A Step Forward in Stroke Care: Our Partnership with Wessex Global Stroke Partnerships

A guest blog post by Dr. Victor Mawuli Morhe

In September 2024, the Ho Teaching Hospital Stroke Unit hosted a team from Wessex Global Stroke Partnerships, accompanied by colleagues from Korle Bu Teaching Hospital, for a collaborative review of our ongoing project. This visit was part of our broader mission to establish a fully functional and efficient stroke unit that can meet the growing needs of stroke patients in our region.

One of the key areas of focus was helping pretest online training modules, which we believe will be instrumental in upskilling our medical and nursing staff. During the review, we discussed how these resources can potentially impact our daily operations and where we could further tailor them to meet our specific needs.

 The visiting team also took part in ward rounds conducted by the local Stroke Multidisciplinary Team. Seeing our progress through the eyes of visiting colleagues allowed us to identify areas where we have made substantial gains, such as improved patient monitoring and more streamlined communication within the multidisciplinary team. These rounds also sparked conversations about introducing protocols to enhance the unit’s capacity to handle more complex stroke cases.

Discussions during the visit focused not only on what we’ve achieved so far but also on the way forward. We explored potential areas for further improvement, including strengthening our rehabilitation services and implementing more structured follow-up care for stroke survivors. These conversations will help shape the next phase of our project, ensuring that we continue to grow and provide world-class stroke care for our patients.

 In all, this visit reaffirmed the importance of collaborative efforts in healthcare development. The input and support from Wessex Global Stroke Partnerships and Korle Bu Teaching Hospital have been invaluable, and we look forward to building on this partnership to improve stroke care in Ho and the surrounding regions.

 Dr. Victor Mawuli Morhe

WGSP secures THET grant funding to continue developing online training modules

WGSP, in partnership with the Neurological Association of Zambia, have successfully secured a further THET grant through the Global Capacity Building Programme to start in October 2024. This small grant builds on the work being carried out with Ghanaian partners to develop online training modules for the 8 core stroke skills:

  • Swallowing and nutrition

  • Positioning and manual handling

  • Communication impairment

  • Continence

  • Mood

  • Functional independence

  • Stroke prevention

  • Discharge planning

The aim is to develop modules that will be accessible to support stroke professional working in resource poor environments around the globe.

Successful Commonwealth Scholarship Commission Application

WGSP have successfully applied for CSC fellowship funding for 2025 to support 4 partners to come to the UK for a period of 6 weeks. The programme will include observation of clinical practice, clinical skills refresher training, leadership and QI training, development of understanding about health systems and how to influence change, and reflection on WGSP work.

Applicants from Ghana and The Gambia will be selected during the summer of 2024.

Dr Lamin Jaiteh, our lead physician in EFSTH, Banjul said “Congratulations to WGSP, and thank you for supporting stroke care in the global South, especially in The Gambia & Ghana. I can't thank you enough, and all those who were involved in setting up this partnership and kept it functioning until date. Thank you very much indeed for your voluntarism, we are grateful and sincerely cherish your efforts. From henceforth, I look forward to actively participating in all the activities of this very valuable partnership.”

June WGSP trip to Tamale and Ho

In June, as part of our THET grant, two of our UK members as well as a small group of colleagues from Korle Bu Hospital travelled to both Tamale and Ho Teaching Hospitals in Ghana. The aim of this trip was to hold key stakeholder events and to deliver initial face to face teaching on positioning and swallowing. The team had a great welcome with lots of enthusiasm to build on core stroke skills.

There was great feedback from the team:

“Heartfelt thanks to the UK and Korle Bu teams for the comprehensive stroke training. Your dedication to improving stroke management is deeply appreciated. Gratitude also to our Head of Department, Dr X, for championing the stroke unit initiative. Our nurses are committed to supporting all teams for excellent stroke care. With our Head of Department’s leadership, sustainability will not be an issue”

“I want to use this opportunity to say a big thank you to the Korle-Bu team and the UK team. We are grateful for the brilliant support. We are highly energised to kick start stroke services. [Named head of department], we are grateful for your exceptional leadership”.  

