Interview with Commonwealth Fellows

In 2025 Wessex Global Stroke Partnerships hosted two Commonwealth Fellows, one from Ghana and one from The Gambia. They visited for a period of approximately 6 weeks and spent time with stroke teams in Winchester, Bournemouth and Bristol. At the end of the 6 weeks a recorded conversation was held to capture the fellows experiences, below are some quotes taken from the conversation.

What were your first impressions of stroke care in the UK?

Teamwork & Skills

 “We notice the high skill sets of the stroke team members, in terms of therapy, in terms of rehabilitation.. the consultant and registrar are so wonderful and everybody is well aware of their roles and they all play them well”

“My impression has been one of excellence in terms of health care here”

  Is there anything in particular you will take back to your teams?

MDT working & delivery of care  

“Everybody knows what they are about, everybody has a role to play… there’s leadership that co-ordinates all this process, it’s been magnificent to see.”        

“More importantly, the coordinated care… getting different skilled health workers to work as a unit gives better results and outcomes.”

Opportunities to develop 

“If we are able to train [our] referral facilities on how to take care of the stroke patient, then in the long run we’ll be able to minimize the morbidity that comes with it.”

“We are thrilled to have this opportunity to be able to see what goes on here...to compare and to send some of the information we pick up here to our country”

Is there anything that could be improved in terms of stroke care in the UK?

Cultural differences around discharge & length of stay

“You tend to keep patients too long on the wards...you may not have family support here like we do in Africa”

 “You wait until the patient is a certain level of independence before the patient comes home…the maximum length of stay in our facility is usually 5 to 7 days...we are able to discharge our patients quicker with confidence that the relatives at home care for the patient”

What were the highlights of the visit?

Staff Competence    

“[Observing] the professionalism and the diligence with which people do work...is amazing. People are committed to what they're doing, they pay attention... and they're responsible. You can have beautiful buildings and infrastructure, but if the people are not well-trained, it doesn't yield…and this really has been the highlight of all of this”

Optimism for the Future

“We are hopeful that this will not be the end… that we’ll be sharing knowledge rather than everybody wanting to run to one place.”

 Reflections on the partnership as a whole

“They are just using what is available to us to teach us to better our healthcare… It is not a one-sided collaboration... it is our skills training ”

Recognition of e-modules by World Stroke Academy

During November 2025, WGSP partners from Ghana, Zambia, and the UK were honoured to be interviewed by Sarah Belson (international development manager) and Laura Ceci Galanos (executive manager) from the World Stroke Academy.

Click on the link below to hear from Farouk and Julius, Ghanian nurses from Tamale and Ho respectively, Malango, Zambian nurse from Lusaka, and Dr Lucy Sykes, UK co-lead and consultant stroke physician. NB: the interview is subtitled but there is no video.

Accessible Stroke Training for all: Voices from the WGSP on the new Core Skills e-Learning Modules

UK Stroke Forum 25-27 November 2025, Aberdeen

WGSP were proud to host a session focused on developing sustainable multidisciplinary stroke care in low and middle-income countries (LMICs) at the recent UKSF in Aberdeen. We were honoured to be joined by Ben Simms, CEO of Global Health Partnerships; Dr Sureshkumar Kamalakannan, Associate Professor at Northumbria University; and Dr Sarah Matuja, Senior Lecturer at University of Leicester. The session was chaired by our UK co-lead Claire Fullbrook-Scanlon and began with an overview of WGSP, including a summary from Amelia Shaw of our most recent work developing the e-learning modules with colleagues in Ghana and Zambia.

Ben gave an insightful overview of the state of global health and the importance of health partnerships in building sustainable care in these challenging times. His praise for WGSP was greatly appreciated.

The audience of 70 delegates were enthralled to hear Suresh discuss challenges and opportunities for developing stroke care in LMICs, and celebrated his successes in India.

Finally, Sarah described her journey to becoming a leader in global stroke care. Sarah, now a leading neurologist in Tanzania, talked with enthusiasm about the advances she has supported her country to achieve in acute stroke care and rehabilitation.

It was a well received session that generated meaningful questions and discussion. We hope to raise the profile of global health and stroke at the next UK Stroke Forum in Liverpool next year. 

