The Indian Council of Medical Research (ICMR) has handed over two Mobile Stroke Units (MSUs) to the Assam Government, marking a significant step in bringing life-saving stroke care closer to people living in rural, remote, and difficult terrain.
With this, India has become the second country globally to report successful integration of MSUs with emergency medical services for treating rural acute ischemic stroke patients.
Stroke remains one of the leading causes of death and long-term disability in India. Medical evidence shows that nearly 1.9 billion brain cells are lost every minute when treatment is delayed. Yet, for large parts of the Northeast, reaching a stroke-ready hospital can take several hours, often rendering treatment ineffective.
“Mobile Stroke Units were first developed in Germany and later evaluated in major global cities. India has demonstrated their effectiveness in rural and difficult terrain,” said Dr. Rajiv Bahl, Secretary, Department of Health Research and Director General, ICMR, at an event here. “This places India among a very small group of countries that have successfully integrated MSUs into emergency medical services.”
The MSU functions as a hospital on wheels, equipped with a CT scanner, point-of-care laboratory, clot-busting drugs, and teleconsultation facilities that connect patients with neurologists in real time. This enables diagnosis and treatment to begin at or near the patient’s home—significantly reducing delays that often lead to death or permanent disability.
The results from Assam have been striking, noted the official. The MSU model has reduced treatment time from nearly 24 hours to about two hours, cut deaths by one-third, and reduced disability eightfold. Between 2021 and August 2024, the units responded to more than 2,300 emergency calls. Trained nurses screened 294 suspected stroke cases, with nearly 90% of patients treated directly from their homes. Integration with the 108 emergency ambulance service has expanded coverage to a 100-kilometre radius.
P. Ashok Babu, Secretary and Commissioner, Health and Family Welfare, Assam, said the handover strengthens the State’s emergency response system and ensures continuity of this life-saving service under state ownership, providing a strong foundation for expansion.
However, the success of Mobile Stroke Units also underscores a deeper systemic challenge. A recent study by government neurosurgeons, led by Dr. Binoy Kumar Singh of AIIMS Raipur and published in Neurology India, paints a stark picture of neurological care in the Northeast. The region, comprising eight States and over 51 million people, has only 55 practising neurosurgeons—just 0.35 specialists per million population, far below the national average.
The distribution is heavily skewed, with 37 neurosurgeons based in Guwahati alone. Several States, including Arunachal Pradesh, Manipur, Nagaland, and Tripura, have no full-time neurosurgeon, while Mizoram has none at all. Advanced subspecialties such as vascular neurosurgery, endovascular stroke care, epilepsy surgery, and neuro-oncology are virtually absent.
Infrastructure gaps compound the problem. Only five hospitals in the region are equipped with advanced neurosurgical tools, and dedicated neuro-intensive care units are largely missing. Stroke care remains fragmented, with thrombolysis available only in parts of Guwahati and door-to-needle times frequently exceeding recommended limits.
“In such a setting, pre-hospital innovations like Mobile Stroke Units become crucial,” said Dr. Singh. “While they cannot replace the urgent need for specialists and infrastructure, they can prevent avoidable deaths and disability by ensuring early treatment.”
Experts note that the Northeast’s geography makes these deficits particularly dangerous. Patients with stroke or traumatic brain injury are often stabilised locally and referred long distances, losing critical time when minutes matter most.
Public health specialists see the MSU model as a pragmatic response to workforce and infrastructure shortages—one that buys time until long-term investments in neurosurgical training, stroke units, and neurocritical care take effect. However, sustained improvement will depend on parallel investments in specialists, infrastructure, and public awareness—without which the region’s fragile neurological care system will remain under strain, noted the experts.
