Joint Media Release with Hauora Tairawhiti
The number of children with rheumatic fever, New Zealand’s third world illness affecting mainly Māori and Pacific children, fell in 2015, suggesting the local Rheumatic Fever Prevention Programme is having an impact.
In 2015 there were three confirmed cases of rheumatic fever inTairāwhiti compared with 10 in 2014, and 7 in 2013. “The figures, while not statistically significant, are very encouraging,” says Chair of the Rheumatic Fever Steering Group, and Hauora Tairāwhiti’s Medical Officer of Health, Margot McLean.
“The figures suggest that the prevention programme alongside increased public awareness, and the hard work of our local nurses, general practitioners and community health workers, has started to take effect,” says Dr McLean.
The Rheumatic Fever Prevention Programme is a partnership between Turanga Health, Ngati Porou Hauora, Hauora Tairāwhiti, and primary care (medical centres). Rheumatic fever and sore throat education, as well as free sore throat swabbing services are available for the public in an effort to reduce the rate of acute rheumatic fever in Tairāwhiti.
As part of the campaign Turanga Health supported the implementation of rapid response sore throat clinics in Gisborne’s general practices, and in its own medical centre at Te Karaka. On the east coast, children with sore throats are managed by Ngati Porou Hauora general practitioners and nurses based at the local health clinics. Anyone with a child or young person aged 4-19 who has a sore throat can visit a practice for free and with no appointment needed. A nurse will take a throat swab and offer free antibiotics.
In Gisborne if a throat swab comes back positive for Group A Streptococcus (GAS) bacteria, which can lead to rheumatic fever, and where there is consent, the child is referred to Turanga Health’s Rheumatic Fever Prevention Programme. The child and family receive education and support from the programme’s kaiāwhina. This support service will be extended to the east coast later in the year and be provided by Ngati Porou Hauora.
Between May 2015 and February 2016, of the 5899 throat swabs taken across the district, exactly 1000 were found positive for GAS bacteria. In the same time period Turanga Health received 211 referrals to its Rheumatic Fever Prevention Programme for antibiotic education and support, and or a Healthy Home assessment.
Rheumatic fever is associated with cold and overcrowded housing. Because of this, children who have been hospitalised with rheumatic fever (as well as certain other infectious illnesses related to poor housing) are referred to the Healthy Homes programme. Housing-related interventions include referral to health and social agencies, installing insulation and ventilation, and design improvements to the house. The support given may be anything from curtains, draft stoppers (made by Vanessa Lowndes Centre clients), or in some cases help with transferring the family to more appropriate housing. Turanga Health’s Healthy Home kaiāwhina is currently working with 25 families.
One Gisborne mum to benefit from the Healthy Homes initiative, Faith Rihia, says she and her daughter are much happier, warmer, and healthier in their new home which they moved into late last year with help from Turanga Health.
“It was stressful and I had no sleep,” remembers Faith from earlier demanding days when her 11-month-old baby girl had numerous chest, breathing, and throat conditions, leading to multiple hospital admissions. “It’s had a real benefit for [baby] Kerry-Anne and me, things are getting easier, it was a bit of extra help.”
Dr McLean said rheumatic fever is sometimes described as the disease that casts a long shadow. ”The ongoing consequences are serious. Although initial symptoms of rheumatic fever like swollen joints and fever get better, the heart valves may be damaged and this damage is permanent.”
“Young people who’ve had rheumatic fever need a decade, maybe more, of monthly painful antibiotic injections, to prevent the development of rheumatic heart disease, or to stop it getting worse. Rheumatic heart disease can lead to heart failure, the need for surgery, and for some people, a shorter life.”
Dr McLean said work initially done across this region including the school-based throat swabbing programme, and now the rapid response clinics and Healthy Homes initiative, mean in time it might be possible to rid the region of the disease. However there has already been one case of rheumatic fever recorded for 2016 – a reminder that families and health staff cannot afford to be complacent. “Sore throats matter!” says Dr McLean.
Parents and caregivers are reminded that if your child has a sore throat and especially if your family is Māori or Pacific, you need to take them to a doctor, nurse or community worker and get a throat swab.
For more information contact: Margot McLean, Chair of the Rheumatic Fever Steering Group, and Hauora Tairāwhiti’s Medical Officer of Health, 027 294 9379.
Rheumatic Fever – what you need to know
Turanga Health is blitzing exercise boredom by adding a heritage focus to its exercise programme walks and runs.
Gisborne’s new cycle and walkways have inspired the Turanga Health Heritage Trials and this week Three Rivers Medical GPs, nurses and administration staff experienced the unique way of exercising. “It was a gentle introduction to physical exercise without knowing you’re actually doing it!” says Dr Tom James, who often refers patients to Turanga Health.
Turanga Health chief executive Reweti Ropiha says the issue for many people wanting to exercise is that “it can be a challenge staying enthusiastic. Sometimes just pulling on your shoes is the hardest thing”.
To improve uptake and keep whānau (clients) motivated and interested, Turanga Health has incorporated a heritage focus to its walks, runs, and outside exercise sessions. “We want our whānau to want to come back, and this is just one way to do that,” says Mr Ropiha.
