“A simple WhatsApp Group is creating a community that provides crucial and timely cardiac care to patients in remote areas of Kashmir Valley”
Sheikh Mustafa
SRINAGAR: Combating the challenges of infrastructure and accessibility in remote and isolated areas, a simple messaging app has become an unlikely lifeline for those facing cardiac emergencies.
This is the story of ‘Save Heart Kashmir’, a grassroots initiative that has turned WhatsApp into a powerful tool for saving lives. This virtual network of cardiologists provides crucial cardiac care to patients in remote Kashmir, bridging geographical gaps with life-saving expertise.
The Birth of a Virtual Cardiac Unit
Dr Imran Hafeez, a renowned cardiologist, additional professor, and the president of the Save Heart Kashmir at SKIMS, Soura in Srinagar, says, “I have seen many patients brought too late, leading to the tragic loss of their lives. This recurring experience inspired me to ponder how he could save more lives by providing timely medication and care to those who come from distant locations. This reflection sparked the idea for Save Heart Kashmir in 2017, to provide timely medical care to those living in remote areas.”
He, thus, envisioned a system where local doctors could receive immediate guidance and support during critical moments, potentially saving countless lives.
Dr Hafeez says, “Kashmir is a resource-limited region with regional challenges, operational limitations and about 64% of ST-Segment Elevation Myocardial Infarction (STEMI) are from peripheries.”
Delays in patient care were primarily caused by patients themselves (59%), followed by transport issues (25%), and referral delays (16%). Most patients arrived at medical facilities after significant time had passed, with 36% presenting between 6-12 hours after symptom onset, and 33% arriving between 12-24 hours later, according to the data compiled by Dr Hafeez.
Dr Hafeez points out serious gaps in heart attack treatment in India. One-third of patients who need urgent care for a severe heart attack don’t get it in time. Advanced procedures to open blocked arteries are rarely used, with less than 10% of patients receiving them. Instead, most patients in India are treated with medications that dissolve blood clots.
He emphasizes the criticality of timely treatment in heart attacks, especially in peripheral areas. He notes that “Delayed treatment can significantly reduce survival chances. And time management is very important in heart attacks.”
To address this challenge, Dr Hafeez highlights the importance of providing accessible clot-breaking medications and essential treatment facilities at the peripheral level, aiming to save lives by reducing the need for patients to travel long distances to hospitals.
The ‘Save Heart Kashmir’ WhatsApp-based group functions as a cyber hub and spoke model, connecting four to five cardiologists and external experts with other doctors in remote areas.
The group operates 24/7, allowing Dr Hafeez to receive video calls from doctors in remote villages. These callers discuss suspected cardiac emergencies, and Dr Hafeez provides guidance on patient management based on their ECG reports.
By analysing ECGs online, Dr Hafeez can confirm heart attacks and quickly prescribe treatment over video calls.
According to National Library of Medicine India is considered to be the capital of heart disease and has a high burden of cardiovascular disease (CVD’s) worldwide.
According to the National Crime Records Bureau (NCRB), 32,457 people died from heart attacks in India in 2022, which was a 12.5% increase from the previous year. This increase is part of a disturbing trend of rising heart attack deaths in India.
The mission is simple yet ambitious
This online network aims to connect doctors across the region, sharing knowledge and providing real-time guidance during cardiac emergencies. The choice of WhatsApp as their platform was both practical and inspiring. The ubiquitous messaging app offered a solution that was both accessible and familiar.
“Almost every doctor, even in the remotest village, has WhatsApp on their phone,” explains Dr. Hafeez. “We realized we could leverage this to create a virtual cardiac care network spanning the entire valley. And today more than 1200 doctors and 130 hospitals across Jammu and Kashmir are in one social network,” he said.
The Save Heart Kashmir WhatsApp group quickly grew from a handful of specialists to include hundreds of doctors from primary health centres, and district hospitals. The format is straightforward when a patient shows symptoms of a heart attack, the attending physician can instantly share ECG results, patient history, and other vital information with the group. Cardiologists and other specialists chip in with their assessments and treatment recommendations within minutes.
“The impact of Save Heart Kashmir has been truly transformative,” asserts Dr Pervaiz Masoodi, Medical Superintendent of Government Medical College Baramulla (GMC).
Dr Masoodi recalls a time when, as Block Medical Officer at PHC Boniyar, he and his team thrombolysed more than 60 patients and referred them to higher centers with remarkable results.
He believes this model could be replicated in many parts of the world. “With just a smartphone and a willingness to collaborate, we can bridge enormous gaps in cardiac care,” he says.
According to the National Library of Medicine, “Annual number of deaths from CVD in India is projected to rise from 2.26 million (1990) to 4.77 million (2020). Coronary heart disease prevalence rates in India have been estimated over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.”
