Rheumatic fever campaign: online videos

These online videos include stories of people who have survived rheumatic fever, and information about getting treatment and support.

On this page:

Rheumatic Fever – an educational video (English, 4 min 20 sec)

Tofiga Fepulea'i: Talofa lava. My name is Tofiga and I’m here to talk to you about rheumatic fever.

I want you to know all about it. How it works and how you can avoid it, so that it doesn’t affect your children or your whānau.

[Video of Tofiga Fepulea’i standing in school grounds, talking to camera]

What is rheumatic fever?

[Title slide with text of heading; music track; no voiceover]

Tofiga Fepulea'i: Rheumatic fever is a serious disease that can affect your child’s heart. You can’t catch rheumatic fever. But you can catch the strep throat germs that can sometimes turn into rheumatic fever.

Sounds tricky? Let’s talk to someone who knows a whole lot more than I do.

[Video of Tofiga Fepulea’i standing within school grounds, talking to camera]

Dr Sarah Sciascia: Kia ora, my name is Doctor Sarah Sciascia. I’m a GP at Ora Toa Takapuwahia Medical Centre in Porirua.

Sore throats are common in children. Usually, a sore throat can be caused by a common cold or a flu and get better on its own.

[Video of Dr Sciascia in her clinic, talking to camera]

But strep throat is different. It needs to be treated with antibiotics straight away.

Rheumatic fever can develop from a strep throat if it’s not treated with antibiotics.

[Dr Sciascia voiceover. Video of children and mum heading towards the clinic in slow motion and being welcomed in by the nurse – children sit on the clinic bed]

Sometimes it can be hard to tell the difference

[Video close up of Dr Sciascia talking to camera]

between a common sore throat and a strep throat by just looking at it,

[Video cuts to close up of nurse’s hands as she puts on rubber gloves]

so get your child’s sore throat checked by a doctor or a nurse.

[Video close up of child getting a throat swab]

They may take a throat swab to test for the strep germs.

[Video close up of Dr Sciascia talking to camera]

How does strep throat turn into Rheumatic Fever?

[Title slide with text of heading; music track; no voiceover]

Dr Sarah Sciascia: In some young people – mostly aged between 4 and 19 – if a strep throat is not treated with antibiotics it can turn into rheumatic fever. This usually happens 1 to 5 weeks after your child has had a strep throat.

[Video of Dr Sciascia in the clinic talking to camera]

Dr Sarah Sciascia voiceover: What happens is, sometimes when the child’s body tries to kill the strep throat germs mistakenly it attacks other parts of the body too.

So the young person can have sore joints like their ankles, their knees and their hips. They can feel really tired.

And these are signs of rheumatic fever. It can sometimes go on to cause damage to the heart valves, which can lead to rheumatic heart disease – the next stage after rheumatic fever.

[Video shows animated diagram of strep throat germs going into the mouth and throat, then pulls back to show the full body with joints highlighted by red pulsing circles and a pulsing, damaged heart – the areas most affected by rheumatic fever and rheumatic heart disease]

Dr Sarah Sciascia: People with rheumatic heart disease may need heart surgery. Because of damage to the heart, rheumatic heart disease can sometimes lead to an early death.

[Video of Dr Sciascia in clinic, talking to camera]

How rheumatic fever affects your child and your whānāu

[Title slide with text of heading; music track; no voiceover]

Tofiga Fepulea'i: My family has been affected by rheumatic fever – my aunty got it when she was just a young girl.  And I hear stories.

Powerful stories. Like a young woman from this very community.

[Video close up of Tofiga Fepulea’i talking to camera]

Tofiga Fepulea'i voiceover: She’s 17 now, but when she was 9 she found out she had rheumatic fever.

Her joints were sore, she was really, really tired every day,

[Video cuts to close up of Tofiga and the young woman’s feet as they walk along the beach]

her feet got so sore she couldn’t even walk.

When she was told she went straight to the hospital and spent 8 months in bed. No playing, no out and about, you know it was a scary, hard time for the whole family.

When she was 10, things got a whole lot worse. The doctors said that she needed a heart valve transplant and she was flown straight to Starship hospital in Auckland.

