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“Stroke can change a life in minutes, but awareness, timely treatment and stronger healthcare services can make all the difference.” Dr. Mohamed Sheikh Hassan Qalaf
There is a medical emergency that can leave a person unable to speak, walk, recognize loved ones or care for themselves. It can strike at home, at work or during an ordinary conversation. Yet many people fail to recognize its warning signs until valuable time has been lost.
That emergency is a stroke.
In Somalia, we need a much broader conversation about stroke — not only in hospitals and medical schools, but also in our homes, schools, workplaces, mosques and communities. Stroke is more than a medical condition. It is a public health challenge that affects families, livelihoods and the future of our healthcare system.
When it comes to stroke, knowing what to do can save a life.
Many people associate stroke with older adults. Although the risk increases with age, younger adults can also experience it.
A stroke occurs when blood flow to part of the brain is interrupted or when a blood vessel in the brain ruptures, causing bleeding. Brain cells depend on a continuous supply of oxygen and nutrients. When that supply is disrupted, damage can occur rapidly.
A person who was healthy yesterday may suddenly develop weakness on one side of the body, difficulty speaking, facial drooping, loss of vision or problems with balance.
These symptoms may be mistaken for tiredness, stress or a temporary illness. Some families may initially believe the person will recover without medical intervention.
But stroke is not something we should wait and watch at home. Sudden neurological symptoms must always be treated as a medical emergency.
Imagine a man who suddenly develops weakness in his right arm and struggles to speak. His family notices the changes but assumes he is exhausted. They wait for him to improve. Someone suggests buying medicine from a nearby pharmacy, while another recommends waiting until the following morning.
Hours pass before the family seeks hospital care.
This example illustrates how a lack of awareness can delay treatment. It is not about blaming families. People cannot be expected to respond appropriately to an emergency they do not recognize.
In stroke care, time matters because brain tissue can be damaged when its blood supply is interrupted. Some patients with ischemic stroke may benefit from intravenous thrombolysis, which dissolves blood clots, or mechanical thrombectomy, which removes clots from certain blocked arteries.
These treatments are available only to eligible patients and require rapid assessment and appropriate imaging.
The sooner a patient reaches an appropriately equipped hospital, the sooner treatment decisions can be made.
We do not need to be doctors to recognize a possible stroke. We need to know what to look for and how to respond.
One simple approach is FAST:
● Face: Is one side of the face drooping?
● Arms: Is there sudden weakness or difficulty raising one arm?
● Speech: Is speech slurred, confused or difficult to understand?
● Time: Seek emergency medical assistance and arrange immediate transport to an appropriate hospital.
Stroke can also cause sudden vision loss, severe balance problems, confusion or an unusually severe headache, particularly in some types of stroke.
One of the most important facts about stroke is that many of its risk factors can be identified and managed.
High blood pressure is a major risk factor. Diabetes, high cholesterol, smoking, physical inactivity, unhealthy dietary patterns and certain heart conditions, including atrial fibrillation, also increase the risk.
Yet how often do we check our blood pressure when we feel healthy? How many people monitor their blood sugar or cholesterol? How often do patients stop taking prescribed medication because they no longer experience symptoms?
Prevention must become part of routine healthcare. Regular blood pressure checks, appropriate diabetes management, treatment of high cholesterol, smoking cessation, physical activity and healthier dietary habits can all help reduce risk.
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People with diagnosed conditions should follow medical advice and avoid stopping prescribed treatment without consulting their healthcare professional.
Feeling healthy does not always mean being free from risk.
Public awareness is essential, but awareness alone is not enough.
A family may recognize stroke symptoms immediately and still struggle to reach appropriate care. Transport may be delayed, emergency services may be limited, and the nearest facility may lack the imaging equipment, specialist expertise or treatment pathways required.
These challenges make stroke a health-system issue, not simply an individual medical problem.
Somalia needs stronger public education about stroke prevention and emergency recognition. Healthcare workers need continuing training in rapid assessment and management. Hospitals need reliable access to brain imaging, clear referral pathways and organized stroke protocols.
Surviving a stroke does not always mean making a complete recovery.
Some patients live with weakness, speech difficulties, swallowing problems, memory impairment, depression or dependence on others for everyday activities. Recovery may require months of rehabilitation, ongoing medical care and substantial family support.
For this reason, stroke care must not end when the patient leaves the hospital.
Physiotherapy, occupational therapy, speech and language therapy, psychological support and caregiver education can all contribute to recovery, depending on individual needs.
We must also recognize the economic consequences. A person who can no longer work may lose their income, while relatives may have to reduce their working hours to provide care. Medical expenses and long-term disability can place considerable pressure on households.
We do not need to wait for a national campaign to begin making a difference.
People can learn the warning signs and share them with relatives. Community and religious leaders can help communicate accurate health information. Schools and universities can incorporate stroke awareness into health education. Employers can encourage preventive health checks.
Healthcare professionals should discuss risk factors during routine consultations rather than waiting until a stroke occurs. Journalists and media organizations can challenge misinformation and communicate practical, evidence-based advice.
Policymakers must strengthen primary healthcare, emergency referral systems, diagnostic capacity, acute stroke services and rehabilitation.
These responsibilities are interconnected. Better prevention reduces avoidable risk; early recognition reduces delays; effective hospital care improves the opportunity for recovery; and rehabilitation helps survivors regain independence.
Stroke can happen suddenly, but our response should not be unprepared.
We should not wait for a parent, colleague, neighbor or young person to experience a stroke before discussing prevention. Nor should we wait until a family has lost valuable time before teaching people to recognize facial drooping, arm weakness and speech difficulties.
As Somalia strengthens its healthcare system, stroke deserves greater attention in public education, clinical services, research and national health planning.
The message every Somali family should remember is simple: know your risk, recognize the warning signs and seek emergency care immediately.
We cannot prevent every stroke, and not every patient will recover completely. But we can improve awareness, reduce avoidable delays, strengthen healthcare services and give more people the opportunity to receive timely treatment.
Every minute matters. Every brain matters. Every person affected by stroke deserves the best possible chance of survival, recovery and dignity.
Let us talk about stroke before it happens — and act without delay when it does.
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Dr. Mohamed Sheikh Hassan Qalaf, MD, FEBN, is a Consultant Neurologist at Mogadishu Somali-Türkiye Recep Tayyip Erdoğan Training and Research Hospital, Somalia.
The views expressed in this article are those of the author and do not necessarily reflect the editorial position of Dawan Africa.