RSUD Sleman is a regional general hospital in a regency on the island of Java where tourists flock to see some of Indonesia’s finest temples and taste salak pondoh, the tropical snake fruit that originated here. At this hospital, stroke care is not just a medical service – it is a commitment that goes beyond hospital walls. This commitment is like a beautiful piece of knitting woven by the stroke team, the hospital staff and management, the authorities and even the community.
The thread that keeps everything intact leads to the hospital’s neurologist Dr Eni Nurhidayati, Sp.S, who has been practicing here since 2013 after completing her neurology residency at Universitas Gadjah Mada. After previously working in primary healthcare as a Puskesmas doctor, she has spent years improving stroke care at the hospital, with the goal to ensure the best possible outcome for every patient.
Dr Eni’s special interest in stroke is a tribute to her late father who passed away as the result of stroke in 2014, a year after she officially became a neurologist. Although she had been taught during her residency that the golden treatment for acute ischemic stroke was thrombolysis, the therapy had not yet been implemented at the time her father needed it. It was just theory – she had never had the opportunity to practice it. However, since the light of recanalization therapy has come into her practice, Dr Eni has made sure that every eligible patient received the treatment they needed. Recalling how stroke affected her father, she is determined to give all her patients the best chance for recovery.
Another significant moment in Dr Eni’s career was in Febuary 2023 when a nurse who had been assisting her for 12 years suffered a stroke during a shift at the hospital.
“She was a nurse for stroke patients. She has given care to stroke patients for years, even since when I was still in residency,” Dr. Eni says.
“When it happened, the nurse saw that the phone was ringing, but she just couldn’t move her body to pick it up. She then told people in the room to pick up the phone, but although in her mind she was saying these words to them, she saw that nobody was listening,” Dr Emi says, describing the shocking event from the nurse’s point of view.
When her colleagues recognized her symptoms, code stroke was quickly activated and the nurse was given the treatment she needed. The clear flow of code stroke in RSUD Sleman and the readiness of stroke team and staff, built by training after training, were like a good fate wrapped as excellent care. It saved the nurse’s life and prevented her from becoming disabled. Two weeks after the incident, she was back at work and taking care of stroke patients, her commitment deepened by the experience of having been in their shoes.
The incident made her realize that stroke can affect everyone, Dr Eni says. “Literally anyone can be a stroke patient, can be the one who needs the help.”
In recognition of their commitment to stroke care excellence, RSUD Sleman won their first gold WSO Angels Award in the second quarter of 2024 after evaluating past cases and identifying gaps. Analysis of their data pointed to the need for public awareness and lead to a collaboration between the hospital and Puskesmas, the primary healthcare facilities that provide the first level of care.
Puskesmas are the first port of call for patients and their role in detecting stroke symptoms and provide fast and accurate referrals is therefore vital. Recgnizing an opportunity to save more lives, Dr Eni has committed herself to closing this public awareness gap by training Puskesmas and other Sleman hospitals about stroke.
The collaboration between RSUD Sleman and several Puskesmas in Kabupaten Sleman consists of training and spreading awareness of the need for swift action so stroke patients can receive treatment within the “golden” hour. The RSUD Sleman team goes from one Puskesmas to the next, and also arranges community-based gatherings in order to educate stay-at-home housewives, regional security officers, village heads, and many others, about how to recognize stroke systems and what to do when they occur.
These activities not only enjoy the support of the local government, but their participation too. Sleman’s mayor has opened some of the awareness events, and has delivered a speech emphasising the importance of not neglecting stroke symptoms and of going straight to the emergency ward. He has publically acknowledged the success of RSUD Sleman in improving their stroke care, and their commitment to saving patients’ lives. The hospital has now won three consecutive WSO Angels Awards.
These threads of collaboration between many parties towards a single goal are creating a safety net to protect Sleman citizens from death and disability caused by stroke. From the trainings and awareness campaigns done by RSUD Sleman team, these threads are becoming longer and reaching deep into the community. Because just like the stroke nurse at RSUD Sleman, it is impossible to predict who will benefit from life-saving knowledge and swift action tomorrow.
