There is a lack of doctors, training, drugs and technologies. Italian neurologists to the rescue of African colleagues also thanks to a tele-neurology service
Last year the World Health Organization published the latest update of the 2013-2030 Action Plan for Mental Health: in Intent, on continents such asAfricathat of
prevent the c
growing number of hyperactivity disorders, autism, alcoholism which strike above all young people between 15 and 24 years oldto whom only half of the African states offer structured health care. In the best of
cases are entrusted to the medicine of the territoryhowever, very much in needMoreover not always managed by doctors, but often by paramedics who, however good they may be, cannot cope with everything, operating in a situation of severe shortage of drugs and equipment. U
There is an additional problem in complying with the WHO invitation to integrate psychiatry with basic medicine.
The IGAP program
In May the attention of the WHO focused on a new global action plan for epilepsy and other neurological disorders in order to improve prevention, early diagnosis, treatment, cure and rehabilitation. Called IGAP, that is Intersectoral Global Action Plan 2022-2031, the Plan over the next 9 years intends to give access to treatment for epilepsy and other neurological conditions for 1 billion people, half of whom are in Africa, where in 70-90% of cases they do not have access to treatment. The plan wants train primary health workers and community volunteersalso raising awareness and educating traditional and religious healers who are an integral part of the African socio-cultural fabric.
Lack of specialists
What is really lacking in Africa are the specialists to whom to provide adequate neurological training and tools so that they can put into practice what they have learned – says the neurologist of the Besta of Milan, Massimo Leone who, even before the WHO asked for it, has been operating in the black continent thanks to a joint venture between the Besta and the Sant’Egidio Community, an initiative which is also joined by the Italian Society of Neurology (SIN) -. Raising young neurologists is the right way to solve a disease that even in the West carries the burden of a pesante stigmae in Africa still the disease of the possessed of the times of Dante Alighieri who in the Divine Comedy describes a patient as “What falls, and does not know how, by force of a demon who pulls it to the ground”.
One neurologist for every 2.7 million inhabitants
Nell’sub-saharan africa c’ only one neurologist for every 2.7 million inhabitants and epilepsy sufferers end up in mental illness centers which, in more than 90% of cases, are managed by paramedics.
Before the WHO directive,
in Ghana
for example, out of 24 million inhabitants, there were 270,000 patients with epilepsy of which 85% had never been treated. Along the lines of the IGAP, the local initiative Fight against epilepsy was launched e 21,000 patients received adequate treatment for the first time. IGAP aims to increase basic medicine, integrating the treatment of epilepsy with that of other chronic and communicable diseases
(HIV, TB, hypertension, etc.) adopting a clinical approach that is almost unknown in Africa: following patients longitudinally, a fundamental principle in the treatment of epilepsy and other chronic diseases. Too bad there is a lack of doctors, training, drugs and technologies.
Teleneurology service
At the invitation of the WHO for this neurological disease to be freed from the mental disorders among which it was relegated in Africa, the Italian Society of Neurology responded by activating a group of experts who have also promoted a tele-neurology service which makes use of an online electroencephalography system: it records the patient’s traces and sends them to the Besta neurologists who return a diagnosis to the African doctors with which to set up an adequate therapy. was the work of tutoring Italy-Africa carried out in recent years than today enable young African doctors to carry forward the WHO IGAP plan. In addition to identifying training courses for young local neurologists – says the president of the Scientific Society, Alfredo Berardelli of the University La Sapienza of Rome – SIN is also collaborating with non-governmental organizations with proven experience in the health sector by networking with local institutions, ministries of health, universities, associations, so build a territorial neurology even in the most disadvantaged areas, and not just for epilepsy.
The African dream
The massive migratory phenomenon that affects our country – continues Professor Berardelli – could increase the request for specific attention and skills for migrants who, once they reach us, develop neurological disorders that are sometimes different from ours and which must already be studied and treated. in aids activated ad hoc in the places where these populations live. Everything has made the Neurological Institute of Milan a sort of hub between Italy and Africa. On 8 November, a conference is held at Besta with experts from all over Italy who have received the patronage, as well as the SIN, also of the Lombardy Region, the Mariani and Sant’Egidio Foundations and the Global Health Telemedicine. We will discuss future projects and the results of the last twenty years of an initiative that, even before that of the WHO, was born with a title full of expectations: The African Dreamil African dreamwhich is actually the happy asynonym of a project with very concrete purposes. It means in fact Disease Relief through Excellent and Advanced Meanscio resolution of the disease with excellent and cutting-edge methods.
November 3, 2022 (change November 3, 2022 | 18:17)
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