Treatment Facilities
Dr Hafeez explains that they use a two-pronged approach for treating heart conditions: administering drugs or performing angioplasty. Angioplasty opens blocked coronary arteries, restoring blood flow to the heart without surgery.
Thrombolysis is another method, of breaking up blood clots in arteries, often used in emergencies. Sometimes, stents are placed to keep arteries open.
He highlights the use of Streptokinase, a medication that dissolves clots and restores blood flow, especially when administered within the first three hours, making it as effective as angioplasty. This approach is vital for patients in remote areas like Kupwara, Karnah, and Uri lacking immediate specialized care.
The numbers tell a compelling story of success.
The data from the last 6 years reveals that Save Heart Kashmir facilitated thousands of patients at different stages with different levels of problems, says Dr Hafeez.
“We analyse 20 to 25 ECGs per day. Around 6,000 STEMI cases were managed with fibrinolysis. Approximately 6,400 cases of unstable angina and non-ST-elevation myocardial infarction (NSTEMI) were treated. About 11,000 arrhythmia cases were managed, including life-threatening ventricular tachycardia (VT) which received direct current (DC) cardioversion. Additionally, 2,700 heart block cases were treated,” he adds.
The initiative has significantly reduced the treatment for heart attack patients across the region. He adds, “In cardiology, we often say ‘time is muscle’. The faster we can diagnose and begin treatment, the more heart muscle we can save. With Save Heart Kashmir, we are seeing patients receive crucial interventions like thrombolysis (clot-busting drugs) much sooner, even in areas hours away from the nearest cardiac centre.”
Save Heart Kashmir has become more than just a professional network it’s a community bound by a shared mission. “The level of dedication and willingness to help at any hour is truly inspiring. We are not just colleagues we are a family united in our goal to save lives,” says Dr Hafeez.
The Impact
“When we started this, we hoped to make a difference,” he says. “But I don’t think any of us imagined just how far-reaching the impact would be. Every life saved, every patient who gets to go home to their family that’s what drives us forward. In the end, it is not about the technology or the accolades. It’s about preserving the heartbeat of Kashmir, one patient at a time.”
Dr. Hafeez emphasizes the success of using WhatsApp for timely cardiac treatment, which has improved vessel patency during angioplasty and reduced mortality compared to patients arriving later. He acknowledges the support from other experts like Dr Nasir Shamas, Dr Muzaffar Zargar, Dr Irfan Bhat, Dr Afaq Jalali, and Dr Masood Rashid, including international doctors. He commends primary-level doctors for their dedication and growing confidence in managing cardiac emergencies, even administering thrombolytic therapy before patient transfer to specialized centers.
Success stories
The human impact of this virtual network is profound.
Abdul Gaffar Sheikh 60-year-old farmer from the village of Sheerwani Pora Boniyar, credits Save Heart Kashmir with saving his life.
“In 2019 I woke up with terrible chest pain,” he recounts. “At our local Hospital doctor seemed worried but uncertain. And he referred me to Primary Health Centre Boniyar (PHC), there the Block Medical Officer started typing on his phone. Within minutes, he told me I was having a heart attack and began treatment immediately. Later, my younger nephew told me that the specialists in Srinagar had guided the Doctor through WhatsApp.”
“I still remember when Dr Pervaiz Masoodi, the Block Medical Officer at Boniyar, immediately contacted Dr Imran Hafeez, a cardiologist at SKIMS, after receiving my uncle’s ECG report from the PHC in Boniyar. The doctors at SKIMS Soura guided them through the process, and my uncle successfully underwent thrombolysis. He was later referred to SKIMS Soura for further treatment, and today, he is doing fine,” said his nephew, Sheikh Maqbool. “It’s a miracle of modern technology,” Maqbool adds.
Rising Awareness
Dr Hafeez says “Our team is working on the toes they are dedicated to raising awareness about cardiovascular health and the importance of physical fitness. On September 29th, we will be hosting a significant event featuring a 5K Run, flagged off by the Secretary to the Government Department of Health & Medical Education. This event aims to highlight the benefits of maintaining a healthy heart through regular exercise and will bring together healthcare professionals, fitness enthusiasts, and the general public.”
The group has also played a crucial role in promoting preventive measures. Members share tips on healthy eating, exercise, stress management, and smoking cessation. They encourage regular check-ups and emphasize the importance of early detection and treatment of heart disease.
As the sun sets behind the mountains, painting the valley in hues of gold and pink, the phones of hundreds of doctors across the region light up with a new WhatsApp notification. It’s another ECG, another life hanging in the balance.
Within moments, the collective expertise of Save Heart Kashmir springs into action, transcending distances and limitations to deliver hope and healing.
—–
Have you liked the news article?