Rita Melifonwu: Nigerian nurse blazing a trail in UK



Research has shown that a health condition known as stroke is becoming more prevalent in Nigeria. It is assuming an alarming increase resulting in premature retirement of people from productive lives.

Disability of patients and eventual deaths are the most common issues. This ailment cuts across all boundaries. Stroke is so devastating that when a victim is affected, one in every six stroke patients in the context finds it very hard to return to their normal lives. In a country like Nigeria, this trend is dangerous because of the diverse socio/cultural issues that sufferers, families and friends are daily confronted with. It therefore, gradually takes its toll on the entire population.

Mission-driven Rita Melifonwu, founder of Stroke Action UK, the first initiative for stroke sufferers is looking to change shocking statistics such as these. With a focus on tools and protocols, Stroke Action hopes to make it easy for doctors, nurses and stroke patients to prevent and mange this health problem..

Daily Sun recently spoke to the Nurse/Consultant about her initiative in Nigeria. Excerpts:

Research has shown that the number of patients living with stroke is on the increase. How do we avoid this? And for someone already living with it, how can it be effectively managed?

Stroke is on the increase globally, it is not peculiar to Nigeria. You would find out that for some people whose folks have stroke, it is like the end of the world for them and the persons are referred to as inactive. Last year, a research which was carried out showed that 1 out of 100 persons will have stroke in their lifetimes. This is pretty shocking and high.

If you look at different countries and economy, it all depends on the facilities and resources and the know-how to prevent and manage this health condition. This is where the problem comes in for Nigeria as a developing country. We lack the medical know-how. We have specialists that are trained but we don’t have the resources to manage stroke properly. Most importantly, raising awareness about the causes is a key issue and the bottom line is that stroke is preventable.

We don’t have to suffer stroke but unfortunately a lot of people are suffering it. It is about knowing what causes it and being aware of it and how to prevent it before it advances. In Nigeria, according to research from the World Health Organization, in 2004, 174,000 Nigerians had stroke.

What is the master plan of Stroke Action Nigeria?

We will like to refer to stroke action as a ‘not sledged ‘ initiative. We started in the United Kingdom when I was a nursing sister in 1998. I was appointed as a senior sister and a ward manager. In the Cardiovascular ward, we cared for people suffering from Cardiovascular disease and its risk factors like diabetes and heart diseases. They are predominantly white people, but what I noticed in my ward that for every black person that comes to my ward, three persons have stroke and I thought, why?

For a 28 persons ward, sometimes we had five black people having stroke and I thought of what to do. They don’t know why people suffer from stroke, but they can’t differentiate between stroke and heart attack.

When patients are discharged, they also don’t have support system in their community. So, that was where my work started in the UK.

So what is the difference between stroke and heart attack?

I would say the causes are the same. The risk factors are the same. For instance, there is a blockage of arteries, so that the blood does not get to one part of the heart to the other, then, there is a heart attack.

That is why we are putting emphasis on calling stroke a brain attack so as to draw the importance it deserves. Brain attack is in the brain while heart attack happens in the heart and they have similar risk factors but people tend to confuse them.

What is the first step towards prevention or effective management of stroke in Nigeria?

The basic thing is public awareness. Nigerians need to be aware of what stroke is.

A lot of issues have come up about stroke being caused by witchcraft, wizards and wicked elements. We need to know basically, that stroke is a brain attack caused by a blockage of an artery, preventing blood from one part of the brain to the other.

When there is a breakage in the blood vessels causing blood to leak into the brain damaging the brain, Thermo logic Stroke occurs.

We need to know what stroke is, we need to know what causes stroke, and we need to know what the risk factors are. Things like excessive high blood pressure, excessive high blood sugar level, diabetes, which is poorly managed and controlled. People that have high cholesterol level which often comes in forms of our diet plan and smoking.

Unfortunately people that have suffered from sickle cell disease, heart disease and irregular heart beat face this risk also. Risk factors for stroke include salt, excessive cholesterol, lack of exercise, excessive weight.

Are our local health sector successfully managing stroke? If not, where are the gaps they need to fill?

Basically, We need to do more in terms of public health. We are lacking in that aspect, it is not everybody that knows what causes stroke. In terms of prevention, I know that there is a lot work going on with primary health care. We are really doing less than 50% of the population in terms of awareness and promoting public health.

Because we don’t have the facilities or an acute unit, anyone who suffers from stroke is on danger list. Someone who has suffered from stroke, needs an acute care in the hospital where we have professionals, doctors, neurologists, nurses that are trained in stroke, physiotherapists, and probably social workers working as a team to care for these patients and supporting their families. We don’t know have even a single acute unit in Nigeria.

So, government needs to do something about that and moving on from that with somebody that have suffered a stroke, the person needs to be rehabilitated to walk again and also learn to speak again. We do not have stroke rehabilitation units in Nigeria. At Stroke Action, we are advocating that the government have a national stroke strategy. Then within the stroke national strategy, we need to have stroke care partners from the time the persons have the stroke, progressing from there to educating the patients’ family on how to manage the person. We need to educate hospitals and the communities.

What is the outline of Stroke Action initiative?

The aim of Stroke Action is to take what we have in the UK and bring back it to the community level. Stroke Action raises awareness of stroke.

All stroke survivors know what causes stroke and the kind of stroke they have, why they have the stroke and what the risk factors are. The strategy for Stroke Action is to make sure that people are aware of what stroke is, causes and how to prevent it. The other thing is about rehabilitation. We offer rehabilitation, stage management to our community, social support, social reintegration depending on the centre of the brain that is affected, the function in their speech or mobility will be affected, which is called self management.

 What steps have you taken to put your initiative to motion?

Well, the first thing that I did when it was brought to my attention that stroke management is really poor in the Nigeria. The first programme we did three years ago was in my own locality in Onitsha, ever since then, every August in Onitsha, we have a stroke conference, which is very well attended.

This year however, has been quite challenging, we have moved away from Onitsha. We had conferences in Lagos, Enugu and Awka, so it is spreading. We have also put stroke specialists in different areas and we have formed Stroke Action as a corporate entity in Nigeria. We are now registered with the Corporate Affairs Commission. We also held a stroke assembly where professionals and people interested in stroke care came together to deliberate on several issues involving stroke care in Nigeria.

How can a stroke patient get access to Stroke Action?

The challenge is primarily getting finance and resources. I think the good point is having database because at the moment, we want to know how many people that have had stroke in Nigeria.

We need to employ someone, a stroke navigator that will help us get phone numbers so that people can phone in and tell us if they want to be involved and be supported.

That stroke patients can benefit, we need to get to them. They need to phone in and say, I am a stroke survivor but I want to get on this database. This is the starting point. We have a help line and we have a national stroke register.


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