A drug which reverses the symptoms of a stroke if taken within four hours of the attack is currently not available in Jamaica because the country’s health sector does not have a stroke unit equipped with trained staff to administer the drug to patients.

The drug – tissue plasminogen activator (tPA) helps break up or dissolve blood clots, which causes ischemic strokes and can limit the amount of permanent disability if given within a few hours of the first stroke symptoms.

“If administered within the first four hours it will break down the clot so the blood can flow freely thereafter and as such it works like a charm,” neurologist Dr Daniel Graham told the Sunday Observer shortly after addressing the Dr Ena Thomas Memorial Symposium held at the Jamaica Pegasus Hotel on Friday.

“We hope that in Jamaica we can move towards having this drug because it is not an expense issue why we don’t have it here, and so I hope symposiums like these will heighten persons’ awareness,” he added.

Acknowledging that the drug has side effects, Dr Graham said this is the reason it must be administered by persons specifically trained to identify which patients are suitable candidates.

“You have to select your patients very carefully, so the use of such a drug would have to be when we have an established stroke unit with people who are trained to identify the patients who we can safely use the drugs with,” he explained.

That aside, he said the unit is long overdue and needs to be established if we are to manage strokes effectively in Jamaica.

“Administering this drug will have its challenges, but it is an exciting challenge and we are at a time in our history where we can and should aim towards that because it is long overdue,” he said.

Given the urgency with which the drugs must be administered, Dr Graham said there are some things which, although they may appear insignificant, must be done for the drug to be as effective as it can be.

“Because the person must get to the stroke unit within four hours, we will need to have a mechanism in place that is so efficient to get the patient from the home to the hospital and into the stroke unit within four hours,” he said.

This, he argued, is not impossible to do, given that the ambulance system has improved significantly from what it was before. “Things like the roads need to be improved and for us to learn to respect the ambulance and get out of the way when they have their sirens blaring,” he said. “Little things that can save lives and impact significantly on the outcome of the morbidity of stroke patients.”

He called for the implementation of a stroke awareness week where persons can be informed so as to take preventative measures. “Just like a breast cancer awareness week, or epilepsy or some of these other medical disorders, we need to bring information about strokes to the public because all of us are potential candidates for stroke, regardless of age,” he said.

“We have to look at the risk factors, such as hypertension diabetes, obesity and prevent the things which we know are the forerunners of stroke,” he said. “If we can do that, we can save ourselves a great deal financially or otherwise.”

Turning to the issue of rehabilitation of stroke patients, Dr Graham said the recovery process is a multi-disciplinary approach. “It is not just left up to the caregiver,” he said. “We have the occupational therapist, speech therapist, the physiotherapist. and it doesn’t just stop when the person leaves the hospital.”

Professor Owen Morgan, retired dean of the Faculty of Medical Science at the University of the West Indies, also addressed the symposium. He said Jamaica has not given the kind of attention needed to the management of strokes.

He added that although this is changing in some instances, it is taking a long time in realising that much more can be done for stroke patients. “In many hospitals you are told that if (the stroke patient) can swallow food then send him home,” he said.

During the symposium, a nurse from the Kingston Public Hospital, Marlene Brown-Smith, was declared the 2006 winner of the Dr Ena Thomas Award for her contribution to the health sector.