Introduction
Assuming a prevalence of 10 per 1000, there are an estimated 15 million people with epilepsy in the 11 Member Countries of the WHO South-East Asian Region (which encompasses the IBE South East Asia and Western Pacific regional structure). More than 80% of these people live in rural areas where appropriate services for neurological disorders are very limited.
In 2005 the WHO Regional Office in South East Asia reported that the magnitude of the problems of epilepsy and the huge treatment gap, as well as its considerable social and psychological impact in the region would make it imperative for all countries to develop a national strategy for the prevention and control of epilepsy with the ultimate objective to improve the quality of life of people with epilepsy.
WHO SEARO launched an initiative to deliver at least minimum services for neurological disorders in the community, using community-based health care providers; epilepsy was one of the conditions included in this initiative. Projects were initiated in the following countries:
India
Epilepsy projects were initiated in 4 districts (Namkum, Ranchi, Sarsol, Kanpur, Manimajra, Chandigarh, Chattarpur, Delhi), where previously a survey was carried out with health care providers. The progress made so far includes:
- Training and orientation of the research staff regarding the project
- Development and finalization of data collection forms for the project
- Development of material and finalization of strategy
- Training of 93 Community Health Volunteers in 45 villages in the identification and care of generalized tonic clonic seizures has been completed
- Training of physicians is in progress.
Indonesia
SEAROs approach to reducing the treatment gap in epilepsy was agreed upon. A training programme started in November 2005, using the instruments developed by WHO SEARO. Financial support was provided.
DPR Korea
The Ministry of Public Health (MOPH) together with neurology and epilepsy experts in the country agreed that epilepsy was a major public health problem in DPR Korea. The MOPH reported that prevalence data had been collected and would be available by the end of 2006. The shortage of anti-epileptic medication was a matter of great concern to the government. WHO provided some funds for the purchase of anti-epileptic medication.
- The training of master trainers for identification and management of epilepsy was completed in November, 2004. The participants were physicians, neurologists and epilepsy experts from throughout the country.
- WHO technical material on identification and management of epilepsy had been translated into Korean.
Maldives
WHO SEARO assisted Maldives in capacity building through training community health workers in the identification and management of epilepsy, using SEARO modules. Two training workshops were held for community health workers on the identification and management of generalized tonic clonic seizures (2004/2005). Data collection, reporting and monitoring forms were also provided to the government.
Myanmar
An epilepsy project was conducted in the Ayeyarwady division of Nyaungdon township, with a population of 2,39,632 people (87.5% rural and 12.5% urban). The progress made included:
- Training of all health care workers in the identification and care of major seizures.
- Training of qualified medical practitioners in the management of epilepsy with Phenobarbital.
- A video was prepared on “Myths and Reality” (Myanmar version) for stigma reduction.
- Patient identification was initiated.
If this project proves to be successful in one district, the Government will extend it to 4-5 districts in different parts of the country and, later, nation-wide.