The walks, runs and exercise sessions take in all or some of the following locations: Kaiti Hill, Oneroa Walkway, Wi Pere Monument, the Hirini St Cemetery, and each of the three rivers: Turanganui, Waimata and Taruhera.
Five Turanga Health physical activity kaiāwhina have received education in the history and heritage of the area including the geography, voyaging history, social history, and flora and fauna.
Physical activity kaiāwhina Albert Tibble, who took last night’s Heritage Trail, says it is important local GPs referring patients to Turanga Health’s wraparound services know and understand what’s on offer. “That way they might be more likely to refer. It’s about relationship building with the GPs, and sharing with them the nature of the services we offer here at Turanga Health”.
Turanga Health’s services complement care and treatment patients receive from their general practice. Its wraparound services include health and fitness programmes for whānau each targeting a different group - whether it be people with diabetes, or mums with babies wanting to get back into exercise.
Dr James said this type of activity is a really great option for spending time away from TV and computer screens. “Albert shared lots of historical and cultural factoids along the way. I didn’t know for example, that the Te Poho-o-Rawiri Marae had been on two previous sites.”
Three Rivers Medical Operations Manager Lisa Hamblin said “it was a treat to actually take the time to really look at, and appreciate, the beauty of our area with the added bonus of a knowledgeable narrator.”
Earlier this week Ilminster Intermediate School teachers took part in a Turanga Health Heritage Trail. Turanga Health works in a number of local schools and in time wants to share the heritage trail walks, runs and exercise sessions with more school-aged children.
Thirty cigarettes a day, maybe more in the weekend, was a standard day of smoking for 40-year-old Kane Akurangi (Ngati Porou, Ngati Kahungunu) of Gisborne.
The Senior IT Technician was having a cigarette every half hour he was awake, and it was costing him about $30 a day, $210 a week, $10,920 a year.
Kane says those figures didn’t worry him at the time. “I was a typical Māori male. I didn’t care at all. Even when he was diagnosed with type 2 diabetes and a thyroid disorder in February 2015, he didn’t change his cavalier attitude to life. “I thought bugger it. I will die happy doing what I want to do.”
But then a friend, younger than Kane, was also given a short sharp wake-up call about his health and Kane’s way of thinking began to change. “I saw the transition he was going through, and he was losing weight, and getting healthy, and the penny began to drop.”
Not long after, this father of four and Child Youth and Family in-home transitional carer of six, took part in a WERO Challenge. WERO is about teams of people quitting smoking together rather than individuals trying to go it alone. It was developed by the University of Auckland in a bid to help Māori and Pacific people quit smoking (though anyone can take part). Participants are supported by health practitioners and are tested each week with a smokerlyzer.
Kane said yes to being in a whānau and friends group. Registration involved signing up to a smokefree programme like the one offered at Tūranga Health in Tairāwhiti. It also involved adding one special member to the team – the coach. This person had to be a non-smoker and someone who would support his or her smoking team members 100 percent in their smokefree quest. For Kane, this person happened to be his wife and number one supporter, Maida. “She has been amazing. She was the coach and the hero and I couldn’t have done it without her.”
Every week Kane and the rest of the group were committed to their WERO meeting with Tūranga Health smoking cessation coaches. As well as education, support, and smokefree patches and lozenges if they wanted, group members had to blow into the smokerlyzer machine which would reveal if they have any carbon monoxide on their breath. It was this regular catch up that kept Kane on the straight and narrow.
“I had tried to quit smoking before by myself but this was different. Having to go every week was good for me. I would put it into all my diaries and I knew I had to be there, Tuesday, 3pm, no excuses.”
Tūranga Health’s smoking cessation programme is Aukati Kaipapa. Rather than going cold turkey the smoking cessation coaches Christine Nepia and Mere Waihi developed a plan with Kane to help him reduce his smoking and achieve a target quit date.
Kane remembers the first time he chose NOT to have a cigarette. He was driving to Ruatoria for work and normally he’d reach for a cigarette as soon as he got into the car. This time, with the words of his quit coach ringing in his ears and the united quit group behind him, he held off for as long as he could. He got to Tokomaru Bay before he succumbed. “I was bursting at the seams” he remembers, but it was the first step towards cutting down.
Slowly but surely the cigarettes he smokes has reduced every week. Six months on he has one cigarette a week. He admits it’s an odd number of cigarettes to have, and he doesn’t really know why he is still having it, but it won’t be for much longer.
As well as a smokefree journey, Kane has also taken more interest in his fitness and set himself a goal of dropping to 100kg which he has just achieved. He joined a social fitness group called Mekefit and hit Kaiti Hill and the Oneroa Walkway as often as he could.
With the help of friends, whānau, and Tūranga Health, Kane can’t believe the transformation he has gone through. He says Tūranga Health was “100 percent” important to him.
“They motivated me. They always did what they said they would. They pushed me to come back to the sessions and it’s what I needed.”
“My whole mindset has changed. I am inspired to finish things. You have got to get your mind right and then set a target. It’s about taking one step at the time and surrounding yourself with support.”
Email us if you want to receive our media releases.