthetist consultant at the PHC, told The Indian Express that the procedure was conducted on a 48-year-old Army porter who was brought unconscious to the health centre that afternoon.

“After his ECG was done, my colleague found it was a case of MI. We shared the details on the group and experts guided us for thrombolysis. Later, we referred him to the district hospital in Leh,” says Angmo.

Says Dr Irfan Ahmad Bhat, cardiologist consultant at SMHS Hospital: “Imagine a patient having a cardiac emergency in Tangdhar. It would take him six hours to reach Srinagar for treatment. In many situations, the delay in treatment leads to death.”

At SMHS, he says, the lives of over 100 patients have been saved after they were referred from peripheral centres under the programme.

Dr Shafat Shams, who is the medical officer at the sub-district hospital in Tangdhar, says he tackled two cardiac emergency cases recently. “Now we are dealing with heart attack cases at our level. We are saving hearts and lives,” he says.

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