International activity for WGSP

October and November were very busy months for WSGP partners with conference attendances and celebration of World Stroke Day - well done to all concerned!

12-15 October saw Prof Albert Akpalu (Ghana) representing his team from KBTH at the World Congress of Neurology in Seoul.

During 22-24 October Dr Lucy Sykes was networking with international colleagues and promoting the e-modules at the World Stroke Congress in Barcelona.

29th October was World Stroke Day and the official launch of our stroke core skills e-modules! Our teams marked the occasion by raising public awareness of stroke: here we see the KBTH team (Ghana) led by nursing matron Monica Appiah and senior physiotherapist Cynthia Osei Yeboah.

Physiotherapists Doreen and Frank (Zambia) presented a poster on behalf of the Zambian, Ghanaian, and UK teams at the African Stroke Organization Conference in Nairobi 3-5 November. Prof Deanna Saylor delivered the B O Osuntokun lecture on Improving Stroke Care in Zambia.

And finally, Doreen presented an overview of recent WGSP work to our sponsors Global Health Partnerships at the Global Capacity Building Learning and Sharing event in Lusaka on 18 November.

Recognition for WGSP on the One Neurology podcast

WGSP partners from Ghana, The Gambia, and UK are proud to have been interviewed by the One Neurology podcast ahead of the UN High Level Meeting on non-communicable diseases. Featuring our very own Dr Valentine Akwulpwa, Yayha Njie, and Dr Lucy Sykes - listen to the full episode here:

•  https://oneneurology.net/episode18/ or wherever you normally get your podcasts

Reflections from Zambia on producing online training modules: Doreen Kawelenga and Frank Sasali Mumba, physiotherapists

DOREEN: The introduction of a stroke unit at the University Teaching Hospital in Lusaka has significantly improved patient outcomes by providing focused multidisciplinary care for stroke patients, leading to reduced mortality, shorter hospital stays, and improved functional recovery. The unit offers a coordinated approach with specialized medical, nursing, and rehabilitation staff contributing to better diagnosis and treatment. The unit is associated with:

• Lower risk of death and a reduced likelihood of poor outcome within a year of the stroke

• Specialized neurological care which decreases mortality and hospital complications, leading to lower disability

• Improved functional outcomes due to early rehabilitation, thereby helping patients to regain lost function and independence

• An amazing multidisciplinary team consisting of medical, nursing, physiotherapy, psychosocial counsellors, and occupational therapy

It is these team members who have participated in the ‘Think Aloud’ sessions for developing the online stroke training modules, identifying issues such as unclear navigation through the material or cultural appropriateness of the content. Participants were invited to complete each module, thinking aloud as they complete the task: “say everything that is going on in your mind”. The team were not shy in offering insights and suggestions! With such feedback we have been able to come up with modules that are not only comprehensive, but simple to use, educative, and fun to look at with very good illustrations.

FRANK: The ‘Think Aloud’ sessions were very impactful with the team members at Chipata Level One Hospital in Lusaka. It was a 1:1 session in formulating the modules and each participant had their own individual experience with each module. The team appreciated the multidisciplinary approach to stroke as shown by the different modules e.g. mood, communication, continence, functional independence, secondary prevention, and discharge planning.

Financial support has been very helpful over the period of the time in which we were reviewing the modules. This included support for data bundles, logistics, food and drinks during the sessions. We are so much grateful for the grants we received. It helped to motivate us and our participants as well.

QUOTES FROM THE TEAMS:

“The mood module has helped me to learn that people with stroke present with different mood swings. I can now safely handle patients with moods knowing that it is part of the presentation for some stroke patients.”

“It’s impactful work. The modules deepened my understanding and empathy for both patients and caregivers, offering a holistic view of stroke’s impact.”

“The modules challenged me to think beyond the clinical treatment, focusing on the human experience.”

“The process taught me kindness, consideration, and deepened my understanding of stroke management in key areas such as mood, speech, and communication.”

Southmead Hospital in Bristol and a visit to the House of Lords conclude CSC fellowship visit

The final 2 weeks of the CSC visit to the UK included time spent at Southmead Hospital, University of the West of England, and a visit to the House of Lords hosted by Lord Nigel Crisp:

This report synthesizes key insights into Bristol’s stroke care ecosystem, emphasizing leadership models, clinical innovations research frameworks, and partnership opportunities for transferable strategies to enhance stroke outcomes in Northern Ghana and The Gambia.

