Alexia Uwajeneza was told that her stroke could have been triggered by severe fatigue at the age of 30. “I was done with university when I had my stroke, I felt paralysed in my whole face. I was rushed to Kigali Teaching Hospital of Kigali (CHUK) but the doctors told me they were not qualified to help me and sent me home. I had friends there that I called and they helped to at least get a bed and be there in the meantime as I waited for a transfer to another hospital. I spent three days in the hospital,” she says. Uwajeneza was unable to talk well, and at some point, she had memory loss and used a wheelchair before being taken to King Faisal Hospital. “At King Faisal, they found that it was an ischemic stroke. Even though I am a diabetic and have hypertension it was not really the cause, but doctors suspected it was tiredness,” she explains. World Stroke Day is observed on October 29 to underscore the serious nature and high rates of stroke, raise awareness of the prevention and treatment of the condition, and ensure better care and support for survivors. According to World Life Expectancy, one of the largest global health and life expectancy databases in the world, stroke is the third leading cause of death in Rwanda. A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. “A study showed that among patients admitted in hospitals because of stroke, 26 per cent die in hospital and the 74 per cent survivors are discharged with mild, moderate, or severe disabilities,” says Dr Gerard Urimubenshi, a researcher at the University of Rwanda. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications. Dr Urimubenshi says that stroke is a very serious condition and one should seek immediate help as soon as there are any symptoms. “There are visible symptoms; a stroke can kill or even cause lifetime effects if not considered serious, but also people that consult a doctor as soon as any symptoms show have a chance to survive it,” he says. Dr Joseph Rukeribuga, also a stroke survivor and president of Stroke Action Rwanda (SAR), had a stroke when he was 57-years-old in 2016. He felt the symptoms in the early hours of the morning and managed to signal his wife to take him to the hospital. “I felt my whole left side paralysed and I couldn’t move, but luckily, I managed to move my right arm and signaled to my wife that something was not right. She then turned to look at me and my whole face had changed, I was taken to King Faisal Hospital. I was given a precision at the hospital and was taken to an MRI machine at 8am,” he recalls. Dr Rukeribuga was taken through an echography and was told by the doctor that the cause of the stroke was that the vessel that takes blood to the brain was blocked, known as ischemic stroke. “I was given aspirin as medicaments to slowly burst the clogged blood so it wouldn’t cause any problems, and I was prescribed physiotherapy. I am a diabetic and I have hypertension, I take my medicines regularly so it won’t trigger another stroke,” he says. Rukeribuga has done physiotherapy for three years now but still has effects from the stroke as he can’t use his left arm well and has trouble walking. Causes “Stroke is caused by two main things; the ischemic stroke is the most common type of stroke. It happens when the brain’s blood vessels become narrowed or blocked, causing severely reduced blood flow (ischemia). And then there is haemorrhagic stroke, which occurs when a blood vessel in your brain leaks or ruptures. Brain haemorrhages can result from many conditions that affect your blood vessels,” Dr Urimubenshi explains. Risk factors and symptoms According to Dr Urimubenshi, in 60 per cent of people that get a stroke, hypertension is the cause. The risk factors are: · Diabetes · Excessive alcohol · Excessive Smoking · Lack of physical exercise · Obesity Symptoms: · Trouble speaking and understanding what others are saying · Paralysis or numbness of the face, arms or legs · Problems seeing in one or both eyes · Headache · Trouble walking “Someone who had a stroke before has high chances of having a second and third; stroke is not a disease that takes long to be noticed, it happens immediately, that is why if you notice any symptoms, you should be taken to the hospital immediately,” says Dr Urimubenshi. “People that had a stroke can get rehabilitation to train the limbs that were affected to work perfectly again, sometimes few people have the effects forever, but others can survive with no effects at all. Not only old people can get a stroke but young people too if they have some risk factors,” he adds.