[Video shots of Tofiga Fepulea’i walking along the beach with the young woman who shared her story]

Tofiga Fepulea'i: Since then she has had Penicillin injections once a month – and she still has a few years of this to go. She tells everyone, if your children have sore throats please get them checked.

[Video of Tofiga Fepulea’i in school grounds talking to camera]

Rheumatic fever is preventable

[Title slide with text heading; music track; no voiceover]

Dr Sarah Sciascia: Rheumatic fever is preventable.

If your child is given antibiotics for a strep throat, they need to take them for the whole 10 days – even if they’re feeling better.

It takes 10 days to kill all the strep throat germs.

Tofiga Fepulea'i: Children can get strep throat more than once. Every time your child has a sore throat, please get it checked out, and if it is strep throat again, they will need antibiotics again.

And just like a cold or a flu, strep throat germs can be easily spread. So remember when coughing and sneezing cover your mouth and wash and dry your hands often, especially after coughing and sneezing.

[Video of Dr Sciascia and Tofiga Fepulea’i in the clinic. As doctor instructs to ‘cover your mouth’, ‘wash and dry hands’, Tofiga mimes the actions, then coughs into his elbow. He jokingly wipes the germs from his arm and sprinkles them over the doctor who reacts with a mock tap at Tofiga]

Text only: Tena Koe, Fa’afetai, Malo
Thank you for your support and help in developing this video.
·Dr Sarah Sciascia and Tofiga Fepulea’i
·Staff and community of Ora Toa Takapuwahia Medical Centre, Porirua
·Parents and caregivers who tested the creative concepts
·Young people who shared their stories

[Video text frame of acknowledgements – music track; no voiceover]

For more information about preventing rheumatic fever visit rheumaticfever.health.govt.nz

[Video endframe with url to visit, programme logo (Stop Sore Throats Hurting Hearts) and organisational logos (Ministry of Health and Health Promotional Agency) – music track; no voiceover]

Rheumatic fever - a parent's perspective (English, 3 min 52 sec)

Paula, mum to Riley and Hakopa, talks about what it was like when Hakopa got rheumatic fever. 

Riley: My name's Riley, and I'm eleven years old and this is my brother.
Hakopa: My name is Hakopa and I had rheumatic fever.
Paula: Hakopa's been a natural athlete pretty much since he was a little kid. He's been playing rugby since he was four years old.
Riley: He's pretty much one of the fastest people I know. He plays nearly every sport.
Paula: He's the last one to get sick in our household. I remember that time that he did have a sore throat I didn't think anything major of it. We let it ride, you know, Pamol, rest and then bouncing back. The next day he was well enough to go back to school. We had no idea what rheumatic fever was. When the doctor told us that he would need heart surgery she mentioned that there was that slight possibility that he may not make it. It didn't seem real. I sort of, I didn't... 
Hakopa: My mum felt really sad when they told her that I had, had to have surgery.
Paula: You know, hearing that your son might not make it through a surgery and then you think back as a parent thinking... how did we get here? How did we get here? How did my son who was perfectly healthy, running around the same as he would every other time, every other day... It makes you think, only if I had, only if I had taken him to the doctor when he had a sore throat six months ago and got some antibiotics to get rid of any sort of infection. He'd be okay. Open heart surgery, penicillin shots til he's 30 years old... these are all things that could have been avoided if, if we had just taken him to the doctors at the time when he got a sore throat.
Riley: We are not really allowed to kick balls around, but we still do.

The boys kick a ball against a fence.

Hakopa: If Mum sees me doing anything including sports she will not let me go outside for the rest of the year...day...no for the year...no...(laughter) Yeah life's real different now because I'm not allowed to do any sport. It feels dumb that I'm not allowed to play rugby.
Riley: A sore throat may not seem like anything really, but it could lead to rheumatic fever and you could end up having a scar down your chest like my brother.
Paula: It's not cool to take the risk of... I'll see what happens tomorrow. I'll see if it's okay tomorrow... As soon as your kid gets a sore throat, then you need to go to the doctors. We all need to go to the doctors to get it checked.
Narrator: Sore throats can lead to rheumatic fever and heart damage. Every time your child has a sore throat please get them checked by a doctor or nurse as soon as possible. If you're not sure what to do, call Healthline for advice.

