Jigmi Wangdi

A brain attack, or commonly known as stroke, was the third leading cause of death in Bhutan. And it was on the rise owing to sedentary lifestyles among the Bhutanese.

According to the medical records with JDWNRH, there has been a total of 876 stroke patients between 2021 and October 2023. There were 316 cases in 2021, which increased to 332 cases in 2022.

The statistics also showed that men suffered more from it than women, and even 1-5 year-old children could suffer from it.

Professor Dr (Colonel) Tashi Tenzin, consultant general surgeon and neurosurgeon, pointed to high blood pressure and heart disease as the main causes of stroke

He said the hospitals in Bhutan were witnessing an increase in the number of stroke cases due to the worsening of non-communicable diseases in the country. Intake of high salt diet, smoking, lack of physical exercise, alcohol, and obesity caused stroke.

The signs and symptoms for stroke could be remembered using ‘BE-FAST’ –B for loss of balance of body, E for sight problem, F for facial drooping, A for arm weakness, S for speech problem and T for time to visit hospital.

“If any of the above signs and symptoms are identified, it means one might be suffering from a stroke and need to be rushed to the nearest hospital. Some may suffer from severe headaches and some may even lose consciousness,” Dr Tashi Tenzin said.

In the type of stroke caused by a blood clot in the blood vessel of the brain (ischemic stroke), reaching a hospital that has stroke services within four and a half hours had a very good chance of survival with minimum complications. Response later than that could result in severe disability or even death of the patient.

Though reliable record on children suffering from stroke was lacking, it could not be ruled out completely. It was rare but when it occurred it often left children with severe disabilities. The causes of stroke among children were heart disease, problems with blood vessels supplying blood to the brain, blood clotting disorders, and sickle cell disease.

Although the mortality rate of stroke patients was comparatively lower, most patients never fully recovered from it and were left with serious disabilities.

However, 90 percent of stroke cases were treatable if the risks were controlled. But lacking a proper stroke care facility in the country, most stroke patients ended up with disabilities while a significant number of died from it.

Dr Tashi Tenzin said that physician-led stroke care, stroke-dedicated physiotherapy services, well-trained stroke care nurses and a supportive environment were important for the good recovery of stroke patients.

“However, we have no neurologist and only three hospitals in the country can provide basic services. The number of physiotherapists, occupational therapists, speech therapists and nurses trained in stroke are also limited,” Dr Tashi Tenzin said.