Experts claim undetected and
poorly managed hypertension, diabetes and obesity have increased the
population of Nigerians dying from stroke.
Stroke, when it occurs in an individual
as the word suggests, is like when one has been struck. This terminal
disease used to be associated with elderly people in their 60s, 70s and
80s.
However, experts including neurosurgeons
and other health care givers in Nigeria have said that stroke is no
more a disease of the aged as it is killing and disabling Nigerians in
their prime.
Continue reading after the cut...
Their major fear is that many Nigerians
who would develop stroke in the next 10 years are not aware of it
now.Those that have seen symptoms continue to dismiss them due to
ignorance, poverty, socio- cultural beliefs and denial.
They also attributed the increasing
population of Nigerians developing stroke to the growing cases of
undiagnosed, unmanaged hypertension (high blood pressure) and diabetes.
They may not be far from the truth.
Sharing his experience with our correspondent in Lagos on Wednesday, Mr.
Segun Oyasanya, a civil engineer, said he had his first episode of
stroke while preparing for a service to mark his 40th birthday.
Oyasanya said, “I have always been
healthy all my life, the last time I had a fever was when I was 20 years
old. I had never been admitted to the hospital or experienced anything
much more than tiredness or headache.
“I was trying to pull my trousers that
morning when I noticed I could not move my fingers, my hand went numb.I
felt some pains through my chest and that was it. Luckily for me, my
family that lived abroad had come for the party. My wife came to usher
me out but she saw me lying on the floor.”
He said he was rushed to the General
Hospital in Surulere where the doctor confirmed he had just had his
first episode of stroke.
Though the family was taken by surprise
by this diagnosis, Oyasanya confessed that he had been warned five
months earlier, when he took his friend to the hospital.
“While waiting for my friend to come out
of the doctor’s office, a nurse approached me to take my blood
pressure. After the test, she said she could not release me until I had
seen the doctor because my blood pressure was not only high but
abnormal.
“This almost turned to an argument, the
doctor and my friend had to intervene. After seeing the result, the
doctor told me I must start taking anti-hypertensive drugs immediately
to reduce my blood pressure.”
Oyasanya said two months after that
visit; he stopped taking the drugs because he was convinced it was an
attack from spiritual forces after speaking with his pastor.
“I stopped because I was not physically
ill but just the usual tiredness. We were also convinced it was
spiritual attack. But three months after I stopped taking my medication,
I suffered a stroke,” he said.
“The doctor told me that if not for the drugs I had been taking, I would have been totally paralysed by stroke.”
Apart from his wife and his three
children that have had to relocate from the United States to care for
him in Nigeria, Oyasanya said he had to abandon some building contracts
he was to execute since he had stroke in March.
According to the Consultant Neurosurgeon
and Stroke specialist, Abuja, Dr. Biodun Ogungbo, about 40 per cent of
Nigerians are living with factors that could predispose them to
developing stroke.
These factors include obesity, alcohol
consumption, smoking, lack of exercise, poor diet rich in salt and fat,
high blood pressure and high blood sugar levels.
He said, “Nigerians in their 30s, 40s
and 50s are developing and dying of stroke due to the increasing
population of hypertensive and diabetic patients in the country.”
Ogungbo, who noted that there were no
quality statistics to go by in Nigeria, raised the alarm that unlike in
other climes where most stroke patients were elderly people, in Nigeria,
there were more patients in their productive years developing and dying
of stroke,.
He stated that stroke, a preventable
disease, occurrs when there is either too much blood in the brain (wet
stroke) or when no blood is going into the brain (dry stroke) and it is
usually due to unmanaged and undetected hypertension.
Ogungbo said, “The incidence of
hypertension is high in Nigeria. Almost half of patients I see for the
first time in clinic for other problems such as back pain have high
blood pressure.
“Hypertension is common in black people.
We do not know why. It is therefore common in Nigerians and some
statistics say over 40 per cent of adults in Nigeria have hypertension.
“Unfortunately, for some reasons,
younger people in Nigeria are becoming hypertensive and suffering the
consequences and also increasing the incidence of stroke and heart
failure in people in their productive years.”