Rheumatic fever - a child's perspective (English, 3 min 29 sec)

Talia'uli tells us what it was like to hear that he couldn't play rugby after he got rheumatic fever.

Talia'uli: My name is Talia'uli Vete, I'm 11 years old. I play for Mount Roskill District. When I grow up I want to be a rugby player for the All Blacks. I'm learning how to kick like Daniel Carter. One day I went to school where we were running. I was coming fourth, and suddenly my chest like just started feeling like slowing down, and I felt so tired and weak. I dropped back and I started coming second to last. I told my mum I was going to die and I nearly died in the race.
Sitela: He said to me, mum, I nearly died at school, I feel like I don't have any air, any more air to breathe.
Talia'uli: The next morning my mum took me to hospital. When the doctor told me my heart was damaged, I was laughing for a while because I thought it was not true, I thought he was joking, and then they told me it's true. I caught rheumatic fever.
Sitela: I was just sitting there crying and looking at my son and I just said to myself, please don't tell me that my son is going to die, because I don't want to lose him.
Vakapuna: What I felt was how much I love my son. It's quite hard to explain how we feel, when they are like telling us, knowing that there's something wrong with his heart.
Talia'uli: I take injections every month. I have to have my injections until I'm 21. That's 10 more years. The doctor told me not to play rugby for a little while. If I couldn't play rugby anymore I would just feel like bored. I thought my sore throat wouldn't be that dangerous, I thought it would just go away just simply.
Narrator: When you have a sore throat it's best to go to a doctor straight away. Sore throats can lead to rheumatic fever and heart damage. If you're not sure what to do, call Healthline for advice.

Porirua College students rap about rheumatic fever (English, 2 min 10 sec)

Porirua College students Willy Koro and Keeda Walters took part in a rap competition sponsored by Taeoamanino Trust during a health week promotion at the college.

Willy: Rheumatic fever huh? I don't have rheumatic fever but I know that it hurts
Everybody that's watching here, put your mind to work
Cause I'm a tell you something pretty wack and weird, but rheumatic fever's here there and everywhere
Rheumatic fever quick stops the heart, leaving all these pieces here shattered apart
Rheumatic fever's oh so smart and cunning, in a heart beat boom boom you'll be running
and if you have a sore throat listen up and stare, this affects you and you and everybody here
It might be weird and it might be queer yo but listen up yeah, this is rare
Check it out for the heart or it's over in a tear
How about we get together and get rid of this fear cause in a few months you won't be here
to witness the greatness that we could achieve in a year.

Keeda: You get rheumatic fever, I take a puffer for reliever, (cough cough) breather, 
the Ministry of Health says for those who do receive it
to get it's really easy, whether you're wheezy sneezy freezy
diseases and fevers brother please listen to me yeah, and I will guide you there
Hold your nose and close a cold before I wipe your tears, no crying yeah
so let me make a simple proposition watch and listen
if your throat is itchin get a checkup at the clinic
make a step to stop prevent and take a test for getting strep to strep
and save the day, you feeling any better yet? 
Take a chance and take a risk, be prepared or be a dick
because the next you know your life is over in a click
you can call them up and they'll be there to help you
It's not as painful as the pain that we would feel without you
I tell you I've seen a brother going through the pain
I'm here to save you going through the same, Mac's the name, word up.

Narrator: Sore throats can lead to rheumatic fever and heart damage. Every time your child has a sore throat please get them checked by a doctor or nurse as soon as possible. If they're given antibiotics make sure they take them for the full ten days even if they feel better. If you're not sure what to do, call Healthline for advice.

Adeaze talk about rheumatic fever (English, 2 min 30 sec)

Brothers Nainz Tupa'i and Viiz Tupa'i, also known as New Zealand band Adeaze, remember what happened when their cousin got rheumatic fever.

