On the 1st of October, 2022, Ethiopia inaugurated the first stroke treatment center courtesy of the Axon Stroke and Spine Center (ASSC).
The center which is noted to be a healthcare game-changer for East Africa was born out of the vision and strong commitment of Dr. Wondwossen Gebreamanuel Tekle whose passion was to bring back advanced stroke care to Ethiopia.
His vision has now become a reality through ASSC – a partnership between Ethiostrokecare PLLC (American-based company founded by Dr. Wondwossen for the purpose of supporting stroke care in Ethiopia) and Samaritan Surgical Center (state-of-the-art and experienced surgical specialty center in Addis Ababa).
In Ethiopia, stroke incidences being the number one killer of Ethiopians between the age of 50–69 years, and the number one cause of long-term disability worldwide; Capital’s Metasebia Teshome reached out to the centers founding neurologists and president of the Ethiopia Stroke Initiative, Dr. Wondwossen, for insights on neurological care;

Capital: Tell us about yourself?

Dr. Wondwossen Gebreamanuel: I am an alumnus of the Addis Ababa University School of medicine having graduated there about 22 years back. Following my undergraduate degree, I headed abroad to the US and specialized in neurology from the George Washington University. Whilst, I was there, I did two different subspecialties, that is, on stroke neuron critical care and neuron interventional surgery. To also widen my horizons in the field, I also did my clinical research at Harvard University. Over the course of the last decade, I have been working as a senior consultant at south Texas. In addition to giving medical treatment and services, I have also been conducting researches on issues related to strokes.

Capital: There has always been a low awareness on the concept of strokes. Can you give us some insights on the same?

Dr. Wondwossen Gebreamanuel: A stroke is a sudden loss of brain function caused by an interruption in the supply of blood to the brain. From the reported cases, 85 percent of stroke diseases across the world occur due to blockage in the brain’s blood supply while the other 15 percent occur when a blood vessel ruptures.
A ruptured blood vessel or cerebral thrombosis may cause the stroke, which can occur in varying degrees of severity from temporary paralysis and slurred speech to permanent brain damage and death.

Capital: What led you to name your practice ‘Axon’? Give us a brief explanation of the services you provide?

Dr. Wondwossen Gebreamanuel: The center’s name is derived from a part of the human nerve called Axon.
With regards to services that we render, the Axon Stroke and Spine Center provides treatments for every kind of neurological, cerebrovascular diseases and spinal diseases and other related ailments related to the nerve. Axon was established by a partnership between Ethiostrokecare PLLC, which I and my colleagues founded in the US alongside the Samaritan Surgical Center, here in Addis.
Our center was inaugurated on the first of October, 2022 becoming Ethiopia’s first comprehensive stroke center that incorporates state-of-the-art and most advanced artificial intelligence which enables biplane Cath lab suite which is the first in sub-Saharan Africa.
The center also offers the best services through its neurosurgical theatres, neurologic intensive care unit, new rehabilitation center, new stroke/neuro/trauma emergency department, CT scanner, and much more. Axon Stroke and Spine Center is located at Samaritan surgical center which is connected to the American Medical Center.

Capital: Strokes are almost becoming the new epidemic in our country as is the trend in most third world countries which now collectively carry two thirds of the global stroke burden and similarly death rates are also increasing, why do you think that is?

Dr. Wondwossen Gebreamanuel: This is mainly due to the absence of effective preventive services, and total absence of acute treatment to reverse the initial damage from strokes and post-acute neuro-rehabilitation to decrease long-term disability.
A significant number of the admitted stroke patients have poor treatment outcomes in which the case-fatality rates are relatively high. Substance abuse and having not received medication for stroke are the significant predictors for poor treatment outcome. That is why we have opened our stroke center, to create more convenience and exceptionally seamless flow of services for patients at the three institutions.

Capital: What makes your service special form other stroke centers in the city?

