Dr Padmanabha Kamath still remembers an incident from five years ago, when a young auto rickshaw driver in a remote village in Chikmagalur, had a heart attack and passed away because doctors couldn’t make a diagnosis on time.
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“He was a 32-year-old, had two small children, and was the sole breadwinner of his family. The only reason for his death was a delay in diagnosis,” says Dr Kamath.
The WHO reports that heart attacks are the leading cause of disability and death in India. A Lancet study estimated that the prevalence of heart disease in the country has increased from 2.57 crore in 1990 to 5.45 crore in 2016, and deaths resulting cardiovascular diseases also increased from 13 lakh in 1990 to 28 lakh in 2016.
Additionally, the average time it takes for a patient with an ongoing heart attack to get treated is 360 minutes. This is a far cry from the golden hour of 60 minutes, which is prescribed by the medical specialists.
“In India, the average time of 360 minutes is incorrect. Here, it can be anywhere between 10 to 13 hours after one sustains a heart attack,” he says.
The incident mentioned earlier disturbed Dr Kamath to the extent that he started a WhatsApp group, Cardiology at Doorsteps (CAD), with about 800 doctors to help aid quicker diagnosis especially in the remote rural areas where specialists are not easily accessible.
While the doctors dispense their professional advice on heart-related illnesses for free, they also guide rural doctors in terms of reading electrocardiograms (ECGs) that are posted in the group for a second opinion.
The cardiologists also help the doctors working in smaller hospitals and PHCs to connect with a referral hospital and the nearest cardiologist.
In the 1.5 years since they began, they have received at least 8000 consultations spread across four groups which comprise of three cardiologists in each group.
“Till date, 500 heart attack and 850 heart diseases have been accurately diagnosed in the group,” mentions Dr Kamath.
Dr Kamath emphasises that the specialists in the group must share their numbers on the WhatsApp groups as remaining online throughout the day, is not possible.
“Every ECG posted is reported immediately and then archived. If ECG is not normal, the doctor is called on mobile in addition to standard WhatsApp reporting to doubly ensure the well-being of the patients,” he says.
The group has also raised money and installed over 200 ECG machines in small hospitals and PHCs in remote rural areas.
Where do they get the money for these ECG machines?
“The funding for these machines comes from patients, their relatives, well-wishers and philanthropists. The banking sector has also funded a few machines,” says Dr Kamath.
CAD has also donated emergency heart attack diagnosis and treatment kits to about 1000 PHCs. These kits comprise of drugs that can be used for immediate treatment in case of heart attacks until the patient is referred to a bigger hospital.
Dr Kamath narrates a recent incident where an intervention by the group helped save a life.
“A rural AYUSH doctor’s brother, started complaining of severe chest pains. This was at 8:30 pm, and the man was at his remote farmhouse in Ishwaramangala. The doctor took an ECG using the machine that was donated by CAD and shared the report on the WhatsApp group. The doctors immediately identified it as a heart attack and asked him to rush his brother to Mangaluru. The team was ready to perform angioplasty on the patient as soon as he arrived.”
Currently, Dr, Kamath and other specialists provide this consultation service only in 14 districts across Karnataka, but they plan on increasing its reach in other states. They have already donated 12 ECG machines to PHCs in Kerala.
Additionally, Dr Kamath also runs a free WhatsApp helpline (9743287599) in case of heart related emergency cases. However, Dr. Kamath emphasises that this helpline is only for online consultations in case of emergencies and is in no way a replacement to clinical knowledge and judgement.
“My ambition is to take this up on a pan-India level with the help of like-minded cardiologists along with donations from probably larger business houses. THAT will be a game-changer,” he says as he signs off.
(Edited by Gayatri Mishra)