Too young for stroke: Think again! The disease is striking across ages

Thirteen-year-old Angel Mwema who suffered a stroke at the age of eight and her mother Dority Gitari. [Ryan Kerubo, Standard]

At eight, Angel Mwema was sitting at home eating an apple with her mother when something unusual happened. She turned to her mother and asked a question that would change the course of their lives.

“Where is my hand?”

Her mother, Dority Gitari, initially thought the question was strange. Angel’s hands were there, yet the young girl kept asking where her hand was. Soon, more questions followed. She asked about oil that had been applied on her body and struggled to understand familiar surroundings.

For Dority, a mother and occupational therapist, the confusion was a warning sign that something was wrong.

“The first time she said, ‘My hand is lost,’ that is when I realised things were not right,” she recalls.

Angel was diagnosed with stroke, a condition many people associate with older adults. Today, 13 and in Grade 7, she remembers the months that followed more vividly than the day doctors confirmed the diagnosis. Hospital admissions became routine. Injections frightened her. Physiotherapy sessions often ended in tears. Tasks that had once come naturally suddenly demanded determination and relentless practice. Now, she is rebuilding and dreaming of becoming a fashion designer.

Her story challenges the belief that stroke is only a disease of old age. Across Kenya, survivors and health experts are warning that stroke does not discriminate by age. It can affect children, young adults and older people, leaving physical, emotional and financial consequences that often continue long after the emergency has passed.

Dr Kuria Waweru, a vascular and endovascular neurosurgeon and Chair of the Kenya Stroke Society, says stroke occurs when blood supply to part of the brain is interrupted, causing brain cells to begin dying due to lack of oxygen.

Irene Chepkemoi who survived a stroke in childhood. [Ryan Kerubo, Standard]

“Stroke is basically limited blood supply in an area of the brain,” he explains.

He compares the brain’s blood vessels to pipes carrying water. When a vessel becomes blocked, blood cannot reach parts of the brain, resulting in what is known as an ischaemic stroke. When a blood vessel ruptures and causes bleeding in the brain, it becomes a haemorrhagic stroke.

Globally, stroke remains one of the leading causes of death and disability. The World Stroke Organization estimates that one in four adults over 25 will experience a stroke in their lifetime, while up to 90 per cent are linked to modifiable risk factors.

While age remains a risk factor, Dr Waweru says the idea that stroke is only an old person’s disease is outdated.

“That assumption is outdated, and it’s dangerous because it delays people seeking care,” he says.

Africa carries a significant burden of stroke in the young, affecting people below 50 years.

“When a 45-year-old breadwinner is struck down, it collapses a household’s income and propagates a destructive cycle,” he says.

For Angel, the stroke happened during childhood. After being taken to hospital, she was eventually transferred to Kenyatta National Hospital, where she began treatment. Recovery was not easy. She struggled with medication, hospital visits and therapy sessions that tested her patience.

“The therapy,” Angel says when asked about the hardest part of her recovery.

She once misunderstood the exercises, believing her mother was punishing her.

“I thought my mum was punishing me, but my mum was helping me,” she says.

Dority became more than a caregiver. She became part of Angel’s rehabilitation team, turning ordinary routines at home into opportunities for recovery.

“I had now to declare like in my house, everything was therapeutic,” she says.

The journey came with emotional and financial challenges, while access to rehabilitation remains uneven across Kenya.

Dr Waweru says comprehensive neurorehabilitation remains one of the weakest links in stroke care, with physiotherapy, occupational therapy and speech therapy concentrated mainly in urban areas.

“Continuity of care is key,” he says, adding that rehabilitation services need to be accessible beyond major hospitals.

Physiotherapist Kennedy Kang’ang’i says recovery after stroke depends heavily on timely treatment and rehabilitation. He explains that physiotherapy is often misunderstood, with many people confusing it with massage.

“Physiotherapy is active exercise to awaken those muscles that have been affected by the stroke,” he says.

For survivors, rehabilitation is about reclaiming independence. Stroke can suddenly take away abilities people once performed without thinking.

“Recovery of stroke first and foremost is very, very emotional,” Kang’ang’i says.

He adds that survivors should not be treated as passive recipients of care.

“They are not passengers in their recovery. They are the main actors,” he says.

For Angel, the work has paid off. She can now write better, participate in school and do things she could not immediately after the stroke. However, the experience has shaped how she views herself and her relationships.

Before falling ill, she had consistently ranked among the top pupils in class. Afterwards, concentrating became harder, and her performance dropped as she struggled to keep pace with classmates.

“I can’t handle many things like carrying water,” she says. “Sometimes when I don’t understand something, I ask my friends.”

Dr Evans Nyambega demonstrates physiotherapy as part of his stroke rehabilitation journey. [Ryan Kerubo, Standard]

Making friends also became difficult because she worried about being judged.

“They are not true friends,” she says, explaining that some classmates could share personal information with others.

