We started our journey of going to rural and more remote areas of the union territory of Jammu and Kashmir on the World Heart Day from Kupwara town and Machil area on the 29 September 2020. The aim was to optimize the treatment of patients, with high blood pressure (BP) diabetes, high lipids and heart diseases related to these common problems. Our mission is “No More Heart Attacks”. These two risk factors along with bad lipid profile (High cholesterol and triglycerides), obesity, tobacco use, lack of exercise, low intake of fruits and vegetables and psychosocial stress explain, the causation of 90 percent of the heart attacks.
By the beginning of April 2021 we have completed seven camps in various districts, Kupwara, Budgam (Kremshore, Khan sahib), Pulwama (Rajpora), Ramban (Banihal), Jammu (Jagati Migrant Township), Kakchin(Manipur)and back waters of the Dal lake (Mirbehri). There were many dissimilarities based upon the ethnic variations and geography but there were several common issues noted. All of them were reported in our reports. Approximately 1000 patients whom the team of Gauri healthy heart foundation saw were subjected to a standardized protocol of evaluation. The common problems noted were; Poor BP and Sugar control despite taking medicines, overweight and very high triglycerides. A large number of patients were on unnecessary drugs, inadequate doses of therapeutic agents with very long drugs lists. Important tests like properly done ECG’s, echocardiograms, stress tests, prolonged ECG and BP monitoring and reliably done relevant blood biochemistry were missing very often. In addition, the evaluations frequently had not been done by non-up-dated physicians with a continuity of care which is extremely important to improve the outcomes of non-communicable diseases.
Keeping all these findings in mind our foundation has decided to start a Healthy heart Clinic under the banner of Gauri Heart Clinic (GHC) starting on 10April, just days to go. The site chosen is in the centre of the Srinagar city at Chanapora. Kashmir Valley which is like a bowl, even the farthest towns can be reached within 2 to 3 hours from the city. The clinic will run throughout the week. It would have at least 2 full time cardiologists available for 8 hours every day. A geriatric medicine consultant for caring the elderly people will also be there.
The centre would have facilities for carrying out all the non -invasive cardiac tests like ECG, stress testing, echocardiography, Long term ECG (Holter monitoring and endless loop recording (ELR), ambulatory BP monitoring and also head uptilt testing to diagnose vasovagal syncope. The equipment setup is state of the art one. Facility of blood biochemistry of all the relevant tests including point of care tests to diagnose heart attack, heart failure and clots in the lungs promptly, will also be available.
Since all the heart related non- invasive tests will be there, every patient seen will be given the full medical treatment on the day he or she presents. Counselling for life style and dietary modifications will be an integral part of the management. The data of all the patients seen will be digitized and compiled for an effective follow up. There would be facility for the registered patients to communicate with their treating doctors in cases of emergency. The centre would also impart training to interns from various technician training courses and also for healthcare workers. A hostel accommodation will be provided in a nearby safe place.
We have made arrangements for patients needing admissions with several private hospitals of the city depending upon the patient’s and their family’s convenience. Fully equipped ambulance will be available for a prompt transfer. Meanwhile facility for carrying out emergency treatment will be available in the GHC. For patients coming during off hours and needing urgent care and counselling, one of the members of the foundation will be available in the clinic premises. All stable patients will be seen with appropriate appointments and waiting would be kept to minimum.
It is hoped that our efforts will help in setting up a model state of art heart clinic to help the needy patients with evidence-based therapy. No patient will be denied treatment and necessary investigations for want of finances.
The author is the Founder Director Gauri Healthy Heart Foundation, a recipient of Padma Shri and Dr B C Roy Award