By Adebayo Oladejo
As Nigeria joined the rest of the world to mark this year’s World Stroke Day on October 29 a neuro-physiotherapist and lecturer in the Department of Physiotherapy, College of Medicine, University of Lagos, Dr. Caleb Ademola Gbiri, has identified ignorance of the cause of stroke as one of the major reasons people die of the illness in the country.
The University don who spoke with Pharmanews in an exclusive interview in his office, disclosed that the myth that stroke is a spiritual attack is what makes many of its victims run to spiritualists and religious leaders, rather than certified medical personnel.
According to him, the fact that it is possible to medically explain the cause, characteristics and management of stroke is enough reason to show that there is nothing spiritual about the condition. He added that stroke is better managed in the first six to 12 months if the person reports to the hospital immediately, assuring that such individual has a higher chance of returning to normal life irrespective of the cause of the ailment.
The medical expert who has also worked with the Federal Neuro-Psychiatric Hospital, Yaba, Lagos, further disclosed that stroke is putting a lot of economic burden on the country, as it is depleting the nation’s workforceby incapacitating people who are supposed to be useful to the nation.
Below are excerpts of the interview;
What does having a stroke mean?
Having a stroke, in a very simple explanation, is a sudden attack of the brain that either results in death or leads to paralysis of one function of the body or the other. However, while it commonly presents itself as a paralysis of one side of the body, it is not limited to that.It might just be a small fraction of the body that will be affected; and, sometimes, there might not be paralysis of any part of the body but the vision, speech and sometimes the mouth might just be impaired.In a nutshell, stroke occurs when bloodflow in the body has been obstructed or there is a rupture in the artery that feeds the brain.
What are the conditions that predispose one to stroke?
The conditions that predispose individuals to stroke are so many and we have classified them into two groups: modifiable and non-modifiable factors. The modifiable factors are the ones that we can do something about so as to limit our possibility of developing a stroke.For example, being overweight and obese are modifiable risk factors that we can do something about. Being hypertensive is another factor;so also is not getting enough sleep.Others include, smoking, drinking of alcohol and lack of exercise, diabetes, among others. One can do so many things to guide against these modifiable factors.
For the non-modifiable factors, age is one.Although stroke can occur at any age, it is most common at an advanced age.There is also the gender factor – nothing can be done about this. Fortunately, however, the modifiable factors constitute about 80 percent of stroke cases – which implies that stroke is preventable if the necessary things are done.
Based on your experience as an expert, which of these conditions are the most common reason why people develop stroke?
I will say high blood fat, being obese and overweight, followed by hypertension and diabetes in that order. If someone smokes and drinks alcohol, it is very easy for the person to develop hypertension or diabetes.So all these lifestyle issues are intermingled. Although in some cases, diabetes and hypertension run in some families, one can still do something about it to prevent it from developing into stroke.
Is there hope for people suffering from stroke?
Yes!There is hope for those suffering from stroke.One important thing that we need to tell our people is that stroke is preventable, provided we live a good lifestyle. Meanwhile, for those who have stroke, the best thing to do is to go to the hospital and get treated immediately. However, for those who have suffered stroke for a while now, it is not too late as they can still go back to the hospital and get treated. An individual can recover fully from stroke without having any visible disability; I could say that boldly because I have treated many people who recovered from stroke and are doing well.
The best thing an individual should do when they have a stroke is to go to the hospital and ensure that treatment is initiated early. The concerned individual should also ensure to adhere to medical instructions and prescriptions. What I am saying categorically is that stroke is both manageable and treatable, irrespective of what causes it.
Are there statistics for people living with stroke in Nigeria?
We don’t have a national statistics for people living with stroke in Nigeria, unlike in the developed world; but we have what we called hospital-based statistics.This hospital-based statistics only account for people who reported to the hospital. We cannot account for people who went to herbalists, churches and other places like that.But for those who reported to the hospital, what we have is about 0.001 percent of the total population.So if the total population is 168 million, it means about 168,000 people are suffering from stroke or have suffered stroke.
Is it true that stroke only affects the rich?
No, stroke affects anybody irrespective of their age, gender or economic status. The only reason people think it mostly affects the rich is that the rich are the ones who are likely to visit hospitals; the poor ones would stay back at home or visit spiritualists. Also, the poor may not have money to buy those junks from eateries all around or buy expensive wines; but the fact remain that stroke affects anybody, whether rich or poor.That aside, stroke is a major burden globally. This is why October 29 of every year has been declared World Stroke Day.
Do you think we have facilities to take care of stroke in Nigeria?
Our stroke management in Nigeria is actually at the sub-optimal level; that is, it is lower than expected. Stroke care is supposed to be a care in a concentrated unit, but we don’t have any stroke unit in Nigeria, not even in any of our teaching or general hospitals. Meanwhile, a stroke unit should involve every specialist that is involved in stroke management because it requires a multi-disciplinary approach in management.So what we are advocating for now is that government should establish stroke units, at least in every tertiary health institution or in every major city in the country.
Talking about experts who are competent, we have them in abundance in the country; but the facilities are not there to work with, unlike those people in the developed world who have better facilities to manage any case of stroke.