Viiz: Yeah I remember the first time of hearing of rheumatic fever.
Nainz: Yeah that's right, that's our cousin from Hamilton eh. Yeah. I think for me it was like a really scary moment. It's the first time I'd seen like a family member. Because you remember what she was like.
Viiz: Yeah.
Nainz: You know, because she had no control over her body, just constant shaking, had to be fed, had to be changed. 
Viiz: Almost like she was paralysed.
Nainz: Yeah.
Viiz: But it was a big shock because seeing our cousin grow up, you know growing up with her...
Nainz: She was fit, skinny.
Viiz: ...she was able to run around playing netball and everything. Just a normal kid eh. 
Nainz: Yeah pretty much. That was the first time I heard of rheumatic fever as well, and yeah she was lucky to survive it, to come out on the better end. You know, she didn't get that check up as well. That was another important thing.
Viiz Yeah, it's hard to believe, man, that it all starts with a sore throat.
Nainz: You know, the sore throat thing, you know like a lot of kids get sore throats.
Viiz: Oh yeah.
Nainz: You know, it's hard for parents to actually take their kid to go in and get checked up, because they are like, aw nah they just got a sore throat. It shows how important it is.
Viiz: Yeah, it definitely is.
Nainz: Man, even just a sore throat, you've got to take your child in and get them checked up.
Viiz: Sore throats can cause rheumatic fever which can lead to heart damage. 
Nainz: If your child has a sore throat, get them checked up, a simple course of antibiotics can prevent real damage occurring.
Viiz: This is really important, sore throats need to be treated by a doctor or a nurse straight away.
Nainz: If you leave a sore throat unchecked it can lead to heart damage and that's a life long condition.
Narrator: Sore throats can lead to rheumatic fever and heart damage. If you're not sure what to do, call Healthline for advice.

Tila's story about rheumatic fever (English, 3 min 57 sec)

Tila Maresala-Thompson is a whānau support worker and survivor of rheumatic fever.

Tila: I'm one of seven children, I come from Sāmoa and I came to New Zealand when I was a year old.

Tila arrives at work.

Tila (to her colleague): Morning Emily!
Emily: Morning Tila!
Tila: How are you? 

Tila (voiceover): When I was a young girl I used to like helping people, mostly my parents doing housework and things like that, helping out at church. In high school I really wanted to be involved in the health industry, so started my dream of becoming a nurse. My life changed when I was 11. It began when I started getting a sore throat.

I never really thought much about it, but as the weeks wore on, my joints were in so much pain, like they were inflamed, and it was just really painful to move. It wasn't until the day that I really felt like I couldn't move at all that we had to go to hospital and we found out that it was rheumatic fever. Rheumatic fever is something that starts from a bug called strep A in your throat, and if left untreated it will travel to your heart and damage the valves.

Being an 11 year old it was really scary. I wasn't allowed to move at all, I was on strict bed rest, which meant that I couldn't even turn around in my bed without having to call for a nurse to come in and move me. Once I was released from the hospital I had to learn to walk again. When I came back to school, it was hard. I had fallen behind because of how long I had been out of school for. After that it was another 11 years of injections every month that I had to go through which was also hard. 

Tila walks through a school and comes across some students.

Tila: Hey girls, hi! How are you?
Student:  Good! 
Tila: Yeah. How was your weekend?
Student: Good. 
Tila: Yeah?

Tila is in a classroom with a number of students.

Tila: Today I am back at my old school, Kia Aroha College, and I am working here as a whānau support worker, looking after the rheumatic fever prevention programme and I am also in my second year of my health science degree at AUT. 

Tila draws a diagram on a whiteboard.

Tila (to students): ...okay, these are your tonsils right? So, with the...
Tila (in voiceover): I absolutely love what I do, working with the students. I'm comfortable in discussing these things with the students because I know exactly what it's like. I know exactly what families have to go through, the sacrifices, everything, I've been there and done that. Rheumatic fever is a very serious illness but it's also preventable. We can change the way things are happening now, just by being knowledgeable and knowing what to do if your child has a sore throat. I'm married and I have 2 young girls. I absolutely love my family. My name is Whitney Tila Maresala-Thompson and I'm a survivor of rheumatic fever.
Narrator: Sore throats can lead to rheumatic fever and heart damage. Every time your child has a sore throat, please, get them checked by a doctor or nurse as soon as possible. If they're given antibiotics, make sure they take them for the full 10 days, even if they feel better. If you're not sure what to do, call Healthline for advice.

Clinicians talk about rheumatic fever (English and Te Reo, 4 min 4 sec)

Dr Lance O'Sullivan is a Kaitaia GP. Dr Teuila Percival is a consultant paediatrician at Kidz First Children's Hospital. Together they tell us about the impact that rheumatic fever can have on a child's life and that of their family.