Leadership and Service Integration:

Bristol’s stroke units exemplify adaptive leadership and operational efficiency. They support dynamic staff empowerment with nurses trained in NIHSS scoring and therapists empowered to screen for thrombolysis. Daily ‘safety huddles’ enable real-time incident reporting and resource allocation. A ‘dynamic zoning’ model alongside enhanced staff flexibility for their 43 stroke beds eliminates mid-pathway transfers between acute and rehab settings.

Clinical Skills and Knowledge Transfer:

Bristol’s ‘low-tech, high-skill’ philosophy aligns with West African resource reality. Standardized dysphagia screening (bedside water tests/video-fluoroscopy), reduced pneumonia rates by 18%. Early mobilization (<24 hrs post-stroke) using cost-effective tools like bamboo parallel bars promotes positive outcomes. Specialized clinics cohorting groups of patients such as young stroke or TIA enables streamlining of diagnostics and increased awareness of less common aetiologies such as sickle cell disease.

Research and Data-Driven Care:

Bournemouth and Bristol’s research infrastructure both offer templates for evidence-based care in Ghana and The Gambia. The UK Sentinel Stroke National Audt Programme (SSNAP) tracks outcomes (e.g. door-to-needle time), enabling quality improvement. Both Ghana and The Gambia could benefit from a nationalized data approach to stroke care.

Bristol participates in research showing telehealth efficacy which could be transformational in low resource settings such as Ghana, where 54% of healthcare professionals report knowledge gaps in post-stroke rehab . Dr. Akwulpwa advocates integrating WGSP’s 8 core skills online modules (e.g. swallowing, positioning, continence management) into staff and family training programmes.

Partnership and Collaborative Frameworks:

Opportunities for skills sharing across WGSP partners includes NIHSS stroke assessment training, protocol design/development based on current in-country templates, and telemedical support for decision-making.

Challenges:

Resource limitations: Tamale Teaching Hospital, Ghana’s non-functional MRI scanners delay diagnostics. Variable availability of CT imaging in The Gambia due to cost to patient and scanner reliability restricts treatment options for patients.

Workforce gaps: Neurologist density remains critically low with only 1:4 million population in Northern Ghana. There are no native neurologists in the Gambia (population 2.5 million).

Recommendations:

1. Leadership development: workshops on "crisis leadership" and advocacy to navigate administrative challenges.

2. Frugal innovation: co-develop low cost tools, such as the realistic dysphagia screens in use by WGSP partners, shared via WGSP networks.

3. Tele-mentorship: virtual case discussions between WGSP partners.

4. Joint funding proposals: target grants (e.g. CSC, Global Health Partnerships) for staff training.

“The partnership exemplifies sustainable change through equity.” Dr Valentine Akwulpwa.

CSC fellows spend 2 weeks with the Stroke MDT at University Hospital Dorset

The CSC fellowship programme for Dr Valentine Akwulpwa (Ghana) and Charge Nurse Yahya Njie (The Gambia) has continued with a busy two-week placement at University Hospitals Dorset (UHD, Bournemouth and Poole). Here they summarise the wide range of topics covered since their arrival in the UK, with reflections on potential benefits for stroke care in low- and middle-income countries (LMICs):

Clinical Skills, Knowledge, and Experience:

• Hyperacute stroke care including assessment for time critical interventions: thrombolysis and thrombectomy. Emphasis on rapid imaging to treatment pathways

• Neurocritical monitoring (e.g. managing raised intracranial pressure, dysautonomia) and post-procedural protocols to reduce haemorrhagic transformation risk

• Advanced rehabilitation techniques including hands on experience of ‘Walkerbot’ gait-retraining for patients with severe motor deficits, integrating AI-driven adaptive support into standard stroke care practices

• MDT-led early mobilization protocols <24 hours post-stroke, reducing pneumonia risk and length of stay

• Complex case management, high-risk TIAs, stroke mimics e.g. seizures, functional disorders, and young stroke clinics addressing rare etiologies

• Dysphagia screening with standardized bedside water tests and videofluoroscopy, minimizing aspiration pneumonia

Leadership:

