Epilepsy services in rural India: Maharashtra model of total care

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Nirmal Surya

Epilepsy Foundation, India

: Int J Ment Health Psychiatry

Abstract

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According to WHO, approximately 50 million people suffer from epilepsy around the world, out of which approximately 12 million patients with epilepsy reside in India and Maharashtra has an approximately 1 million people with epilepsy. It is one of the major neurological disabilities present which affects all age, sex, religion and caste alike. In rural India the treatment gap is up to 85% largely due to poverty, lack of awareness, myths and taboo associated with the illness and stigma of disease itself with unavailability of specialist to treat this disease. Epilepsy Foundation of India in association with National Health Mission (NHM), State Health Society, Government of Maharashtra has founded a public-private partnership and developed a Maharashtra model of epilepsy which is been working successfully for past 7 years. The model includes: (1) Training of medical and paramedical by CME/SEMINAR/HANDS on training/telemedicine; (2) Sensitization of medical officer, health worker and society; (3) Awareness in society by audio-visual, movie, street play, pamphlets, radio and other modes of broadcasting; and (4) Rural epilepsy camps-organized in district, sub-district level hospital-across Maharashtra every month. Assessment and administration by nervous system specialist or pediatric nervous system specialist. EEG/CT/MRI/Drug level free of expense for the required patients. Neuropsychological assessment and directing. 3 months free pharmaceutical to all. Information passage of all patients for future subsequent meet-ups and for inputs. Assessment and treatment of handicap related with epilepsy amid the camp follow up through telemedicine at area clinic, at EF Center in Mumbai. Set up of 10 provincial epilepsy focuses in various areas of Maharashtra. In the last 7 years a total of 69 camps have been organized by Epilepsy foundation in association with NHM, Government of Maharashtra, which saw a total of 26,137 patients. 3,340 free EEG have been done, 640 free CT scans and MRI, 1876 patients have been counseled, drug level and BERA were done of 502 and 118 patients respectively. 125 neurologist and 25 pediatrician/pediatric neurologist rendered their services during these camps. These camps have reduced the treatment gap to 25%; this model can be used in all the rural setup for various conditions across India. This model can be considered on a larger scale for other developing countries as well.

Biography

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Nirmal Surya is currently working as a Consultant Neurologist at Bombay Hospital and Research Center, Saifee Hospital, Mumbai. He is also the Chairman of Surya Neuro Center, Mumbai. He is the Founder Trustee and Chairman of Epilepsy Foundation, India. He has been at various posts for neurological societies in India, Founder President of Indian Federation of Neurorehabilitation, Past President (2013-14) of Bombay Neuroscience Association (BNA), Treasurer (2014-2020) Indian Academy of Neurology (IAN), Founder Secretary (2005-10) Maharashtra Association of Neurology (MAN). He is also the Regional Vice President of World Federation for Neuro Rehabilitation (Since 2006) Chairperson, developing world Forum, SIG, WFNR.

E-mail: nirmal_surya@yahoo.com