The agenda for the weekend leading to October 29th contained our first live Facebook event debuting with a panel discussion lead by our astounding founders Dr Bhavya Rehani and Dr Ankur Bharija joined by international guests from Paraguay, Nepal, Cameroon, Sierra Leone and US specialists in neurological diseases.

We then followed on Sunday with a live workshop telecasted in Nicaragua with Spanish translation (thanks to Señorita Alma Villacastin ), and Monday with four more seminars for our audience in Uganda, Philippine, Malaysia and Bangladesh.

Indeed a busy weekend; and the success can be measured by the over two thousand views, over 150 shares in real time in Nicaragua, and blessings sent through comments in English and Spanish.

All this is amazing, yet we measure success not by numbers but by the passion of all those involved and their hard work to bring the stroke awareness message in remote areas and places who suffer from health disparities.

I emphasize passion and dedication because they are at the core of all these events. For those watching the Facebook videos, they might not think of the work that happened in the background for these discussions to be featured live. Months of planning, aligning the doctor’s busy schedules with different time zones, researching local information to present for everyone, combining motherhood with professional work (in case of Dr Laia Flores, who offered us the pleasure of meeting our youngest supporter). Yes, this is passion and dedication, and it is not happening in a 9 to 5 office schedule. These leaders are taking their mission beyond a day in the hospital. They talked about local challenges, well known and similar in low and middle-income countries, and the steps each of them as community leaders are taking to ensure the message of prevention is well understood and carried out to those who need information the most.

Everyone recognized that in addition to the known risk factors of the stroke there is also a lack of stroke awareness and stroke-related information targeting hypertensive patients.

Grateful for the collaboration with H4TW Dr Thapa, Dr Laia and Dr Albert admitted the message of awareness should start with the medical professionals as leaders so that the community follows and take on the advice. In a humorous yet guiding example Dr Thapa who is a young professional calculated his own risk of stroke, showing in a clear way that this disease although present in a higher percentage in people over 60 years of age, does not discredit based on age and looks and knowing the signs of stroke could benefit anyone.
As the doctors present have found common ground in medical challenges, they have also seen the support of Health4TheWorld and displayed the same hopeful and encouraging attitude in bringing innovation to their hospitals, community and relation with patients.

These young professionals have realized that presented with reduced clinical resources, the only efficient and impactful way of increasing prevention is to harvest the power of technology. We were touched by the powerful feedback from Dr Thapa, who considers himself and the Nepali people “lucky and fortunate” to be supported by H4TW and Dr Bhavya, as they use the app to educate stroke patients and their caretakers and increase prevention. They use the app to teach members of the community and spread the stroke awareness message but also to improve the patient’s life after stroke. They are hopeful that with the app being available in local Nepali, the efficiency of this educational tool will increase.

Encouraging and hopeful feedback was shared by Cameroon who though the leadership of Dr Albert is not only disseminating the app to patients but participating actively in our online telecast lectures. The entire group of medical students and residents are incredibly enthusiastic and eager of knowledge, making an excellent audience for the renowned professionals involved in the Grand Rounds talks. To quote Dr Albert, “the students found these talks enriching, uplifting and inspiring”, primarily since they provide up to date and new research information about a series of diseases management to improve outcome in patients. What makes the lectures so successful is the free online availability, with a wide range of topics formatted to be easily accessed in areas with low internet settings, and following a template specifically designed to support healthcare workers in low resource regions. The lectures are also accompanied by quizzes to assess knowledge and performance.This format gives the students the possibility for continuous professional development. Joining the medical students from Cameroon, the lectures gained popularity in Bhutan and Nepal also.

The H4TW stroke app is definitely everyone’s favourite child described as “overwhelmingly awesome” with a significant contribution to improving communication between the patients and health professional as well as in the patient-caregiver relation.

