Dr. Evans Nyambega is a pharmacist by profession. He is a stroke survivor as well as a founder member and chairman of the Stroke Association of Kenya. Dr Nyambega is a stroke advocate in Kenya and is passionate about stroke prevention and the plight of stroke survivors and says, “I wouldn't wish stroke on my worst enemy"
It happened while going to work in the morning
Could you access hospital?
Since I was deep in the village, I couldn’t access hospital as the nearest health facility is far away from my home and there was a challenge of transport. The people around me could not comprehend what was happening to me because I was in a coma for a long time and couldn’t talk. The medical facility was also ill equipped so they were unable to immediately diagnose the problem so they could not offer any stroke related first aid at all. The problem was detected after three days after my situation worsened and I was transferred to Nairobi city for further treatment. Indeed I am lucky to be alive.
What expectations did you have for your treatment, rehabilitation, recovery?
I expected to be attended to immediately and get well to continue with my normal activities. This was not to be. Diagnosis alone took a very long time. I didn’t expect treatment to be life long, as I have to take medicine on a daily basis.
With failed expectations at treatment level I was forced to have rehabilitation at a prohibitive cost. I am not able to continue with normal life as I am dependent on drugs, physiotherapy, occupational therapy and assistance of caregivers who may not take care of me as I expect because they also have their own responsibilities and also they may not be well versed with care for this kind of condition. The life of a survivor in Kenya is almost wholly dependent on ill prepared and ill trained caregivers
Recovery is very slow. I expected to recover immediately and did not know what was ahead for me; I never expected recovery to take this long. Due to slow recovery, I lost my gainful employment because my employer could not understand my problem. Employers are focused on productivity and my impaired movement and speech could not guarantee this.
What was your experience of treatment and/or rehabilitation?
The first problem I encountered with stroke treatment was diagnosis which took too long. The cost of treatment is also prohibitive as the drugs are very expensive and I could not afford this, bearing in mind that I eventually became unemployed. I had a problem in remembering things like the time to take drugs because I suffered cognitive challenges (memory, judgment, self-criticism) so I needed a caregiver permanently. A special diet is recommended and I was discouraged from eating favourite foods like soda, red meat and a lot of others that are classified as possible causes of NCDs. Impaired movement led to difficulty in accessing treatment and rehabilitation. I lost gainful employment resulting to abject poverty. This situation made treatment and rehabilitation inaccessible.
What has helped you in your recovery?
· Use of recommended drugs
· Occupational therapy
· Healthy eating
· Positive attitude
· Taking one day at a time and taking life as it comes
· Formal and informal psychological education
What have been/are your fears?
The fears are if at all I will one day manage to get my full function capacity and get to provide for my family? My greatest fear is the occurrence of another stroke and how to prevent this.
How did your family and friends feel and respond?
The family did not have much information on stroke at the time. Their expectation was that I would be treated, and then catch up with life activities, they never anticipated long term care and this caused a lot of economic and emotional anxiety to people around me.