High blood pressure is the leading cause of stroke, but many Malawians blame witchcraft for the sudden disruption in blood flow to the brain that fuels deaths and disabilities.
A perception survey conducted in Karonga shows that most rural dwellers remain unaware that hypertension worsens the risk of stroke.
Hazzie Mvula and her research team interviewed 739 rural dwellers aged over 15 to gauge the knowledge of stroke symptoms, risk factors and prevention.
“Knowledge of stroke was poor. Up to 71 percent of the respondents who consented to the study knew no correct risk factor,” they report.
The findings published in Stroke journal call for educational interventions that reach those with poor knowledge, at high-risk and care providers to prevent and manage “the growing burden of strokes in rural areas”.
A fifth of the participants in the study funded by Wellcome blamed the crippling but deadly condition on witchcraft, not hypertension, obesity or diabetes.
“Witchcraft was mentioned as frequently as hypertension as a cause of stroke,” reads the study.
Some 19.8 percent of the interviewees got it right that that high blood pressure can cause blocked or constricted blood vessels to rupture or leak.
The aftermaths of interrupted oxygen supply to the brain include trouble walking, speaking and understanding.
Over two thirds of the interviewees described the paralysis of the face, leg or arm as kufwa vibalo, with 20.8 percent saying witchcraft triggers stroke.
In Nyungwe, south of Karonga Town, Wezi Mwanguku, who lost her son to stroke, says she is tired of being told “he was struck by a magical hammer” in the night.
“It’s tough to explain sudden deaths where beliefs in witchcraft are deep-rooted, but death is inevitable,” she says, likening deaths from stroke and high blood pressure to being struck by lightning or a vehicle.
“There is no time to say farewells,” she says.
Prevalent beliefs in witchcraft fuel mob attacks on elderly people in Malawi. Recently, an elderly woman in Fumbwa Village, Traditional Authority Tambala in Dedza, was stoned to death by her family members. This prompted President Lazarus Chakwera to ask law enforcers to protect vulnerable targets from such horrors and ensure justice is done.
Catholic Bishop Martin Mtumbuka of Karonga Diocese, where the purges are common, says: “Witchcraft does not exist, but it is a sign of poverty and illiteracy.”
The study shows the knowledge about stroke remains low, especially among the poorest and the least educated.
“Programmes to support early recognition and timely hospital presentation after stroke are needed,” it reads.
A quarter of the global population will have strokes in a life time, World Health Organisation reports, but the health care system focuses more on infectious illnesses. Even far-apart health centres in rural Malawi, home to 84 percent of Malawians, mostly lack equipment for detecting non-communicable diseases (NCDs).
But Elias Chipofya, medical laboratory scientist at Thyolo District Hospital, warns: “Gone are the days NCDs were thought to be diseases of the rich and noble townspeople.
“There is a huge spread and impact of these silent killers in rural areas, where old people are mostly accused of witchcraft and many patients die without health workers knowing the cause.”