The app shows a proven benefit in helping those at risk and their family members to recognize the warning signs of stroke, as well as being used as a tool for “home-based rehabilitation” to gain full recovery by following the physical therapy exercises incorporated in the app, as recommended by Dr Simon.
The help me speak section of the app has received encouraging support from the patients with aphasia; the doctors are predicting an increase in the numbers of phone and tablet acquisition by stroke patients and family members to be used for app download.

Therefore, aligning our goals under Dr Claude Hemphill’s’ message: “What is your reason for preventing stroke?” the emphasis everyone carries, is on the modifiable risk factors such as:

1. Control high blood pressure
2. Maintain a healthy diet to avoid diabetes and reduce cholesterol
3. Stop smoking
4. Understanding the warning signs of stroke accentuating:
   B(balance- sudden loss) E(eye; sudden loss of vision) F(face drooping on one side) A(arm weakness) S( speech difficulty) T(time to call the ambulance).

How exactly we bring a contribution in stroke prevention and how we work with our collaborators to have an impact locally? Is this actually attainable or it is just a discussion?

Yes, it is real, it is the work of many people spanning over more than a year, and we do so in two ways:
1. Disseminating with the help of our dedicated collaborators the Health4theWorld Stroke app, encouraging patients to use and learn from the advice promoted by the app
2. Inviting medical students and medical professionals to the attend the curriculum of free online lecture for professional development.

A little bit about Health4theWorld stroke app. I always describe it as an accurate, comprehensive tool (now available in English, French, Spanish, Swahili and Nepali) with multiple sections designed to help a patient manage life post-stroke. It is also useful for the caregivers and family members of the patients, in providing up to date information on reducing risk factors, adjusting diet and maintaining a healthy lifestyle.

The free access through iPhone and Android make the app an efficient means to reach people worldwide (it is now downloaded in over 22 countries).

Apart from the educational information, recognising stroke signs and reducing risk factors the app has two interactive features bringing this mHealth tool to patients in the form of a “friend”. The chatbox and virtual reality components are engaging the stroke patients, reducing the effects of solitude and depression.

Does it really work? How is it different from the other apps on the market?
Most answers come from actual patients using it, and the workshops held on Sunday featured patient’s experiences using the app and their testimonials.
Our fantastic neurologist collaborator in Nicaragua Dr Marvin Salgado had enlisted a tremendous campaign sharing stroke awareness message to patients and caregivers advising them to join us live on Facebook for Health4theWorld stroke fair.

He has invited in his own home stroke patients and family members to experience the H4TW stroke app and the “how to use it” demonstration. What we heard as feedback was humbling, pure happiness and joy, the patient Redolfo felt understood, as if what the app promoted described his condition accurately and knew exactly how he is feeling and what his symptoms are. Through smiles and congratulations, we received incredible encouraging live comments, solidifying our belief that our mission is needed.

A friendly atmosphere has followed in the workshops with Bangladesh and Philippines. On our website are featured actual stroke patients and their experience with the app and every time I read it it makes me emotional (please visit www.health4theworld.org to learn about patients and how the use of the app has improved their lives; such as Anjali Shaha from Bangladesh who relies on the home-based exercises featured in the app to enhance her mobility post-stroke, as an alternative to regular physiotherapy which is too expensive).

And it should be emotional, this is our team’s drive, described as “seva”, selfless giving. We help others, we collaborate we share, we work together, we are emotional, we join in joy and celebrate, as we spread the stroke awareness message.

And we do not stop here, this is a mission with a purpose to impact many and to help people have a better life, through innovation with the help of technology and the passion of many selfless hearts.
There are many ways you can be a part of it too, by reading the message to self educate, by sharing, volunteering or just directing those around you to benefit from our health promotion tools. Whichever way you choose as long as it helps even one person prevent stroke or have a better outcome as a patient it is sure a great and efficient method.

By Cristina Dan, Health4TheWorld member since Feb 2017, Recent MPH graduate, proud and fortunate to be a part of a passionate team whose mission and work for health promotion and educating the community is outstanding.