“The knowledge acquired during these few days was great, it is going to greatly improve stroke care going forwards”

“A very educative and enlightening training programme” 

“I believe the programme was very beneficial. I learnt new things and reinforced knowledge” 

Training Workshop for Participants from Ho and Tamale Teaching Hospitals at the Korle Bu Stroke Unit, Ghana

A guest blog post from MDT colleagues from regional hospitals in Tamale and Ho who spent the week learning about stroke care at KBTH Stroke Unit

Introduction

On Sunday, April 14th 2024, our team arrived in Accra eager to learn from the renowned stroke unit at Korle Bu Teaching Hospital (KBTH). The participants were Julius (Nurse) and Ramous (Physiotherapist) from Ho Teaching Hospital, as well as Farouk (Nurse) and Mensah (Physiotherapist) from Tamale Teaching Hospital.

Warm Welcome and Team Introductions

We were warmly welcome to the stroke unit on Monday. Their warm smiles and genuine hospitality immediately put us at ease. We got to meet several team members; Prof Akpalu, Dr Nkromah, DDNS Monica, Mr Maxwell, Ms Cynthia, Ms Getrude and many others.

Insights into Stroke Care

DDNS Monica kickstarted our journey with an enlightening lecture. She delved into the intricacies of stroke—its types, deficits, and potential complications. She then introduced us to the core skills essential for stroke care:

  1. Swallowing: Understanding the physiology of swallowing and assessing it in stroke patients.

  2. Positioning: The art of placing patients optimally for comfort and function.

  3. Communication: Bridging gaps through effective communication.

  4. Functional Independence: Empowering patients to regain autonomy.

  5. Continence: Managing bladder and bowel function.

  6. Mood: Addressing emotional well-being.

  7. Stroke Prevention: Equipping patients with knowledge.

  8. Discharge Planning: Ensuring a smooth transition back home. 

Swallowing Assessment and Feeding

DDNS Monica and Mr. Maxwell provided in-depth training on swallowing physiology and swallowing assessment for stroke patients. It helped us understand how a seemingly simple act could impact a stroke survivor’s quality of life.

On Tuesday 16th April, 2024 we had practical demonstrations on swallowing assessments, positioning a patient for feeding, and feeding via NG tubes. 

Leadership Insights

Also on Tuesday, we shifted gears. Dr Nkromah gave us a lecture on leadership, where we got to know the difference between a leader and a manager. We learned that leaders inspire, innovate, and envision change. Managers, on the other hand, focus on processes and stability. Our takeaway? Effective stroke care demands both leadership and management skills.

Leadership lecture

Ward Rounds and the MDT

Wednesday dawned, and we joined the general ward rounds. Each multidisciplinary team member contributed—doctors, nurses, therapists—all working in harmony. Seeing this holistic approach to care first-hand was invaluable.

Positioning Stroke Patients

Later on, Wednesday, Mr. Abdul Kahad, physiotherapist took us through the very important role positioning plays in the recovery of stroke patients, especially at the acute stage. We grasped the rationale behind every adjustment, realizing that small shifts could yield significant gains.

On Thursday the 18th April, Ms. Cynthia, another amazing physiotherapist, then led practical sessions on both positioning and transferring patients. It helped us in understanding how position changes and proper positioning do have a great impact on a stroke patient’s recovery.

Zoom Connections

Virtual meetings on Tuesday the 16th April and Thursday the 18th April, 2024 connected team members in Ghana and the UK. We shared experiences and learned about upcoming training plans for the coming weeks and months.

Another Meeting with DDNS Monica

DDNS Monica walked us through the stroke unit’s daily workflow, providing essential insights for operationalizing a stroke unit. Details such as feeding times, bathing schedules, and positioning changes were crucial for our understanding.