• Service consolidation, and culture following a strategic merger of acute / rehab units, enhancing staff flexibility and reducing mid-pathway transfers

• Daily safety huddles, incident reporting, resource allocation, and real-time problem-solving

• Staff empowerment and fostering psychological safety within the team; cross-discipline training initiatives e.g. nurses trained in NIHSS scoring; therapists empowered for thrombolysis screening

• Succession planning: deputy leads shadowing consultants ensuring service continuity for the future

• Resource optimization: 43-bed unit with dynamic zoning (hyperacute / rehab), maximizing capacity without new infrastructure

Partnership:

• Regional networks including Hub-And-Spoke Model of regional care provision. Witnessed coordinated transfers from Winchester to Southampton for thrombectomy with shared telemedicine consultation

• Community integration: witnessed collaboration between the UHD stroke service and Integrated Community Stroke Service (ICSS) for seamless home-based rehab, reducing readmissions by 18%

Global health synergies:

• Contextual adaptation: UHD’s ‘low-tech, high-skill’ approach e.g. manual handling techniques which are directly applicable to LMIC resource constraints

• Knowledge exchange: we shared WGSP's 8 core skills modules (e.g. swallowing, positioning) for potential integration into UHD training programmes for staff and families alike

• Frugal innovation: UHD use of low-cost gait aids (e.g. bamboo parallel bars) aligns with WGSP's philosophy of sustainability

• Data-driven care: the national UK electronic stroke registry (SSNAP: Sentinel Stroke National Audit Programme) tracking outcomes such as door-to-needle time, demonstrating potential for improvements in LMIC services and care provision through audit

Appreciation to all the WGSP UK team:

• Hospitality: Thank you for the warm reception, accommodation support, and inclusive participation in MDT meetings, ward rounds, and community visits

• Mentorship: Special gratitude to all the consultants, rehab therapists, and nurse leaders for their patience in skill demonstrations and case discussions

• Collaborative spirit: The willingness to share protocols, governance frameworks, and failures openly has equipped me (Dr Val) to advance stroke care at Tamale Teaching Hospital

• This attachment exemplifies the WGSP's mission of sustainable change through equitable partnership

Commonwealth Scholarship Commission Fellows placement starts at Hampshire Hospitals

WGSP is proud to be hosting two CSC fellows for a 6-week programme across three stroke centres in our region. Dr Valentine Akwulpwa shares his reactions following his stay in Winchester:

The remarkable team at Wessex Global Stroke Partnership with its unwavering dedication to transforming stroke care in Ghana, particularly at Tamale Teaching Hospital (TTH), is nothing short of inspiring. The partnership has become a beacon of hope, demonstrating how collaboration, innovation, and cultural sensitivity can revolutionize healthcare in resource-limited settings.

Our combined efforts led to the creation of two additional stroke units in Ho and Tamale, in addition to the one earlier established at Korle Bu Teaching Hospital in Accra. Through hands-on training, workshops, and online modules, WGSP has equipped Ghanaian clinicians with critical core stroke skills. This has resulted in a significant reduction in stroke morbidity and mortality with heightened confidence in managing stroke patients.

The leadership cultivated through the collaboration has given us the capacity to lead stroke care initiatives independently. The financial contributions of GHP (formerly THET) and the CSC-UK sourced by WGSP have enabled us to be able to come for training in the UK, attesting to the commitment for long term skill development by the UK team.

My heartfelt thanks goes to all WGSP team and partners. My travel to the UK and my first two weeks at Winchester has been a remarkable experience. The reception has been overwhelming and the care both academically and socially has been second to none.

I'm optimistic that all the knowledge, insight, skills and leadership training I'm gaining will go a long way to further improve stroke care in Ghana and TTH. Thank you!

Dr Valentine Akwulpwa, WSGP CSC Fellow; Lead for Stroke and Emergency Medicine, TTH

UK Africa Health Summit 2025

Two members of the UK team recently had the opportunity to present at the UK Africa Health Summit in London (19th March). The presentation was part of a breakout session in preparation for a high-level meeting to be held by Global Health Partnerships on non-communicable diseases. It was an exciting opportunity to share the progress we have made with our recent grants and give some of our recommendations when working with a non-communicable disease workforce. The presentation was well received by those that attended and the day gave us an opportunity to learn from other partnerships alike.