NEW DELHI: As there is a wide gap in training of neurosurgeons in the country, while there a rapid growing issue related with it in country like India, we could have hardly nearly 3000 neurosurgeons in the country which is not enough, a New Delhi based neurosurgeon, Dr. Manish Kumar says.
The neurological disorders are priority health problems these days which including, stroke, dementia, epilepsy, migraine, Parkinson’s disease, central nervous system (CNS) infections and neoplasms, account for 8.7% of premature deaths and disability across the world.
This excludes traumatic brain injury which itself is a harbinger of major disability. With increasing life expectancy, the burden of neurological diseases is also increasing in rural areas too. India, which massively lacking these facilities in rural areas, where people have no enough money to put in the treatment of such diseases.
I would rather suggest that telemedicine should be developed for all parts of country and rural areas in particular. I often see people coming from different part of country and they can hardly afford that much amount for this disease, so in technology ear one can have treatment facility at rural areas also.
Telemedicine is particularly useful in neurotrauma by helping in the institution of therapeutic measures before the transfer of patients, and, in reducing their unnecessary transfers. Successful use of telemedicine in the remote management of head trauma in India has been reported, he added.
In the last many years, remotely evaluated patients with head trauma. Several serious head injuries were successfully managed. Tele-discussions of treatment options were conducted when transfer was recommended. Tele-consultation was used for the subsequent follow-up of these patients. A general surgeon, tele-mentored by the remotely, operated upon three cases of compound depressed skull fractures, Dr. Manish added.
Interestingly, there was a subsequent drop in neurosurgical tele-referrals from telemedicine-enabled centers. The doctor at these remote center had acquired the confidence to manage most cases of simple head trauma without the need for further tele-consulting. Eighty percent of India’s specialist doctors live in urban India. 700 million people living in rural India have to travel a distance of 75 to 100 km for a tertiary consultation.
Indian Universities only train 387 new postgraduates annually in neurology and neurosurgery. While Southern India has 205 seats and Northern India 126, North Eastern India with a population of 260 million has only 4 seats. The National Board of Examination produces an additional 44 specialists per year (some of whom have already cleared their qualifying examination earlier).
Neurologists located in the districts see about 80 patients daily leaving little time for academics and research. Indian neurologists examine four times the number of patients seen in USA and UK. Greater involvement of primary physicians and internists in the neurological care of patients is extremely necessary.
Promoting health literacy is critical in improving health outcomes. By deploying multi-point video-conferencing. There is also need of initiating a knowledge based empowerment programme at the internet enabled Village Resource Centers in rural across country.
The problems like dangerous headache,” “Management of head injuries,” “Management of brain tumours,” many neurological conditions can eminently preventable and e-Lectures by specialists go a long way in providing necessary awareness quickly and cost effectively.
Neurologists and neurosurgeons need to embrace telemedicine to extend their reach to their patients. Deployment of ICT can make neurological services available in regions where proper medical facilities do not exist. Our services should be universally available to anyone, anytime and anywhere. Dr. Manish says.