Imagine waking up unable to speak, see clearly, or move, struck suddenly by a stroke. Medical bills pile up, your job may be gone, or if self-employed, savings and property are drained. Stigma and life-changing challenges follow, all from a condition that could have been prevented. On September 7, 2020, Faustin Ndayishimiye, then a Data Manager at a health centre in Kirehe District, travelled to Nyamata, Bugesera District, for a training session. That week, he recalls, the workload was overwhelming. ALSO READ: Stroke: What’s behind rising occurrence in young adults? “I was overworked. I had to compile and submit data for HIV patients, maternal and child health, and general reports. The system was slow because it was used nationwide, yet deadlines were tight,” he recalled. “I went almost a week without sleeping, as I had to attend training and ensure to work on reports at nighttime. On the morning of September 11, while brushing his teeth, he began to feel strange. “The toothbrush fell from my hand, my voice was faint, and one leg felt weak,” he said. ALSO READ: King Faisal Hospital performs Rwanda’s first stroke-related heart surgery “I knocked on the door to call for help, and luckily, a cleaner who was near the apartment I was in found me and called others who helped me to wear clothes and get me the bike to the training venue.” Even if nurses attended the training, they could not recognise the signs of a stroke. “One nurse thought I was drunk and joked about me drinking early in the day,” Ndayishimiye said. “It was painful because I could not speak well to explain.” Trainers later took him to Nyamata Hospital, and he was later referred to Rwanda Military Hospital and then to CHUK. “I cried like a child when I could not move my arm,” he recalled. After a month in Kigali, Ndayishimiye was transferred to Gahini District Hospital to continue treatment closer to home. “Transport alone cost about Rwf 20,000 for a round trip. It drained my savings,” he said. “After six months, I tried to return to work, but I was too weak. Eventually, I was dismissed.” ALSO READ: Chronic stress linked to higher stroke risk, women more affected – study In 2021, during the COVID-19 pandemic, Anny Salama Murekatete, a resident of Nyamirambo Sector in Nyarugenge District, suffered a stroke while caring for her six-month-old baby. She spent three months in a coma. “When I woke up, I could only breastfeed from one side,” she said. “At work, I was dismissed immediately, despite all my efforts before I fell sick. My insurance was cancelled.” She described how her life changed drastically. “Using the toilet was a challenge, and the cost of pampers, medicines, and transport was unbearable. Stroke pushed me into poverty,” Murekatete said. In 2016, Joseph Rukelibuga, now President of Stroke Action Rwanda, woke up one morning feeling unusually thirsty. “When I tried to stand, one side of my body was paralysed,” he said. His wife noticed that his face looked different and rushed him to King Faisal Hospital. He reached the hospital within an hour, but diagnosis was delayed. “Getting MRI results took about nine hours, and even then, the cause wasn’t clear,” he said. “The next day they did more tests. At that time, stroke care was still limited.” Rukelibuga, who was already living with diabetes and hypertension, spent six days in hospital. “Afterwards, I began physiotherapy and slowly recovered. It took six months to regain basic movement,” he said. Today, he acknowledges progress. “MRI services are faster, and more stroke survivors are identified and treated. But we still need specialised stroke care units to fast track treatment in the hospitals, as seen in some countries,” he said. He also pointed to gaps in rehabilitation. “Many patients are discharged before full recovery and lack access to neurorehabilitation, speech therapy, or occupational therapy,” he noted. According to Dr Leon Pierre Rusanganwa, the Health Programme Coordinator at the Private Sector Federation (PSF), prevention and awareness are key. “Stroke awareness is vital to saving lives. People should remember the signs: Face drooping, Arm weakness, Speech difficulty, and Time to act — known as F.A.S.T.,” he said. Dr Rusanganwa emphasised that prevention starts with lifestyle choices. “Manage blood pressure, exercise regularly, and eat healthy. Employers can promote wellness by offering health screenings and encouraging physical activity,” he said. He also pointed out PSF’s initiatives: “We have a Health Desk for disease prevention and a Health Protection Scheme for those who cannot afford other insurance. Through partnerships with Rwanda Biomedical Centre (RBC), Rwanda Workers' Trade Union Confederation, Ministry of Public Service and Labour, and Rwanda Social Security Board, we promote workplace wellness.” He added that public-private partnerships could support stroke units, mobile clinics, and rural outreach, while insurance companies and tech firms could drive innovation in early detection and care. Speaking during Rwanda’s commemoration of World Stroke Day on Wednesday, October 29, under the theme “Every Minute Counts: Let’s Act Together and Fast Against Stroke,” Dr François Uwinkindi, Head of the Non-Communicable Diseases Division at RBC, said early treatment makes a crucial difference. “When stroke patients receive timely care, they can recover fully and walk again. Delayed treatment often leads to disability or death,” he said. He explained that stroke kills one in two patients, and two out of three survivors live with disabilities. Dr Uwinkindi urged greater awareness to counter misconceptions that stroke is caused by witchcraft or poisoning. “People should rush to hospital immediately after noticing symptoms,” he said. “Regular exercise, blood pressure checks, and proper management of diabetes can reduce stroke risk by up to 30 per cent.” RBC’s 2022 report indicates that stroke-related deaths in Rwanda escalated from the seventh position in 2009 to the third in 2019, becoming a significant cause of mortality, representing 5.1 per of total deaths. It indicated that in light of that, Rwanda anticipates implementing the ‘Act FAST’ campaign, a public health initiative aimed at raising awareness about the signs of stroke and the importance of acting quickly, in 13 districts to control 12,685 cases of hypertension, a major risk factor for stroke, per year.
