At the MRC children’s cardiac clinic we see many hundreds of children with heart disease. About half of these have congenital defects, from simple ‘holes in the heart’ to more complex anatomical problems that would be a challenge for any cardiologist to manage, even in a well-resourced centre. The other half of our young patients have rheumatic heart disease (RHD) which develops following infection with streptococcus bacteria — a common cause of sore throats and skin infections. This disease used to be very common in Europe but has virtually disappeared as a result of improved living conditions and public health.
Early treatment of streptococcal infection with appropriate antibiotics can prevent the development of both rheumatic fever and rheumatic heart disease, while long-term penicillin treatment can stop the progression of damage to the heart if RHD is already present. The main obstacles to controlling heart disease in developing countries, together with poverty, are lack of awareness and resources to implement these preventive measures. For more information on RHD see this
Lancet article.
Rheumatic heart disease is devastating because it ruins young lives, snatching away childhoods and denying children the opportunity to run, play or even walk to school because they are too short of breath. Many more children and young adults are affected by RHD but remain hidden from the healthcare system because they don’t, as yet, have any symptoms. What we see in the MRC clinic is just the tip of a very large iceberg of cardiac diseases.
The Chain of Hope has been working in The Gambia since 2007, providing cardiac surgery in Europe and Aswan, Egypt. So far they have provided corrective heart surgery for over 30 children from the clinics at the Government Teaching Hospital and the MRC. This represents only a small fraction of all those in need, but for the lucky ones their lives have been transformed by the charity’s work. Chain of Hope also helps by providing funds to enable our children to travel to Dakar in Senegal for echo cardiography — a detailed scan of the heart that determines the specific problem and severity — as well as funding blood clotting tests for those who have had surgery and replacement of heart valves.
