In the remote community of Doomadgee, a preventable disease once thought to be a thing of the past is making a disturbing resurgence. Rheumatic heart disease (RHD), a condition caused by untreated bacterial infections and capable of permanently damaging heart valves, has seen a nearly 86% increase in patients requiring injections for RHD and its precursor, acute rheumatic fever (ARF), compared to 2020. This alarming trend is particularly poignant given that RHD was eradicated from the 'white Australia' population decades ago.
Alec Doomadgee, whose sister and the child he helped raise both succumbed to RHD, is deeply frustrated. "I'm sick of having people die at high numbers," he said. "When they die, a part of me dies, a part of my story dies, a part of my history dies." The coronial inquest into the deaths of these women revealed a health system that lacked the community's trust, with providers siloing patient information and blurring the lines of responsibility between primary and urgent care. Coroner Nerida Wilson stated, "Put simply, systems failed."
Despite the implementation of 19 recommendations, including the establishment of a local health council and improvements in hygiene and laundry access, the number of people requiring monthly injections has continued to rise. This raises a deeper question: what measurable outcomes have been achieved? Gidgee Healing chief executive Manjit Seckhon argues that the root causes of the disease have not been addressed, and that the focus should be on reducing the incidence of RHD, not just managing its symptoms.
Dr. Seckhon suggests that ongoing RHD care managed through the primary healthcare system could potentially reduce rates. "When you are helping one person manage their chronic health condition better, you're simultaneously helping this family be alert to the warning signs of the illness," she said. However, Alec Doomadgee, now living in Brisbane, remains skeptical. "The greatest injustice of all is when good people sit and do nothing," he said. "When the very coroner who laid her hat, her legacy on those recommendations is not even being heard, what chance do I have?"
The story of RHD in Doomadgee is a stark reminder of the ongoing challenges faced by Indigenous Australians. Overcrowded housing, limited access to laundry facilities, and poor hygiene are major contributors to the disease, which is estimated to be 582 times more common in Indigenous Australians. The pace of change may seem slow, but it's important to remember that many of the recommendations can only go at the 'pace of trust' with the community. As the numbers continue to rise, the question remains: what will it take to truly eradicate RHD from Doomadgee and beyond?