Despite the challenges, Angel remains determined. Her dream is to become a fashion designer and build a future where she can support her family.

Irene Chepkemoi, 39, a mother of two, understands that journey deeply. She was only 10 when a stroke changed her life. Following a road accident, she developed symptoms that were not immediately recognised. One afternoon, while walking home from school after the rain, she suddenly collapsed.

“I didn’t know anything,” she recalls. “I was totally unconscious.”

Doctors later determined that she had suffered a haemorrhagic stroke caused by bleeding in the brain. At the time, stroke awareness was limited, and warning signs such as facial drooping and arm weakness were not recognised.

“The face dropping, the arm weakness, it wasn’t noticed,” she says.

That delay is something stroke specialists continue to battle today.

“I still meet families who believe a stroke is a spiritual attack rather than a vascular emergency,” says Dr Waweru. “One of the commonest situations is a man or woman who wakes up feeling a bit tired on one side of the body. The spouse assumes they simply slept badly and proceeds with the day’s activities. Hours later they return home to find that person unable to speak.”

“Each of these beliefs costs time, and time is the one resource stroke does not forgive.”

His warning reflects a wider challenge in Kenya, where many patients first visit small health facilities that lack brain imaging or stroke treatment services. Hours can be lost before they are referred to hospitals equipped to diagnose and manage stroke.

Ideally, Dr Waweru explains, every suspected stroke patient should undergo an urgent brain scan to determine whether the stroke is caused by a blockage or bleeding. That distinction determines treatment.

“If it’s a clot and the patient qualifies, we can give clot dissolving medicine or physically remove the clot. If it’s a bleed, we institute measures to stop the bleeding from expanding.”

Arriving within the first few hours can determine whether someone returns to work or spends the rest of their life dependent on others.

“The problem in Kenya isn’t the science,” he says. “It is that less than one in every two hundred eligible stroke patients currently receives these life changing treatments.”

Irene’s recovery involved physiotherapy, where she gradually regained movement and independence. She spent about two months working with physiotherapists before she could walk again. Today, she walks with the support of a cane and uses her experience to encourage others.

“Life needs acceptance,” she says.

“Disability is not inability,” she adds.

Dr Evans Nyambega, a pharmacist and chairperson of the Stroke Association of Kenya, also knows what it means to rebuild after stroke. Before the illness, he lived independently, ran his pharmacy business and managed his daily activities. After stroke, many things changed.

He recalls experiencing forgetfulness, changes in sleep patterns and fluctuations in his blood pressure. Looking back, he says the body often communicates when something is wrong.

“I have learned that it’s always good to pay attention to your body’s complaints,” he says.

When stroke eventually happened, it affected the right side of his body. He had to relearn tasks many people take for granted. His therapist helped him regain skills such as brushing his teeth and putting on shoes independently.

“This was a big, big step,” he says.

The experience also changed his relationships.

“I stopped having friends,” he says, explaining that some people began seeing him only as someone who needed help.

His family became a major source of support. Today, he uses his experience to advocate for other survivors.

“Stroke is not a death sentence,” he says.

That belief drives his work with the Stroke Association of Kenya, established in 2015 to provide a collective voice for stroke survivors.

“We could not talk on ourselves. We needed something to talk on our behalf,” he says.

The organisation focuses on awareness, survivor support and advocacy for better stroke care. It teaches communities to recognise warning signs using FAST: face drooping, arm weakness, speech difficulty and time to seek help.

Dr Waweru says recognising these signs early is critical because stroke is a medical emergency.

“Time is brain,” he says.

Every minute matters because delays can mean the difference between recovery and disability. Yet rehabilitation remains one of the weakest links in stroke care. For many survivors, recovery does not end when they regain movement. It continues through rebuilding confidence, reconnecting with family, returning to work where possible and learning that they are not alone.

Support groups have become an important part of that recovery.

“When I talk to relatives of stroke patients, I think of stroke recovery in terms of milestones,” Dr Waweru says. “Survival is only the first milestone.”

Many survivors continue living with weakness on one side of the body, speech and swallowing difficulties, memory problems and depression.

“These aren’t small problems,” he says. “For many families, they become the defining reality of daily life long after hospital discharge.”

For Angel, Irene and Dr Evans, recovery has not been a straight path. It has involved setbacks, adaptation and support from families, healthcare workers and survivor communities.

Angel, who once struggled to write and use her affected side, now continues with her studies and dreams of creating fashion designs.

“I always try to work hard to reach my dreams,” she says.

Her dream is to become a fashion designer and one day give back to her mother.

For Irene, it has become a lesson in acceptance and resilience. For Dr Evans, survival has become a responsibility to help others understand stroke.

Their stories reveal a reality Kenya can no longer ignore. Stroke is not only about the moment the brain is attacked. It is about everything that follows: rehabilitation, family sacrifices, emotional battles and the determination to rebuild.