Tools of the Trade

Our teams received laptops, wireless mice, and Wi-Fi dongles to help in participating in the online lectures that will be coming on in the weeks and months ahead.

Comfort and Gratitude

Beyond the workshop, we found comfort in a good hotel and well-prepared meals. The Korle-Bu Stroke Unit’s meticulous organization impressed us. They followed protocols religiously, proving that excellence transcends resource constraints.

Key Lessons and Future Impact

  • Resourcefulness is Key: Even with limited resources, a highly effective stroke unit can be established.

  • Organization is Paramount: Strict adherence to protocols is crucial for optimal patient care.

  • Collaboration is Power: A multidisciplinary team approach leads to better patient outcomes.

As we bid farewell to Accra, our hearts brimmed with gratitude. We carry these lessons, these connections, back to our institutions. Our stroke unit dreams are no longer distant—they’re within reach.

With gratitude,

Julius, Ramous, Mensah, and Farouk

Ho Teaching Hospital & Tamale Teaching Hospital Teams

Tamale Teaching Hospital Team

Ho Teaching Hospital Team

THET grant success 2024

We are delighted to announce that we have been awarded a Global Health Workforce Programme small grant to run from 1st Feb 2024 - 31st Jan 2025. This will allow us to further expand our training and impact in reducing stroke morbidity and mortality in West Africa, through the dissemination of training to two further centres in Ghana. We will also be developing and piloting online resources that will ultimately be available globally for all healthcare workers to access.

Watch this space for updates!

Happy Birthday to KBTH Stroke Unit!

Sustainability has always been the aim: January marks the 10th anniversary since the opening of the Stroke Unit at Korle Bu Teaching Hospital, Accra. The Unit, and more importantly, the team behind it, have become a beacon for stroke care across Ghana, and beyond. Countless patients and families have benefitted from receiving specialist stroke care over the past 10 years. The team celebrated this amazing achievement, including welcome back the very first patient to have received care on the Unit!

Welcome to new WGSP UK team members!

This year, we have welcomes new volunteers to the UK arm of the WGSP. Lucy Sawyer (OT), Alpha Cham (Research Nurse) and Debs Broadbent (SALT) jointed the team in 2023. Here, Debs tells us a bit about herself and why she decided to get involved…

I am a Speech and Language Therapist and have been working for more than 30 years in the NHS in the UK and I have recently joined the Wessex Global Stroke Partnership (WSGP). 

I have always worked in stroke services, amongst other areas, during my career and over the years I have seen many changes and improvements to how we care for patients following stroke in England. These changes have made big differences for the better to the care, outcomes and patients’ experiences after a stroke. 

When there was an opportunity to join this group I was very keen to be part of the progress and changes being made in stroke care in The Gambia. 

I have worked with many overseas doctors and nurses and am always interested to hear how stroke care is provided in different parts of the world, especially when my role is undertaken by different members of the team. 

I am delighted to be part of WSGP and be involved with plans to improve stroke care.

Zambian Link update September 2023

Since 2020 an informal link between WGSP and the University of Zambia (UNZA) / University Teaching Hospital (UTH) in Lusaka, Zambia has developed: the Zambian team are developing a neurology training programme including a focus on stroke.  In July 2023 a Letter of Agreement was signed between WGSP and UNZA / UTH outlining the relationship which includes sharing of resources, knowledge, and experiences for the benefit of both parties.

In order to support Zambian staff training ahead of the imminent opening of the first stroke unit in their country, during September 2023 two Zoom calls were facilitated between nurses from KBTH in Ghana and nurses from UTH.  These took a semi-structured format with questions being asked about the experiences of the KBTH nursing team as the stroke unit there has developed from small beginnings to the widely recognised regional centre of stroke care that it is today.  Challenges and successes were explored and the positive impact on patient care was discussed.

The Zambian nurses engaged in the discussion with insightful questions and observations, reporting that it was one of the most helpful and best sessions during their training.