Advances in stroke rehabilitation in the Western Cape have reduced severe disability and the need for institutionalisation; however the incidence and prevalence of stroke victims is still increasing and remains the third leading cause of death in the Western Cape.
This is according to Western Cape Minister of Health, Dr Nomafrench Mbombo, who delivered the keynote address at a stroke awareness roundtable hosted at the Western Cape Rehabilitation Centre (WCRC) in the lead up to World Stroke Day, observed on October 29 and Stroke Awareness Week which takes place from the 28th October – 3rd November 2017.
Mbombo applauded the WCRC for the valuable contribution it makes to physical rehabilitation services offered to residents in the Western Cape, but highlighted that preventative action always surpasses the best treatment.
“Stroke is the leading cause of disability in the South Africa; more than 400 South Africans suffer from a stroke daily. Many survivors are left chronically disabled and one third of these survivors are at risk of having a second stroke within a year. Maintaining a healthy and disciplined lifestyle is the best preventative measure for stroke. Whereas, cure cannot always treat us completely, especially when the damage of a stroke has already happened,” says Mbombo.
Referred to as the flagship for physical rehabilitation services in the Western Cape, the WCRC offers specialised, multi-disciplinary rehabilitation programmes for persons with physical disabilities, including stroke survivors. “The WCRC admits approximately 700 – 800 patients per year. Approximately 30 – 35 percent of patients admitted to our facility are stroke victims. Men and women were admitted at equal rates,” says Jenny Hendry, Chief Executive Officer at the Western Cape Rehabilitation Centre.
Hendry explains that majority of strokes are caused by hypertension, diabetes, tobacco and substance abuse as well as obesity. “Sedentary lifestyle choices such as inactivity and poor diet, increases your risk of obesity, diabetes, and heart disease, which are all precursors to stroke. These are controllable and if altered can reduce the likelihood of stroke,” she says.
She states that over the past 3 years the facility has seen a noticeable increase of younger patients between the ages of 15 - 40 years being admitted for stroke rehabilitation. “26% of patients admitted during the 2014/ 2015 financial year were between the ages of 15 - 40 years, this percentage increased by 9% by the end of the 2016/ 2017 financial year,” explains Hendry.
She also reported that Individuals with stroke, who are HIV positive, are younger than patients with stroke who do not have HIV. “HIV weakens and slowly destroys the body’s immune system, leaving an individual susceptible to numerous illnesses. Your central nervous system is also affected, causing a number of neurological complications, such as stroke,” says Hendry.
Mbombo explains stroke or cerebral vascular accident (CVA) is caused by an interruption of the blood supply to the brain. “Approximately 80% of strokes are caused by thromboembolic disease (a blood clot), while 20% of strokes are caused by bleeding into the brain (Haemorrhage).
“Stroke can cause permanent/ partial paralysis, loss of speech, vision and cognitive difficulty, bowel or bladder control problems and swallowing challenges,” explains Mbombo.
Hendry states that the WCRC provides a service to residents of the Western Cape and many neighboring provinces. “Approximately 60% of our clients reside in the Metro East District, which includes areas such as Khayelitsha and Mfuleni. Individuals are at greater risk of acquiring a disability if they live in an impoverished area. This is mainly due to the general lack of health care, nutrition, sanitation, and safe working and living conditions that the poor endure,” explains Hendry.
She highlights that it is impossible to ignore the strain stroke survivors place on their families/ caregivers, especially in impoverished areas. “Caring for stroke survivors can cause high levels of emotional, mental, and physical stress for both the stroke survivor and caregiver. As a caregiver of a stroke survivor you are required to take care of the individual and his/ her individual needs, but also manage out-of-pocket medical expenses, travel costs and lost wages, which place an additional burden on both the family member and stroke survivor,” concludes Hendry.