Fight stroke with urgency

Lazarus Sauti

Martin Mafios (not his real name) recently suffered a stroke. His right side of the face, arm as well as leg is paralysed, and it is now difficult for him to speak or understand speech, to see as well as to walk.

Due to his condition, he sometimes loses balance, coordination and suffer severe headache with no known cause.

His wife of two years, Stella, is not only the breadwinner now, but Mafios’ pillar of strength.

Narrating her husband’s struggles, she said: “Mafios’ predicament completely changed our lives completely. I am now the breadwinner as well as his carer,” she said emotionally, adding that the new development drained her family financially as Mafios, who used to be the sole breadwinner, is now bedridden.

Stella also thanked well wishers who sometimes support her with food stuffs as well as clothes, but her main challenge is money for medication.

“In as much as I am juggling between feeding the family and caring for my husband, I want to thank well wishers who sometimes chip in with food stuffs.

“However, the challenge is money for a wheelchair and other medical expenses,” she said.

Cases of stroke have been confirmed to be on the increase in Zimbabwe although recent statistics are not available.

In 2008, for instance, the National Health Information recorded 592 cases were recorded and 155 of these cases resulted in deaths whilst in 2012, there was a remarkable increase where 1 134 cases were recorded and 167 of these cases resulted in deaths.

Unfortunately, not all cases and deaths were reported, especially for those who die at home.    

A stroke, says the World Health Organisation (WHO), a specialised agency of the United Nations (UN) that is concerned with international public health, is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot.

This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.

“The effects of a stroke depend on which part of the brain is injured and how severely it is affected. A very severe stroke can cause sudden death,” added the WHO.

Stroke, according to the World Stroke Organisation (WSO), a leading organisation in the fight against the disease, is causing more death than HIV and Aids, Tuberculosis as well as malaria.

“Stroke claims more than twice as many lives as Aids. In fact, the disease continues to be responsible for more deaths than those attributed to HIV/Aids, Tuberculosis and malaria combined,” said the WSO.

In its 2014 Factsheet, the WHO added, “Stroke, heart disease, lower respiratory infections and chronic obstructive lung disease have remained the top major killers during the past decade.”

A substantial number of these deaths, notes the WHO, can be attributed to tobacco smoking, which increases the risk of dying from coronary heart disease and cerebrovascular disease 2 to 3 fold.

“Physical inactivity and unhealthy diet are other main risk factors which increase individual risks to cardiovascular diseases,” added the WHO.

Lack of resources and servicers like rehabilitation are some factors stalling the fight against the burden of stroke, says Bart Muswaka, the Chief Executive Officer of St Giles Rehabilitation Centre, during commemorations to mark the World Stroke Day in Harare recently.

“Services like rehabilitation are beyond the reach of many people in this country because of high costs.

“The elderly who are no longer employed and no longer on medical aid are the ones that are mostly affected. They fail to access proper treatment as they cannot afford it,” he said.

Representing the Minister of Health and Child Care, Dr David Parirenyatwa, during the same commemorations, the Health Services Board Chief Executive Officer, Dr Lovemore Mbengeranwa, lamented the disproportionate allocation of resources to diseases, saying conditions such as stroke are not getting enough budget allocation.

He added that there is need for Zimbabwe to mobilise support for diseases such as stroke.

“The fight against stroke must be treated with urgency,” he said. “All stakeholders, therefore, need to fund efforts to curb the burden of the disease.”

“When you consider the amount of money being put to fund Aids, TB and malaria and resources being put into this very important disease, you will find that there is a dis-proportioned allocation of resources,” Mbengeranwa said.

Enhanced advocacy and sustained public health education at national level, says the WSO, must be undertaken if the country is to effectively deal with stroke.

“There is need to scale up awareness of national fight against the disease. Information, education and communication initiatives, especially with respect to carrying out a prevention-to-care continuum must be adopted,” said the WSO.

One of the strategies to respond to the challenges to population health and well being due to the global epidemic of heart attack and stroke is to provide actionable information for development and implementation of appropriate policies.

As part of such efforts, the WHO in collaboration with the United States Centers for Disease Control and Prevention (CDC), the national public health institute of the US, has produced for the wider audience, “The Atlas of Heart Disease and Stroke”.

The atlas addresses the global epidemic of heart disease and stroke in a clear and accessible format.

This highly valuable reference material has been designed for use by policy makers, national and international organisations, health professionals as well as members of the public.

This picturesque atlas is in six parts: cardiovascular disease; risk factors; the burden; action; the future and the past; and world tables.