Afcon 2023: The African footballers putting their hearts on the line

One major issue is that the African heart is believed to be more susceptible to cardiac problems, with a medical research team backed by world governing body Fifa determining, in 2009, that “black African athletes seem to have an increased risk of adverse cardiac events during sports events”.

The other primary issue is the refusal of some players with heart issues to heed medical advice.

South African doctor Lervasen Pillay is someone who knows this only too well, having had to advise five different footballers to quit because of heart-related problems.

“It’s never an easy conversation, because someone has been doing this job for 10-15 years and now you’ve given him news to say, ‘Listen, you can’t do this anymore, you need to make a plan B’,” Dr Pillay told BBC Sport Africa.

“Most footballers have not established a Plan B by the time they’re 25, and the conversation often boils down to that exact question: ‘What am I going to do if I stop playing football?’

For Dr Pillay, it is hard to watch when players who have been told not to play stick to Plan A despite knowing the dangers.

“When you see the guy’s name on the starting line-up you cringe – and if it’s going to be a televised match, I’ll change the channel,” he said.

One patient, who cannot be named without breaching confidentiality rules, died two years after he failed to heed Dr Pillay, leaving the latter “depressed for a while”.

“If you find someone with a cardiac problem, then ensure your medical care around that – so (that) you have things like automatic external defibrillators around, access to hospitals and emergency vehicles, because if you don’t have them, you are creating a problem.”

While FC Zurich took precisely that action in relation to Dwamena, many other clubs have not.

There have been notable incidents in the past where basic medical provisions are not available in African grounds, such as when local Nigerian footballer Chineme Martins died in 2020 following a catalogue of failures.