Dr. Wondwossen Gebreamanuel: We have tried to bring all the latest medical equipment to our country, coupled with extensive experience on the ailments of strokes, diabetes and obesity which stem from our years of work in the US.
We are also currently providing acute medical treatment with intravenous thrombolysis as well as neurointerventional mechanical thrombectomy in the biplane Cath lab suite. We will be performing minimally invasive brain surgeries by accessing and opening clogged brain arteries with catheters and other devices which are first advanced through the arm or leg and then navigated inside to the brain without having to open the skull.
The center also boasts of a neurological ICU which is equipped with advanced cerebral and hemodynamic monitors, latest diagnostic software and CT scanner, portable wireless ultrasound, X-ray, a centralized oxygen supply system, etc, which are well suited for acutely ill neurologic patients. Besides strokes, the center has numerous neurological procedures including radiofrequency ablation for spinal pain and other pain disorders, using one of the most advanced radiofrequency generator machines as the first machine in Ethiopia.

Capital: What kind of benefits does the center have on the economy?

Dr. Wondwossen Gebreamanuel: Usually stroke patients in our country travel abroad to get treatment, one of the main reasons for this is because there is a lack of stroke treatment institutions in our country. Axon will now fill this gap not only in our country but also across the region as a result being a health tourism destination from neighboring countries in the process. This will help to minimize the overall forex that goes abroad for treatment and will lead to increase in forex flows as it will attract patients from neighboring countries.

Capital: Does your center offer trainings besides providing treatments to patients?

Dr. Wondwossen Gebreamanuel: Yes. We are only two Ethiopians who are highly specialized in neurology and my team and I want the clinical team involved in the care of stroke patients to be highly equipped so as to save lots of lives.
To this end, as a teaching facility, Axon Stroke and Spine Center is collaborating with Addis Ababa University College of health sciences in training neurosurgeons and neurologists to become sub-specialists in stroke and neurointerventional surgery. The center will also provide telemedicine-based services where physicians will see patients without physically being present at the center.

Capital: What should be done to prevent strokes?

Dr. Wondwossen Gebreamanuel: A stroke interrupts blood flow to an area of the brain. Strokes can be fatal, but the risk can be reduced. More than 80% of strokes can be prevented. You can take action to lower your risk of stroke. The F.A.S.T test is an easy way to remember the most common signs of stroke.
Face: Check their face. Has their mouth drooped? Arms: Can they lift both arms? Speech: Is their speech slurred? Do they understand you? Time is critical. If you see any of these signs you have to go to a health institution straight away.
There can be other signs too: Your face, arm or leg can be numb, clumsy, weak, or paralyzed. This can be on one or both sides of your body feeling dizzy, losing balance, or falling over for no reason. Similarly, losing your vision might be signs too and this can be in one or both eyes.
In order to prevent stokes, one should aim to be active for 30 minutes most days. You need to increase your heart rate, feel a little warm and get a bit out of breath. You also need to do activities that build muscle strength. The key to eating well is to enjoy a variety of nutritious foods from each of the five food groups. Moreover, there should be a need for better awareness of the risk factors associated with high blood pressure, especially in regions with a high burden of stroke, including Ethiopia. Efforts should be focused on the primary prevention of non-communicable disease and stroke in my opinion.

Capital: What are the factors that are increasing the number of patients in Ethiopia?

Dr. Wondwossen Gebreamanuel: Urbanization and changes in lifestyle in the developing world will remain atop in raising the burden of stokes. Many stroke risk factors are lifestyle related, so everyone has the power to reduce their risk of having a stroke.
Not doing enough physical activity is the second biggest risk factor to strokes. It can lead to high blood pressure, diabetes and cholesterol. It can also lead to being overweight. These things increase your risk of having a stroke.
Eating unhealthy foods can lead to high blood pressure and cholesterol. It can also lead to being overweight. These things increase your risk of stroke.
Being overweight can lead to high blood pressure and type 2 diabetes. These things can increase your risk of stroke.