A stroke unit in Freetown will test whether a centralised model of care can cut death and disability from stroke in Sierra Leone, one of the world’s poorest countries. Stroke is a leading cause of death and long-term disability globally, yet in many low-income countries there are no dedicated stroke services, no ambulances coordinated for rapid transport, and no paramedics trained to recognise the signs. The 2014–2015 Ebola epidemic exposed how fragile Sierra Leone’s health system was, but it also created political will to rebuild. This project seizes that opening. The team will establish a stroke unit at Connaught Government Hospital and a stroke team at 34 Military Hospital, linking them to a new national emergency hotline and ambulance fleet. If the model works, it could become a template for other low-income countries in sub-Saharan Africa. The research is applied and practical: it directly aims to change how stroke patients are diagnosed, transported, and treated. Success would mean fewer families losing a breadwinner to a preventable death, and a health system better equipped to handle non-communicable diseases—a growing burden in countries that once focused mainly on infectious disease.
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KCL GLOBAL HEALTH STRATEGY King’s is a global top 20 university and the ‘King’s Strategic Vision 2029’ is ‘to make the world a better place’. KCL has strengths in biomedical and allied health profession education and research, KCL recognised a need to cohere its global health (GH) activities, with a solid base and plan for investment and growth. The new King’s GH Institute (KGHI) is a focal point for King’s GH researchers, a mark of the institutional commitment, and provides expertise in research and education for the wider university. The inclusion of Kings Centre for Global Health within the School of Population Health and Environmental Sciences supports the strategy by bringing expertise together. The strategy is “to focus on high value partnerships, where there is good research infrastructure and established collaborations with KCL that can be broadened and deepened; but also committing to long-term research capacity building with less developed partners with important need and potential”. Our iBSc in GH, Public Health and MScs in GH, Global Mental Health, and GH and Social Justice attract 160 students annually. KCL plays a leading role in the South London CLAHRC (King’s Centre for Implementation Science coordinates implementation and QI research across health themes), and in two NIHR BRCs (GSTT/ KCL and Maudsley; clinical informatics and translational medicine). The School of Public and Environmental Health hosts the NIHR Statistics lead, the London Research Design Service, the CTU and the CRN. KCL hosts world leading research and clinical expertise that addresses all of the United Nation Sustainable Goal 3 targets, including non-communicable disease. In line with the UK aid and international development strategy, the plan is to deliver outstanding applied global health research for the direct and primary benefit of patients, families and the public. The focus of the work is the improvement of the management of non-communicable disease using stroke care in Sierra Leone as a model. PARTNERSHIPS, STAFFING, FACILITIES, NETWORKS AND SUPPORT. This application will build on an award winning partnership with Sierra Leone, King’s Sierra Leone Partnership (KSLP). King’s College, London (KCL) have invested in KSPL with in country academic and support staff. The Freetown team of 15 includes Dr Daniel Youkee (Country Director) , an education manager as well as five clinical academics, 2 research coordinators , 2 nurses and research support staff (operations manager, IT, finance, communications). In London, Dr Andrew Leather directs the partnership with help from skilled operations, partnership, financial and logistics support staff. KSLP actively support education through the College of Medical and Allied Health Science (COMAHS) and has strong government links. The 2014-2015 Ebola epidemic has driven a renewed national and international commitment to strengthen weak health systems and led to ongoing redesign of the national strategic health plan, offering a vital opportunity to develop evidence based stroke clinical and preventative care in Sierra Leone and across the sub-region. We aim to develop centralised stroke services in Freetown and establish a stroke unit at Connaught Government Hospital and a stroke team at 34 Military Hospital. The recent establishment of a national emergency services telephone hotline, a new ambulance fleet and the training of a new paramedic cadre provide a key opportunity to implement centralised stroke services in Freetown. The work will widen the partnership to include world leading stroke researchers and clinicians (Wolfe, Rudd, Langhorne, Sackley, McKevitt, Watkins, Legg), scientists (Peacock, Fox Rushby) and other networks (World Congress of Physical Therapy, Lancet Neurology Commission for stroke in LMIC, Global Burden of Disease Collaboration (cardiovascular), the INDEPTH network, the European Stroke Organisation). The ‘vision’ is to establish a co-produ
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