Page 6 - SHJ V5 No2 2018
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SHJ Vol 5 No 2, 2018                                              Khalil, Status of cardiac care
                                                            http://dx.doi.org/10.25239/SHJ/Vol5/No2/Editorial

                   3.  Creation of improved primary cardiac care and emergency service in the main hospitals
                       throughout  all  states.  This  is  by  simple  means  e.g.  simple  coronary  care  unit,
                       thrombolytic therapy, emergency drugs and appropriate ambulance service. All general
                       physicians are capable of running this service.
                   4.  Ambulance service in Sudan should be better organized e.g. improve easy localization of
                       patient’s  address,  and  create  ambulance  lane  or  fast  tracts  to  improve  movement  of
                       ambulance vehicles. With eminent delays expected a doctor should be available on board
                       to  administer  lifesaving  medicine,  intubation  and  DC  shock  if  required.  Better  still,
                       telecommunication system should be installed to transmit information about the patient
                       and receive help from the receiving center.
                   5.  Patients admitted as an acute emergency and those with chronic valvular RHD should
                       receive treatment free of charge, including surgery and prosthesis.
                   6.  The  available  service  can  be  largely  improved  by  government  centers  adopting  the
                       strategy  of  primary  PCI  which  will  reduce  costs  and  improve  outcome.  Interventional
                       cardiologists are doing a great job and it is expected that they will avail themselves to
                       receive  calls  for  Primary  PCI  throughout  the  24  hours  of  the  day.  This  will  reduce
                       mortality,  load  of  waiting  cases  and  improve  the  flow  of  work.  The  finance  of  such
                       service including pay of cardiologists and CL staff should be met.
                   7.  The concept of private wing for cardiac cases is on its way at Ahmed Gasim Hospital. It
                       is expected that the patient receives care similar to what he gets abroad. This can be done
                       by  better  physician  and  nurse  care,  immediate  PCI  or  surgery.  Improvements  should
                       extend to the laboratory, pharmacy, housekeeping and the provision of waiting place for
                       patients’ relatives. This policy should be applied to all government hospitals with cardiac
                       setup. Implementation of a private wing is simple, possible and will certainly solve the
                       greater part of the problem.
                   8.  If the treatment for heart cases is provided locally a good amount of foreign currency can
                       be saved and used to support the local cardiac service with consequent improvement in
                       the overall outcome.

                   This report is written with the intension of shedding light into the deficiencies of our present
                   cardiac care service and to suggest some achievable solutions, to that extent one can only
                   hope that the Federal and Khartoum State ministers of health would give it due consideration.

               Acknowledgement
               I am grateful for Professor Mamoun Homaida, Khartoum State Minister of Health for his help
               and  the  provision  of  statistical  data  from  SNMC,  Dr  Salah  Mohamed  Ibrahim  and  Professor
               Sulafa Khalid for providing statistical data on CVD.

               References

                   1.  Khalil SI, Khalil S, Albadri H et al. Emergence of ischemic cardiomyopathy as the main
                       cause of heart failure in urban Sudanese population. International Cardiovascular Forum
                       Journal 2015; 2: 37-41.




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