Strengthening Stroke Care in Fiji

Middlemore Hospital's stroke unit doesn't slow down. Six stroke physicians, three registrars, four specialist nurses, a 19-bed ward with its own hyperacute unit, and three to four new "code stroke" calls landing most days. It's one of the busiest stroke services in New Zealand, and for two weeks in July, it was also a classroom for a team from CWM Hospital in Suva.

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This is the second year the Reddy Foundation has supported this work, through the Mr YP Reddy Observership Programme.

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The programme began in 2024, a commitment in honour of the late Mr YP Reddy. The scholarship gives two practising medical professionals from CWM Hospital an extended period in New Zealand, training in a specialist field currently unavailable in Fiji. It grew directly out of the inaugural Fiji National Stroke Conference, run by Friends of Fiji Health in Suva in July 2023, which identified stroke care as one of the country's most urgent gaps. In Fiji, one in five people will have a stroke in their lifetime, and heart disease, Fiji's leading cause of death, carries an 81% chance of a stroke alongside it.

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The first cohort, Dr Shrish Acharya and Maikeli Cabemaiwai, spent four weeks at Middlemore in 2024, the longest observership Friends of Fiji Health has sponsored to date, and returned to CWM to help pilot a stroke thrombolysis workshop, run in-house nurse training, and begin work on Fiji's national stroke guidelines.

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This year's cohort continued that work. Dr Ane Atalifo, a Consultant Physician, and Isimeli Malimali, a Stroke Nurse Specialist, both sponsored by the Reddy Foundation, joined Dr Komal Singh and physiotherapist Rusiate Vecoso, sponsored by Friends of Fiji Health, for two weeks coordinated by Friends of Fiji Health NZ and hosted by Consultant Stroke Specialist Dr Ajay Kumar.

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The days were full. Morning stroke huddles, ward rounds, the rapid-access TIA clinic, neuroradiology sessions, stroke MDT meetings, and the unpredictable rhythm of code stroke response, all inside Middlemore's protocols for assessment, imaging and thrombolysis.

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The real work, though, happened in the space around the clinical hours. Using what they'd seen on the ward, the team spent the final days drafting practical adjustments to CWM's own thrombolysis protocol, contributing to Fiji's National Stroke guidelines under Ministry of Health direction, and outlining a plan for in-house stroke and TIA teaching sessions back at CWM. An exit report for Fiji's Ministry of Health is also underway.

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The team returned to Fiji on 1 August. Two cohorts in, the goal hasn't changed: stroke multidisciplinary teams in every major Fijian hospital, consolidated outreach services, and a dedicated TIA service at CWM. The Reddy Foundation's commitment to Friends of Fiji Health runs through to 2027, with two more scholarship years still to come.

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