When Robert Twongyeirwe suffered a stroke at the age of 35 in December 2012, his life changed dramatically. A former school inspector at the Ministry of Education, he suddenly lost his independence and source of income. ALSO READ: Your blood type affects risk of early stroke, study reveals In the days leading up to the stroke, he experienced body weakness, dizziness, and frequent headaches. Concerned about his condition, he planned to visit a hospital on December 21. However, before leaving home, he collapsed. ALSO READ: Stroke: What’s behind rising occurrence in young adults? “I woke up at around 5 a.m. to use the toilet, but I fell down and lost consciousness,” he recalled. His wife helped him back to bed after he regained consciousness. When he woke up again around 6:30 a.m., he discovered that the left side of his body was paralysed. He was rushed to King Faisal Hospital, where doctors found that he had high blood pressure, which was later identified as the cause of the stroke. The father of four had previously been diagnosed with hypertension and prescribed medication, but he stopped taking it after completing the initial treatment. “When I finished the medicine they gave me, I somehow relaxed. I did not continue the medication until I got that problem,” he said. He spent three weeks in hospital and began physiotherapy immediately. He later attended daily rehabilitation sessions at a clinic in Gisement for two years. The stroke severely affected his speech and mobility. For two months, he communicated mainly through gestures and writing. “I could only use signs. If I wanted something, I would point at it or write it down,” he said. Although his memory remained intact, damage to the part of the brain responsible for language affected his speech. Some physical limitations also persist. At his worst, he could neither walk nor stand without assistance. “You become disabled. You cannot move or stand unless you are supported. Today, I estimate I have recovered between 70 and 80 percent. For me, that is very big progress. I can now talk. I can travel by myself. I can do almost everything for myself,” he said. Twongyeirwe continues to take medication for high blood pressure and occasionally seeks specialised treatment. While grateful for his recovery, he says stroke survivors often face stigma, particularly in employment. “Some people would say, ‘Can you really manage to work?’ Yet the fact that I passed the written interview implies that I am able. I can work,” he said. Through Stroke Action Rwanda, he has seen many survivors lose their jobs despite having the qualifications and experience to continue working. He urges employers to retain or reassign workers who develop disabilities and to recognise their abilities rather than their limitations. Twongyeirwe also encourages people to regularly monitor their health, manage conditions such as high blood pressure and diabetes, recognise the warning signs of stroke, and seek immediate medical attention when symptoms appear. “Once you detect those symptoms as early as possible, you can take measures before you get struck,” he said. How Does Stroke Manifest? Stroke, often referred to as a “brain attack,” occurs when blood flow to the brain is blocked or when a blood vessel in the brain ruptures, according to Dr. Joseph Rukelibuga, legal representative of Stroke Action Rwanda, a support organisation founded by stroke survivors. Stroke is among the leading causes of death in Rwanda. According to the National Institute of Statistics of Rwanda's Vital Statistics Report 2025, stroke accounted for 353 deaths (3.9 percent) among males and 386 deaths (5.4 percent) among females in community mortality data. “An ischemic stroke happens when the blood supply to the brain is blocked, while a hemorrhagic stroke occurs when a blood vessel in the brain bursts,” he explained. Dr. Rukelibuga said stroke commonly presents through three key warning signs, remembered using the acronym FAST: face drooping, arm weakness, speech difficulty, and the need to seek care immediately. “Anyone, including children, can have a stroke, but the risk increases with age and is generally higher among men. About one in four strokes are recurrent, meaning people who have already had a stroke face a greater risk of having another.” He noted that smoking, excessive alcohol consumption, physical inactivity, unhealthy diets, high blood pressure, high cholesterol, diabetes, and obesity all increase the risk of stroke. “High blood pressure is the single most important treatable risk factor for stroke. Preventing, diagnosing, and controlling it through lifestyle changes and medication is critical to reducing stroke risk,” Dr. Rukelibuga said. To lower the risk, he encouraged regular physical activity, a healthy diet rich in fruits and vegetables, maintaining a healthy weight, avoiding tobacco, limiting alcohol consumption, and managing underlying health conditions. Dr. Rukelibuga added that stroke is a medical emergency, noting that every minute a stroke goes untreated, about 1.9 million brain cells die. “Delayed treatment can result in permanent brain damage, disability, or death. Getting a patient to hospital as quickly as possible, preferably by ambulance, can improve the chances of timely treatment and recovery.”
