Emmie Katangwe had just begun praying for her sick mother when a strange sensation spread through the left side of her body. Within minutes, she could no longer stand. She was having a stroke.
The 61-year-old wife and mother had woken early that Tuesday morning as usual, preparing to pray, make breakfast and complete her household chores.
However, with her mother unwell, she spent more time in prayer, asking God for her recovery.
“I felt as if my body was tearing apart. It started in my thigh and spread to my arm, as if I was losing control,” Emmie recalls.
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Panicked, she called out to her husband, John, who was asleep in the next room. Unable to walk, she crawled towards him.
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He immediately came to her aid. With his help, Emmie called a close friend and prayer partner, who prayed with her over the phone. The numbness eased and Emmie felt restored.
“In that moment, I felt restored,” she says.
But moments later, the numbness returned, this time more severely.
Her husband called their daughter, who was living in the United Kingdom, to tell her what had happened.
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The daughter promised to pray for her mother and did so over the phone. Once again, Emmie’s symptoms eased. However, John remained concerned and insisted that they seek medical attention.
As Emmie prepared to leave, a third and more severe attack struck while she was putting on her shoes.
“That was it. I was completely helpless,” she says.
Her husband carried her to Seventh-day Adventist Hospital, where she was assessed by a doctor, Tamara Phiri.
Recognising the signs of stroke, Phiri advised that Emmie be transferred immediately to Queen Elizabeth Central Hospital (Qech), a public referral hospital for the Southern Region.
Although Emmie worried about whether she would receive adequate care at a public facility, she trusted the doctor’s advice.
At Qech, she was admitted to the stroke unit, where she received specialised care and treatment. For three nights, she was monitored by a team of health workers who supported her recovery.
“It was a relief. The treatment was excellent and I felt a sense of comfort that I had not expected,” she says.
Through physiotherapy and continued support, Emmie gradually regained her strength. She has since returned to work and continues to live a full life.
“My advice to other people is not to hesitate to seek medical attention whenever you experience signs and symptoms similar to those of a stroke. I accepted medical care immediately and now I am almost healed,” she says.
A growing burden
The Global Burden of Disease (GBD) study defines stroke as a medical emergency that occurs when something prevents the brain from receiving enough blood flow.
It is among the leading causes of death and disability worldwide, accounting for approximately seven million deaths annually.
The study found that nearly 87 percent of stroke-related deaths and 89 percent of disability-adjusted life years occur in low and middle-income countries.
In Africa, the three-year mortality rate after stroke exceeds 80 percent.
Researchers attribute the trend to an epidemiological transition driven by demographic and lifestyle changes, including unhealthy diets, physical inactivity, excessive alcohol consumption, smoking and the high prevalence of HIV.
The impact of stroke is further worsened by limited resources and inadequate prevention and treatment services.
Before 2022, Malawi had no specialist neurology services, leaving stroke patients to be treated in general medical wards despite the risk of avoidable complications such as aspiration pneumonia.
A turning point in stroke care
However, through a partnership between University College London, University College London Hospitals, the Ministry of Health and Qech, Malawi’s first specialist stroke unit was established at the referral hospital.
The facility provided the specialised care that helped restore Emmie’s health.
On Monday, local and international stakeholders gathered in Blantyre to recognise the progress made by the stroke unit and discuss ways to sustain its services during a documentary screening event.
Tiwonge Phiri, an adult neurologist with the Ministry of Health and head of the stroke unit, said the five-bed facility treats at least 30 patients each month.
“Since the unit was introduced, we have seen improvements in mortality and disability among patients who have passed through it,” Phiri said.
Growing demand, limited resources
She, however, indicated that the unit is constrained by limited space and a shortage of specialists.
As the only specialist stroke unit in the country, it relies on just two neurologists, including herself, making it difficult to meet demand.
Rodrick Sambakunsi, Head of Public and Community Engagement at the Malawi Liverpool Wellcome Programme (MLW), highlighted the importance of involving communities in stroke recovery.
“Once stroke patients are discharged, guardians should continue supporting physiotherapy exercises at home. This is why it is important to involve them in everything we do,” Sambakunsi said.
MLW played a key role in supporting the establishment of the stroke unit.
Its Director, Henry Mwandumba, encouraged people to seek treatment quickly after experiencing stroke symptoms, warning that delays can lead to death or permanent disability.
“It is critical to get help within the first 24 hours of having a stroke to survive and achieve better outcomes.
“If patients do not receive treatment or support early enough, they are more likely to die or live with disabilities for the rest of their lives,” Mwandumba said.
The GBD study found that in Africa, only 10 percent of stroke patients reach hospital within three hours of symptom onset, while more than 70 percent take longer than two hours to arrive at a health facility.
