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Rheumatic Heart Disease Australia

RHD Resouces

Nurse takes home top honours for her work in Maningrida and shares how her community is working to end rheumatic heart disease

Roz Baartz has taken home the Northern Territory Primary Health Network (NTPHN) Nurse of the Year award in recognition of the valuable work she has carried out in Maningrida since 2011. As the school nurse, Roz, in addition to providing healthy school aged checks, skin checks, immunisations and day-to-day care, is responsible for giving around 80 school aged children their secondary prophylaxis (penicillin injections) to prevent acute rheumatic fever (ARF) and rheumatic heart disease (RHD).

“It’s so nice to be recognised because, you know like many health professionals, I don’t just do my seven and half hours a day and go home, I’m often going around the community after school to help the kids. Even though I’m the school nurse, if I can’t find them in school, I’m not afraid to get out there in the community and make sure they are keeping up with their injections,” said Roz.

Roz knows firsthand the impact ARF and RHD can have, and works closely with the community to prevent, diagnosis and manage ARF and RHD.

“I’m passionate about rheumatic heart disease because it’s such a big problem in Maningrida. As the echo screening showed during the Pedrino study, the rates of RHD here are among the highest anywhere in the world”, said Roz.

Results from the study made headlines around Australia after the study found many cases of RHD.

In her capacity as a well-known and trusted member of the community, Roz and her colleagues at Mala’la Health Service, along with school staff and community members, played a key role in helping carry out the Pedrino study.

“In the second round of screening I didn’t do any echo screening like I did in the first round, instead Killa, Tiffy and I went around the community and brought the kids in who weren’t engaging with the school. These were kids that were missed in the first round or sometimes kids already diagnosed with RHD who needed a follow up with Dr Bo,” added Roz.

The Pedrino study, like Roz’s approach, was successful because of the way it brought researchers, local health staff, teachers and members of the community together. This whole community approach was successful in identifying a large number of undiagnosed cases of RHD while also teaching children about ARF and RHD in their own language.

“After the study, I had this little five-year-old girl bring her mother in to see me. The mother didn’t know why she had been brought in. It turned out the child had a cut on her finger and was worried it was a sore. She said she needed to bring her mum in so I could fix her up, so she didn’t get the sick heart. She learned about skin health and sore throats at school as part of the Pedrino study’s education component.

“During the Pedrino study, they learned in their own language all about skin health and about how serious sore throats can be. Now they know that if they get a sore throat or have skin sores to come in and see me, so they don’t get the ‘sick heart’ as they call it,” said Roz.

In addition to screening for RHD, the Pedrino study involved working side by side with the school’s Lúrra Language and Culture unit to develop a six-week course to teach students about the illness using the local Aboriginal languages.

As the Honourable Warren Snowden recently noted, the whole of community approach happening in Maningrida is “breaking down silos” and children, "don't need to be told, they've learnt. They seek treatment for their cuts and bruises, their infections. They themselves, are taking control."

Teacher Linguist, Mason Scholes told the NT Department of Education, “The students are being taught about the function of the heart, how germs and white blood cells act, how medicines support white blood cells, and the symptoms of RHD, and how to prevent it from worsening.

“These are complex issues, best taught using students’ first languages and resources appropriate for their age. Reducing the burden of this malady demands community participation and culturally relevant education.”

Roz and the community are proud of their efforts and she credits the school education delivered in language for providing the children with messaging they can understand and use to empower themselves to take control of their health.

“The school is going to keep teaching the 6-week course in language each year as part of the curriculum and by teaching the kids, it generates knowledge that will be carried into the future.

“Plus, I love how the kids have taken responsibility now and worrying about their siblings and cousins. It’s really nice when they bring them in and show me their skin,” said Roz.

For people who have ARF or RHD, it’s critically important that they receive these timely penicillin injections every 21-28 days. These injections are necessary to prevent further occurrences of ARF and stop the progression to RHD. Once a child goes beyond the 28-day window they are unprotected and risk a recurrence of ARF and further damage to the heart valves, which can lead to disability and in some cases, death.

“It’s really quite serious and something the community has decided to make a priority and we really think we’re onto something that’s sustainable and will bring real positive change to the community,” said Roz.

And the Commonwealth Government has taken notice as well. A recent pledge by the Commonwealth will see Mala’la health service and four other Aboriginal Medical services across northern Australia receive significant funding over the next three years to add in programs aimed at reducing ARF and RHD

Congratulations Roz! It’s easy to see why you’ve taken home top honours as the NTPHN Nurse of the Year in 2018. And congratulations to the researchers, health professionals, teachers and of course, community members who made the Pedrino study such a success!