Community members, leaders and Elders worked together to paint a mural, with colourful and culturally safe messages about healthy skin and happy hearts. Dolls were washed in soapy water, teaching children lessons about preventing and treating skin infections by identifying skin sores from infected mosquito bites, scabies and animal scratches. And, excitingly, the kids got to listen to their hearts using stethoscopes and even see their organs working on an ultrasound scan.
These were just some of the activities taking place at recent community events held in Biloela and Woorabinda, where preventing rheumatic heart disease is a key priority of community members and healthcare providers.
Both events resulted in a living mural that will now share prevention messages with the broader community and hope and cheer for those living with rheumatic heart disease. Serving as a permanent reminder for the community about the importance of preventing the illnesses that can lead to RHD and promoting stronger collaborations between health organisations, committing to provide a more wholistic level of care.
What is rheumatic heart disease?
Rheumatic heart disease, or RHD, is a health condition caused by inflammation of the heart valves. It can affect people of all ages, with Queensland children as young as five currently living with the condition.
Initially caused by seemingly small infections, like Strep throat or an infected cut in the skin, RHD is preventable. Left untreated, RHD can lead to heart disease and stroke, and greatly affect a person’s quality of life. RHD will often require surgery to fix or replace the damaged parts of the heart.
Events like those held in Biloela and Woorabinda are part of the effort to stop RHD in its tracks in Queensland. Bringing communities, healthcare workers and social services together to educate each other and discuss what can be done to prevent RHD is an approach many hope will see fewer Queenslanders suffering from this preventable disease.
How communities are working to prevent RHD
Community-led health education allows communities to be actively involved in how they learn about and prevent a health condition like RHD. Facilitators say this approach allows for education to be tailored to the needs of the community and delivered in the way they will best receive it.
‘Education should be community led, as we have many different members with various lived experiences,’ says Wendy Gardiner, Indigenous Liaison Officer at Biloela Hospital. ‘What works for one community may not work as effectively in another area.’
Julie-Ann Drayton is the Nurse Unit Manager at Woorabinda Community Health said the Woorabinda event showed firsthand how community-led health education could have a big impact.
‘The event delivered health education in a unique and creative way for the community. Around two hundred people consisting of community members, healthcare workers and different services from Woorabinda, Rockhampton and surrounding areas came together to learn about RHD,’ says Julie-Ann. ‘Involving the community in health events gives them an opportunity to share ideas and provides them with the knowledge to care for each other.’
Julie-Ann feels excited for the future of her community, knowing that this kind of collaboration between community and health services could save many from experiencing RHD.
‘Looking at our now completed mural on the front wall of community health centre is a reminder of what we can achieve when we all work together. This day was only the beginning, and now Woorabinda is committed to eradicating RHD from our community.’
Wendy feels similarly optimistic about a future with lower rates of RHD for the people of Biloela.
‘I feel blessed to be involved in this much needed project for our community, especially seeing how diagnosis and ongoing treatments can be challenging and traumatic for patients and their families if not done correctly,’ says Wendy. ‘Biloela’s event was a great success and enjoyed by all who attended.
A new clinic for people with RHD and acute rheumatic fever is being opened at Biloela Hospital to provide treatment for locals living with the conditions in a dedicated safe space outside of the Emergency Department.
‘I hope that by all working together through education, promotion and support we can work towards eradicating this preventable disease while walking alongside and supporting patients living with ARF/RHD to ensure they have the best possible experiences when receiving treatment,’ says Wendy.
Causes of rheumatic heart disease
To get RHD, a person must first have a Group A streptococcus infection, otherwise known as ‘Strep A’.
Strep A infection
The bacteria that cause a Strep A infection are often found on the skin and throat, and many people carry the bacteria without becoming infected.
When it does cause an infection, Strep A can cause skin infections or throat infections. These infections can be serious and require treatment with antibiotics.
Symptoms of Strep A infection include:
- fever
- sore throat
- swollen lymph nodes (glands) in the neck
- redness and/or weeping around a skin wound (scratch, cut, bite or graze)
- skin rash
- muscle aches.
If you think you or someone you care for has a Strep A infection, it’s important to see a doctor, as infections can become serious quickly.
Acute rheumatic fever
Some people who have a Strep A infection then go on to have acute rheumatic fever. Acute rheumatic fever (ARF) is an autoimmune response to Strep A infection, which happens when the body gets confused and creates inflammation that affects healthy tissues and organs.
ARF can be mild or severe and can look different in different people.
Signs and symptoms of ARF can include:
- fever
- arthritis which causes one or more joints (like knees, ankles, wrists or elbows) to become hot, red, painful or swollen
- jerky and uncontrollable movements of the hands, legs, tongue and face, called Sydenham chorea
- inflammation of the heart and heart valves – this may or may not cause symptoms
- skin discolouration on the trunk of the body, arms or legs that may look like blotches or patches
- small, round painless lumps called subcutaneous nodules on the elbows, wrists, knees, ankles and spine.
People can go on to develop RHD after having one or multiple cases of acute rheumatic fever.
Preventing rheumatic heart disease
The best way to prevent rheumatic heart disease is to prevent Strep A infections and treat them quickly with antibiotics if they happen.
If someone has had acute rheumatic fever, they can also have monthly antibiotic injections to reduce the risk of them having the condition again and developing RHD. This treatment is required for ten years. This is also the recommended treatment for people with RHD, because having ARF again can make the disease worse.
Rheumatic heart disease in Queensland
RHD is preventable, but hundreds of Queenslanders are diagnosed with the condition each year.
While the disease no longer affects people in many parts of the world, Australia has some of the highest rates of RHD globally. First Nations peoples are particularly affected, and it is one of the leading causes of inequality between First Nations peoples and non-Indigenous Queenslanders.
In Queensland, RHD is one of the most common but preventable chronic conditions among First Nations peoples. RHD takes the lives of two young First Nations people each week and costs $27million in open heart surgeries and medical care per year.
The risk of these skin infections is increased where people live in overcrowded houses with inadequate health hygiene infrastructure, and lack access to culturally safe healthcare. The effects of colonisation and socioeconomic marginalisation increase these risk factors for First Nations people. Because of this, addressing RHD in Queensland requires a multifaceted approach from different government and community services.
Events like those held in Biloela and Woorabinda and programs like the Darling Downs Hosptial and Health Service’s Healthy Skin Healthy Heart and Cairns Hospital and Health Service’s Happy Heart Clinic aim to work with local communities to spread prevention messages, facilitate appropriate treatment for people with RHD, coordinate healthcare services and provide environmental health support.
