World Stroke Day 2020: The referee giving stroke the red card

His fellow match officials tried to help him but the assistance angered him. “I didn’t feel bad, I didn’t fall down, nothing. I went to the hospital but really, I was alright.”

A growing trend in Sub Saharan Africa

Mr Tarawally’s experience is increasingly common in Sierra Leone, where 75% of people over 40-years-old have cardiovascular issues that put them at severe risk of stroke.

The picture is equally stark elsewhere in sub Saharan Africa, where the fatality rate one month after suffering a stroke is around 40%. This compares to just 14% in parts of the UK, according to data provided by the South London Stroke Register.

The growing prevalence of stroke on the continent is a significant reason for the Stroke in Sierra Leone (SISLE) project, a research collaboration between King's College London, University of Central Lancashire, Glasgow University and the College of Medicine and Allied Health Sciences (Freetown, Sierra Leone).

Funded by the National Institute of Health Research (NIHR), SISLE has created a stroke register with data from over 600 survivors. Face-to-face community engagement and follow-ups with survivors at 90 days and 1 year also help to understand how stroke affects their lives and those of their family.

Out of the blue

Mr Tarawally was generally fit and healthy before the attack. He exercised regularly, rarely drank alcohol and mostly ate rice and fresh vegetables.

“Almost every morning, I would go around the stadium five or six times and then do sprints across the pitch. I had no problems”.

When he had his attack, Mr Tarawally initially put his episode down to the mid-afternoon heat and fact that he was fasting for Ramadan.

But it soon became clear that he would need to seek medical care, first at 34 Military Hospital in Freetown and then Connaught Hospital. When a doctor asked him to raise his left hand and foot, he found he was unable to do so.

From strength to strength

Since his stroke, Mr Tarawally’s recovery has been slow and arduous. He spent a month at Connaught working with a physio to improve his speech but had to stop when he ran out of money to fund the one-on-one sessions.

He took it upon himself to do the exercises at home and slowly built up his strength. “In time, I decided to walk from my house to Mini Stadium [where he had the stroke] and started to do things that I was unable to do. That’s how I started to feel better.”

SISLE’s stroke survivors WhatsApp group — in which members are encouraged to share voice notes and ask trained healthcare workers questions about stroke — has been a source of inspiration and useful information, explains Mr Tarawally.

“It gives me some precautions about my health which I take into consideration, including the types of food I need to consume to keep my body fit and recover from the stroke”.

The group became particularly important during the coronavirus pandemic, when the in-person meetings with other survivors were cancelled for the safety of participants.

Hopes for the future

Despite a huge improvement in his health, Mr Tarawally continues to suffer from pain in his fingers and legs and has been unable to return to refereeing. This has left him out of pocket and struggling to buy food and other essentials.

But he hasn’t given up hope of taking charge on the pitch in the future. “If God gives me the fitness that I used to have, I will referee again”.