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Study reveals low stroke awareness Region

A national survey shows that stroke is not recognised as a major awareness was high when participants were prompted with a
cause of death. It also reveals low-level awareness of stroke among list of possible responses. However, unprompted questioning
Pacific peoples. resulted in lower awareness of stroke risk factors.
A random sample of 400 adults participated in the national Only 30 percent of participants correctly identified two or
telephone survey. more stroke risk factors without any prompting. There was a
When asked to identify the most common cause of death, tenfold decrease in the proportion of people able to identify five
participants named heart disease (37 percent) and cancer (33 stroke risk factors, compared to prompted responses.
percent). Only 1.5 percent of those surveyed named stroke as a Having a university level education was associated with a 75
common cause of death. percent greater number of people identifying stroke risk factors
“The recognition of stroke as a common cause of death was when unprompted, compared to those with up to high school
low, well below heart disease and cancer. This may be due to low level of education.
level awareness of stroke as a cause of death in general, and to the Participants from middle income households were almost
higher profile of heart disease and cancer in the media, screening twice as likely to correctly identify stroke risk factors, compared
and fundraising campaigns,” says Associate Professor Rita to low income households.
Krishnamurthi, Deputy Director of the National Institute of Stroke
and Applied Neurosciences at AUT.
“Our findings suggest that public health messages on the
importance of modifiable stroke risk factors need to be significantly
enhanced, particularly around blood pressure control for stroke
prevention.” A poster from the 2015 action blockbuster ‘Wolf Warrior’
Associate Professor Krishnamurthi is the lead author of the study,
Community Knowledge and Awareness of Stroke in New Zealand,
published in the Journal of Stroke and Cerebrovascular Diseases.
Funding was provided by Brain Research New Zealand. UNDIPLOMATIC DIPLOMATS
The researchers found that being more educated and having a
higher income are associated with higher stroke awareness. Personal
experience of stroke also contributed to better knowledge and By Nic Maclellan were shocked by the unprecedented behaviour of a Chinese
awareness overall. official during the Forum dialogue session, when he demanded
This is the first national stroke awareness survey with an ethically Around the kava bowl in Suva, people were discussing some the right to speak in preference to Tuvalu Prime Minister So-
stratified sample – almost equal representation of New Zealand’s
four major ethnic groups; European, Māori, and Pacific peoples (25- undiplomatic behaviour by Chinese diplomats last month. For poaga, challenged Waqa as the session chair over procedure,
33 percent); and Asian (14 percent). a day or two reports that Chinese officials had intervened at a and eventually stormed from the room.
The findings reveal that Pacific peoples had the lowest level of Taiwanese National Day ceremony in the Fiji capital, lead- As reported at the time, President Waqa was clearly angry
stroke awareness. Pacific peoples identified fewer stroke symptoms ing to a physical confrontation, dominated local media and at this conduct: “Disrespecting the Pacific, the Forum island
and were 58 percent less likely to correctly identify stroke risk factors. featured internationally. There were conflicting reports about leaders and other ministers who have come to join us in the
“Low stroke awareness, especially among Pacific peoples, needs which head first attacked which fist, followed by duelling Pacific, in our territory, in our little corner of the world! Look,
to be addressed urgently. This is particularly important given the press releases from Beijing and Taipei. Fiji police later issued he’s a nobody, he’s not even a minister. Never mind that they
disproportionately high burden of stroke among Māori and Pacific a statement saying, “the matter is now being handled at the are our partners, they should not disrespect us. There are
peoples,” says Associate Professor Krishnamurthi. diplomatic level, as agreed to by all parties involved.” protocols to be respected.”
Low functional health literacy is also associated with low stroke
awareness, and English is commonly a second language among It’s not the first time that disputes between Chinese and
Pacific and Asian peoples. Taiwanese officials have played out in the Pacific, but the tone Wolf warriors
“We need to develop language-specific, culturally tailored of the debate is getting sharper. In 1604, British diplomat Sir Henry Wotton stated: “An
material and methods of delivering information to these Speaking at a press conference in Beijing in May 2020, Chi- ambassador is an honest gentleman sent to lie abroad for
communities. Training key staff in community groups to na’s Foreign Minister Wang Yi said that his country’s diplomats the good of his country.” In the 21st Century, both men and
help educate members has the potential to increase access would push back against “deliberate insults.” women are equally engaged in this fine art.
to and uptake of stroke information.” “We never pick a fight or bully others, but we have prin- Most diplomacy is routine and incremental, gathering intel-
According to a previous NISAN study, the incidence ciples and guts,” he stated. “We will push back against any ligence on the capacity and intentions of the host govern-
of stroke among Māori and Pacific peoples was deliberate insult, resolutely defend our national honour and ment, promoting trade, commercial and strategic interests,
30-60 percent higher than Europeans, and they
suffered strokes from a significantly younger age. dignity, and we will refute all groundless slander with facts.” issuing visas and consular support and generally waving the
The same study also showed that the The latest brouhaha in Suva replicates other reported flag. But every now and then, a more robust statement is
mortality rate of stroke among Pacific peoples incidents around the region in recent years: a long-running required. As the stakes get higher in a time of US-China com-
was almost double that of Europeans. And, dispute between the Chinese Consul-General and his landlord petition, we’re likely to see more undiplomatic diplomacy in
the prevalence of stroke risk factors, such as at the consulate in Tahiti; reports that Chinese officials barged the Pacific.
diabetes and smoking, was almost threefold into the PNG Foreign Minister’s office during APEC in 2018; and In the 1980s, Chinese leader Deng Xiao Ping promoted the
higher among Māori and Pacific peoples, the seizure of equipment from Chinese journalists by security maxim that China “must hide its strength” in international
compared to Europeans. officers in Australia. diplomacy. Today, the current government under President Xi
The national survey was conducted in In 2018, Nauru’s close alignment with Taiwan generated Jinping has encouraged diplomats to publicly rebuff criticism
the absence of any major stroke awareness
campaigns, allowing for testing of baseline dramas as the Micronesian nation hosted the Forum leaders of China, engage in Twitter wars and reinforce key govern-
awareness. It also compared two methods meeting. Then-President Baron Waqa delayed issuing visas for ment perspectives, especially on the ‘One China’ policy that
of questioning, which yielded very the Chinese delegation to come to Nauru unless they travelled regards Taiwan as part of the People’s Republic.
Associate Professor Rita Krishnamurthi, Deputy
different results. Director of the National Institute of Stroke and on personal, not diplomatic passports. Then Forum delegates This more assertive diplomacy from China has been evident
Researchers found that stroke Applied Neurosciences at AUT.
Islands Business, November 2020 19