Recently in clinic, a teenage boy came in to see me with his dad, because he had some difficulty breathing.

When calling people in from the waiting room, you can observe a lot - the way someone is sitting, how they respond to their name, how they walk etc. 1/11

This looked typical. A disinterested teenager, dragging his feet, hauled in by a nagging parent.

His dad started. Yesterday while his son was jogging up a small hill to his friend's house, (to grab an extra controller), he started to feel very short of breath. 2/11

His son interrupted- it only took about a minute to be so short of breath, that it stopped him in his tracks. "I couldn't catch any air". He fell to his knees, felt faint and nauseous.

It took him a full further minute to recover. 3/11

During that time, he said he felt worried that he might not be able to catch his breath again and it was scary. He couldn't even call for help.

His dad held his hand. 4/11

To examine, a distinctive long vertical scar ran down the middle of his chest. The familiar "lub-dub" heart sounds were overwhelmed by loud crescendo-decrescendo whoosh.

He asked, why did this happen? Will I have any more operations? What will the recovery be like? 5/11

I tried to explain via makeshift analogy, it was due to Rheumatic fever, that the ‘gates’ (valves) to his heart were rusted/damaged, that he will need another operation, and the recovery would take some time...

He looked back at the floor and started to cry silently. 6/11

I tried to give him comfort, explain how brave he was, but the words felt hollow.

This young man loves Basketball - a Golden State fan (he's a bit annoyed they didn't make the playoffs). He loves spending time with friends hanging out and playing PlayStation. 7/11

But due to this brutal disease - typically ONLY seen in third world countries, he can’t play his beloved game or let alone do much that risks get his heart racing.

Something almost completely eradicated in most developed countries, has found itself a home, in god’s own. 8/11

This sad indictment on our society results in every year, 150-200, 4-19year olds, mainly Māori and Pacific kids. Being set up for lifelong disability and disease.

A disease of poverty, inequality, and inaction. 9/11

"The current government and every government has dropped the ball” RNZCGP Medical Director Bryan Betty. @RNZCGP

Again this doesnt have to be the case (ie UK)

But we need commitment from leaders action now on addressing inequity, improving access to housing & healthcare.
10/11

Until then “...there’s no team of five million when it comes to Rheumatic fever” Prof Michael Baker 11/11
@NZCPHM @publichealthUOW @NZDoctor_news @TheRACP @yourNZMA https://www.stuff.co.nz/national/health/122260447/we-have-totally-failed-rheumatic-fever-the-third-world-disease-entrenched-in-new-zealand