Ogungbo described stroke as a brain
attack that could result in loss of speech, paralysis, urinary
incontinence, mental disability, physical disability, blindness, loss of
body movement and even death in most cases.
“We do not have credible statistics in
Nigeria. We do not know how many people are affected, living with or
dying from hypertension. But we have some evidence that over 60 per cent
of patients with stroke die within three months. That is significant
and makes stroke almost a certain death sentence in Nigeria.” he stated.
Ogungbo noted that there was need for
urgent awareness among Nigerians on the fact that stroke is a
preventable disease if hypertension and diabetes are detected early.
He said, “Anyone with a pressure
consistently above normal has high blood pressure. The cut off is
pressure above 140/90 mmHg. It does not give any warning and usually no
one knows if their pressure is high or not until they do a test. By the
time you have definite symptoms such as headaches, organs such as the
heart, brain and kidneys may have been damaged.”
Ogungbo stressed that the only treatment
for stroke was prevention which should start from formative years in
order to save the younger generation from the severe consequences of
stroke which include loss of livelihood, death and disability.
He said, “The real prevention must start from childhood. We need to encourage healthy living and healthy
“Fat forms layers in the blood vessels
and causes them to become narrow. This increases the work of the heart
in pumping blood through the vessels leading to high blood pressure.
“Eat plenty fruits and vegetables. Do
not smoke and avoid alcohol. Lose weight. That 20 minutes walk or
exercise daily may just save your life.
“If you need medication for blood
pressure control, please use it and do not stop because a pastor or
preacher tells you to. Hypertension is for life and does not go away. It
cannot be cured but can be managed and controlled.”
Ogungbo, a member of Stroke Action
Nigeria, added that a major reason why people should prevent stroke was
the shortage of experts in the country to care for stroke patients and
the high cost of treatment.
According to him, there are just about 35 neurosurgeons and 50 neurologists in the country.
Ogungbo noted, “We do not have enough
trained medical and nursing experts to manage hypertension and its
consequences such as stroke. A patient suffering from the first episode
of stroke would spend almost N3m to be a bit stable. Most Nigerians
can’t really afford to manage stroke.”
Also, the Executive Director, Stroke
Action, United Kingdom, Mrs. Rita Melinfonwu, stated that a challenge
facing early detection was that stroke was still being regarded as
traditional or spiritual attack.
Melifonwu said a lot of patients
diagnosed with high blood pressure, high glucose level or high
cholesterol levels often refuse to comply with their medications.
She added that another group does not
know they are at risk until they had an episode of stroke because they
have never been diagnosed.
“When a Nigerian experiences his/her
first stroke, the family members would say an arrow was fired at the leg
or spine. They are rushed to a native doctor or herbalist to remove the
arrow or stone. Then, they suffer more strokes instead of recovering
from it.
“Also, when patients are diagnosed and
given hypertensive drugs, they refuse to take them, they say God has
removed it and stop taking their medication, and then they suffer a
stroke. Stroke does not occur due to wickedness,” she said.
The nursing expert in stroke management
noted that Nigerians should reduce their chances of developing stroke
because the country lacked physical structures and a social system that
could help stroke patients to pick up their lives again.
“Who cares for you when you have stroke
in Nigeria? It is the wife, husband or the children that has to drop out
of work, school to take care of that person, definitely not government
or the society.
“As a stroke patient in Nigeria, you are
already out of the society, you cannot go to the bank in a wheel chair
or cross the road so why not prevent it?, she asked.
Melifonwu, who is the founder of a
stroke care organisation in the United Kingdom, charged the Federal
Government to implement disability access laws in all sectors, to ensure
that Nigerians who had suffered stroke and other disabilities are not
ostracised from the society.
She stated, “Imagine a husband who can
no longer be husband, a managing director who can no longer manage or an
individual who cannot go shopping or attend a meeting because of
stroke. How can they move around in Nigeria?
“By this lack of social care, the
society is telling them to hide and drop dead. But in the UK, a stroke
patient is managed to the level that he/she does not have another one
and they can eventually live an independent life. Government should be
able to say no, if you do not have this in place in your church, mosque,
supermarket, bank, office for the physically-challenged, we are sorry
you cannot operate.”
-Punch
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