Community and data at the center of health journeys

The case of Fight The Stroke Foundation

Francesca Fedeli and Roberto D'Angelo are the co- founders of FightTheStroke.org, a foundation that supports the global cause of young stroke survivors and children with a disability of Cerebral Palsy, as their son Mario. Francesca and Roberto never knew strokes could happen to newborns and children. Despite there are 17 millions of people with Cerebral Palsy in the world, they were left alone as parents, helpless and hopeless about who to consult for support and care. In response, Francesca started a closed Facebook group for family and caregivers experiencing similar situations. To her surprise, people poured in to join the group, elated to connect for the first time with those with similar experiences with their own loved ones. From this experience, Fight The Stroke Foundation was created, to advocate for young stroke survivors and their families. For Fight the Stroke, integrated health means building a community that pushes towards new clinical research and policy. From day one of this movement, a sense of community was key to bringing people together in order to tackle the knowledge and care gap for kids who survived strokes. Everyday, 1000 survivors and their caregivers connected over similar experiences, solving problems together when no other resources were accessible for them. Fight The Stroke provided a new model of community-led healthcare

within a safe environment that had never existed before. This was created to be an inclusive environment built through the freedom to express thoughts about health and the desire to combine knowledge through connection and scientific data.

“Fight The Stroke works in the disciplines of disability, developmental medicine and digital health. A challenge in these intersections has been regaining trust in the relationship between the patient and the healthcare provider.”

An important issue of the current healthcare system is the lack of consolidated data on many conditions across Europe. This was the case for measuring the number of people with cerebral palsy in Italy. A bureaucratic problem occurred when the responsibility of providing data was left to each individual town, with only one town providing the information. Without agreeing to a national approach, this presented the false record of only three kids being diagnosed with cerebral palsy in all of Italy. In addition, the latest public available data were related to 2011, furthering the lack of accessibility and usability. Especially when monitoring trends in children, continuous updating of health data is crucial to understand and predict trends. Collecting and maintaining accurate and usable data on Cerebral Palsy as well as on People with Disabilities in Italy and Europe would allow people and patient associations to better frame the phenomenon, opening up new possibilities and perspectives to care for children, to rethink goods and services and to imagine a fairer and more inclusive society. Without a specific cure or treatment from the pharmaceutical field, cerebral palsy is a ‘forgotten disease’.

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Although rehabilitation interventions are available, many of them are not scientifically validated and there is no current push for research because of the lack of data.

Impact Story: Rebuilding relationships between health practitioners and patients

Many patients feel inept at expressing their own health concerns, and the power imbalance between the healthcare provider and the patient creates an environment in which patients feel they are not allowed to ask questions. Proactive communication for treatment must occur on equal levels with mutual understanding and trust. Fight The Stroke approaches this hurdle with different solutions to facilitate communication. One way is through providing health literacy initiatives. When families of stroke survivors want to understand and manage their child’s health, Fight The Stroke Foundation is the first landing place providing reliable resources and guidance on navigating the healthcare system experience. This includes guidance on how to read a scientific paper, explanations of certain drug information, members’ sharing parts of their own data and generally providing validated information meant to assist people in making informed medical decisions. This aims to reestablish the information asymmetry between doctor and patient, between the medical system and people with disabilities: having beneficiaries sitting together at the same decisional table with other stakeholders would allow the whole civil society to find faster and better solution to care about over one billion people, the 15% of the world’s population with a disability. When Fight The Stroke was elected as an Ashoka fellow in 2015, community-led healthcare was not part of the prevailing public discourse. Since then, Fight The Stroke Foundation has become a trailblazer.

Policy impact(s)

Key relevant impacts for policy change and work:

1.

Fight The Stroke conducted extensive research and clinical trials, resulting in various scientific publication to address the gaps in the current healthcare system, as it happened for the inclusively designed services in the digital health system: concrete examples are the first tele-rehab platform Mirrorable and the epilepsy research kit MirrorHR.

Fight The Stroke is a unique stakeholder for policy makers as they hold key insight and reputable information on the intersection of science, health technology and disability: with this aim they launched the Disabled Data platform, to open a window on the data associated with the phenomenon of disability and to support citizens and policy makers in researching and understanding the data currently available.

Fight The Stroke is proving that for patients and individuals to thrive, health practitioners and caregivers holding different expertise need to be connected and learn from one another, recognizing mutual knowledge: they opened up the first Neonatal and Children Stroke Center in Italy in order to ease this process.’