Stroke: the silent epidemic impacting lives - Academia

On October 29, World Stroke Day forces us to face a stark reality: stroke devastates millions of lives worldwide. Behind the statistics are a host of personal stories, each a testament to the critical need for stroke awareness and rapid intervention. One such story concerns Joko, a 57-year-old man from rural Indonesia, whose experience starkly illustrates the life-changing consequences of delayed action.

Joko’s ordeal began with a sudden weakness on one side of his body. Like many others dealing with unknown symptoms, he hoped the problem would resolve itself. Days turned into weeks, and the persistent weakness robbed him of his ability to work and support his family. Only then did Joko seek help at his local community health center. The diagnosis hit hard: Joko had probably had a stroke a week earlier. The GP delivered the sobering news that the ‘golden period’ for optimal treatment was over. The doctor realized the need for specialized care and referred Joko to a hospital with a neurologist – a facility two hours away.

The revelation came as a deep shock for Joko. Although he was aware of stroke as a concept, he had never seen himself as a victim. The realization that he could no longer care for his loved ones left him struggling with feelings of hopelessness and worthlessness.

Neurological disorders, with stroke at the forefront, are a staggering global health problem. A 2024 World Health Organization report shows that these conditions affect more than a third of the world’s population, making them the leading cause of health loss and disability worldwide. Since 1990, we have witnessed an alarming 18 percent increase in disability, illness and premature death from neurological disorders, with a disproportionate 80 percent occurring in low- and middle-income countries, a stark reminder of global health inequalities .

Stroke, defined as an episode of neurological dysfunction caused by focal brain, spinal cord or retinal infarction lasting more than 24 hours or leading to death mainly due to a neurovascular problem, takes a devastating toll, the data show. Global Burden of Disease 2019. million incidents worldwide, making it the second leading cause of death and third leading cause of disability worldwide.

Indonesia faces a particularly dire situation, with the prevalence of stroke rising from 7 percent in 2013 to 10.9 percent in 2018, and forecasts suggest this could affect as much as 30 percent of the population in the future. The country’s 2018 Basic Health Survey found that 2.5 in 1,000 Indonesians are at risk of having a stroke, with mortality and disability rates of 15 percent and 65 percent respectively. This health crisis is putting a strain on national resources, evidenced by the Rp 2.5 trillion ($158 million) allocated by the Indonesian National Health Insurance (BPJS) for stroke treatment in 2020 alone. This underlines the urgent need for comprehensive prevention and treatment strategies to combat this growing epidemic.

As we celebrate World Stroke Day, Joko’s story is a powerful reminder of the work that remains to be done in the fight against stroke. It is a loud cry for better stroke awareness, prevention and care, not only in Indonesia but worldwide. Based on Joko’s experience and the alarming statistics, several key areas require our attention to reduce the stroke burden in Indonesia and globally.

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