In Nigeria, the work of advocates such as Rita Melifonwu and her team at Stroke Action Nigeria, is helping to raise the profile of stroke at community, state and national levels.
Stroke Action Nigeria’s mission is to provide services that help to reduce the incidence, complications and burden of strokes in the lives of individuals and communities. An important part of achieving this mission are the organization’s activities at the Life after Stroke Centre in Onitsha. In a city where there are no other life after stroke activities in the community, the programme at the Life after Stroke Centre is seen by stroke survivors as the only option that provides stroke survivors and their carers with hope in terms of recovery. The programme includes health information discussions, psychosocial support, prevention advice and gym sessions.
Setting up and continuing to run the Life after Stroke Centre is no easy task. Without the donation of a building by His Royal Majesty Nnaemeka Alfred Achebe, Obi of Onitsha, it is difficult to imagine how this initiative would have begun. In addition, the gym equipment used at the centre was also donated.
‘’Our work at the LASC has contributed immensely to helping people in Onitsha to be more stroke aware, understand the need for improving lifestyle, addressing misconceptions about stroke, including stigmatization of stroke survivors. The presence of the LASC has improved participatory action that means citizens are willingly self-referring and referring other stroke survivors to receive the support that Stroke Action Nigeria offers. Community leaders at home and diaspora are also becoming interested in the work of Stroke Action Nigeria. This is a marathon task achieved!’’ says Rita Melifonwu.
The centre aims to offer a life after stroke service that is approachable. One way that Stroke Action Nigeria promotes the activities available at the centre is through befriending at local hospitals. With agreements from hospital management, Stroke Action Nigeria’s staff visit stroke patients on the wards. The staff talk through what has happened with people that may have had little knowledge of stroke beforehand, and the kind of support that Stroke Action Nigeria can provide.
And of course, the centre needs to be accessible, there is now a wheelchair ramp – another donation from the community. In addition, managing electricity and water supplies are crucial if this is to be a safe and comfortable place for stroke survivors to attend. This all takes money and daily management.
To deliver the activities at the centre, Stroke Action Nigeria needs staff and volunteers. Both the availability of community therapists and the money to pay them, is not constant. Stroke Action Nigeria therefore decided to train non-health professionals and stroke survivors, known as Stroke Ambassadors, to deliver activities at the centre. Stroke Ambassador, Irene Tabansi says, ‘'Attending the Life after Stroke Centre, being involved in my assessment and goal planning, working on my self-management goals, participating in group exercise with my peers, and befriending other stroke survivors have all contributed to my stroke recovery journey.''
Currently Stroke Action Nigeria is undertaking a pilot research project to understand whether a community-level stroke rehabilitation intervention programme can be delivered by non-professionals at the Life after Stroke Centre. Professor Jackie Bosch, co-PI of the project along with Rita Melifonwu, says
“Stroke Action Nigeria has identified a need for community based stroke rehabilitation and has developed a novel delivery model, that provides some services where either none existed or are too expensive for most people. The Life after Stroke Centre provides a diverse activity programme and the opportunity for stroke survivors to support each other. We are conducting the pilot study in preparation for a larger study that will hopefully demonstrate the effectiveness of the Centre in helping people regain function after stroke. “
The current staff team at the Life after Stroke Centre are Michael Anikamadu (Centre Coordinator), Peace Chukwuma (Research Assistant), Somto Emenike (Logistics Assistant), Elizabeth Chuke (Nurse), Dubem Nzegwu (Study Coordinator) and Juliet Usoagu (Physiotherapist). They are building a collaborative team and working hard to deliver both the daily activities and managing the research project.
All this work at the community level in Onitsha, is complemented by the influencing work that Ms Melifonwu and her team do at state and national level. The team are engaging with the NCD Division within the national Public Health Department in Abuja to explore how stroke prevention and risk factor management can be included in training for community health workers. At state level, discussions are taking place about how life after stroke activities could be delivered in hospital settings. This could enable increased support to stroke survivors much sooner after they have had a stroke and also contribute to increased partnership between Stroke Action Nigeria and government hospitals. Such partnerships will be vital to increase the sustainability of life after stroke activities in Nigeria.
Achieving our vision of a life free from stroke is a task that WSO cannot achieve alone. We are committed to building our partnerships at the global, regional and national level to scale up and deliver improvements in prevention, treatment and support to reduce the burden of stroke.
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