Time to up the ante in the battle against stroke

By the time you finish reading this editorial, another Thai citizen likely will have died of a stroke. According to a report released to mark World Stroke Day this week, the so-called “silent killer” takes on average one Thai life every 10 minutes. 

The statistic could be better or it could be worse, depending on the point of view. In terms of global statistics, Thailand is utterly average – the same level of public awareness and understanding as the worldwide median, the same access to treatment, the same post-stroke rehabilitation available, the same quality and availability of medication, and the same level of cooperation among patients.

But being “typical” is hardly reassuring when a stroke strikes right out of the blue, turning a life upside down, perhaps yours or perhaps that of a loved one. In dealing with the scourge of stroke, nationally and personally, prevention becomes of the utmost importance. When preventive steps have not been taken, stroke can kill immediately, paralyse or partially paralyse – the latter outcomes requiring long-term care and rehabilitation. The financial and mental strain can be immense for all concerned, adding to the sufferer’s physical burden.

On World Stroke Day, healthcare officials make a concerted effort to warn and educate, but the fundamental advice never changes: Stop smoking, maintain an acceptable weight, monitor your blood pressure and exercise regularly. Heavy drinkers are told to cut it down heavily. Fatty foods and diets high in cholesterol are asking for trouble. 

Regular medical check-ups are highly recommended, more so for people over 40 and especially if there’s any history of stroke in the family.

The cost of ignoring such common sense can be enormous. The physical rehabilitation that a stroke sufferer must undergo is no guarantee that normal strength and capabilities will be restored, even after years of effort. 

Rehabilitative exercise is essential in saving joints and endangered muscles from becoming irretrievably weakened and thus useless, but it is a long, demanding and often frustrating regimen, so much so that many sufferers, abetted by their worn-out families, simply give up when improvements aren’t soon forthcoming.

Their dismay at the lack of early results is aggravated by the stroke victim’s mood swings, stemming from medication to some extent but primarily triggered by a damaged nervous system. The victims and their families have to be as fully apprised of this hazard as the caregivers, so that understanding and patience come into play as needed. 

Thai city hospitals advertise prompt response when stroke occurs, but this is largely a service for the wealthy, whereas the less fortunate are left to cope with insufficient knowledge of the disease and its effects and thus, when the time comes, slow response and limited care.

Medication for treating stroke is not overly expensive, though it certainly could be cheaper. The government should be subsidising the cost of medication and treatment for those in need, not just for humanitarian reasons but also for the offsetting economic benefit to the country. Stroke affects everyone associated with the victim, including employers. 

Thailand doesn’t have enough medical personnel trained in the specifics of stroke care, and those we do have are not paid commensurate to their skills and dedication. 

For the government, stroke has to rank among the top medical budget priorities. It is, after all, more of a threat to people beyond middle age, and, due to Thailand’s declining birth rate, ours is rapidly becoming an ageing society.

Caregivers frequently remind families where stroke has hit that “everyone is in this together”. They’re referring to the parents, spouses, children and friends, who must form a solid support group for the victim. But, given the extent of this disease, the admonition is just as easily aimed at the nation as a whole. Until healthy habits become routine or another way is found to block strokes, we need a more unified front in acknowledging the risks and treating the outcome.