Lance O'Sullivan: Kia ora, my name's Lance O'Sullivan. I'm a GP working in the far north town of Kaitaia.

Lance gets to work and greets his colleagues as he walks into the practice.

Lance (to colleagues): Mōrena tātou ma. Kia ora, kia ora.
Lance (voiceover): Yeah I see a lot of rheumatic fever, way too much than we should be seeing, and I'm keen on being a part of stamping it out.

Dr. Teuila Percival, a specialist doctor, is walking down the hallway of a hospital, reading from a folder, then examining a young patient.

Teuila: My name is Teuila Percival and I'm a consultant paediatrician at Kidz First Children's Hospital.

Lance goes into an examination room. There's a parent and child there. He greets the child with a high five and then examines their throat.

Lance (voiceover): Rheumatic fever is so endemic in communities such as Kaitaia, that we see generations of people that have rheumatic fever. We see grandchildren, children and grandparents all having rheumatic fever.
Lance (to patient): Say ah, ah. Is this sore?
Lance (voiceover): That says to me a couple of things. One is, it's been here for a long time and two is, it's not going away.

Teuila is sitting on a hospital bed, talking to the camera.

Teuila: Rheumatic fever is caused by a bug called strep, which affects children by causing an infection in the back of their throat.

Both doctors are examining patients. Then, we see Lance in the examination room.

Lance: What we know is that if you have a strep throat, which is a bacterial infection of the throat, if you don't get antibiotics then there's a chance that within two or three weeks, your body can react in a way that damages the heart.

Teuila examines a chest x-ray on a computer screen.

Teuila: They get inflammation of their joints and they get inflammation of their heart, which is what we worry most about.
Teuila (to colleague): What we are looking at here is the size of their heart.
Lance: So it's really important that we see sore throats early, and that we give treatment and antibiotics. And they have to be taken for ten days.
Teuila: The thing that frightens families most is when you say it's affected your child's heart.

She examines a young patient's chest. The patient is in a hospital bed.

Teuila (voiceover): It comes as quite a shock to families to realise that they've got a serious illness and they don't know how it happened.

She examines the child's throat and then talks with members of the patient's whānau.

Teuila (to the patient): Big wide mouth for me.
Lance: The long-term effects of rheumatic fever on the individual -- it's going to mean that they are going to miss weeks or months of school; they are going to have to ongoing injections, which are painful. The child goes home and they have to be in a wheel chair and carried around the house.

We see some of the families from the Stop Sore Throats Hurting Hearts advertisements.

Lance (continues): That impacts on family, whānau. It impacts on relationships, marriages. What concerns me about rheumatic fever is the future of that child has changed.

Lance approaches the front door of a home and greets everyone as he arrives.

Lance (to the household)Kia ora, kia ora, stranger. Kia ora, kia ora whaea. Kia ora anō.
Lance (voiceover): The potential for that child has been influenced by a simple thing like a sore throat.
Lance (to a boy in the home): Can I have a look at the scar and just see how it's healed? Oh yeah.
Boy: It's all good.
Lance: Yeah, it's not too bad eh.

Children, including Lance's, play on scooters and skateboards at a skate park.

Lance (voiceover): When I'm at home with my children and I'm playing with them, I feel a great sense of joy knowing that these children are going to grow up and be great kids, great New Zealanders. Sometimes though, when I'm holding my children I think: does every dad and every child have that same opportunity? What we are trying to prevent is more kids walking around our community with this scar from having heart surgery. My dream is seeing kids playing on our street, Māori and Pacific children walking to school, and know that they are healthy and they are protected from diseases such as rheumatic fever. Knowing that they have a full opportunity to reach their potential.
Narrator: Sore throats can lead to rheumatic fever and heart damage. Every time your child has a sore throat please get them checked by a doctor or nurse as soon as possible. If they are given antibiotics, make sure that they take them for the full 10 days, even if they feel better.  If you are not sure what to do, call Healthline for advice.

Rheumatic fever—sore throat checks (English, 1 min 45 sec)

Practice nurse Juanita To'o tells us what happens when you take a child to the sore throat clinic, and why it's important to take the full course of any antibiotics.

We're spending time with Juanita To'o, a practice nurse, who's welcoming a young patient and his mum to the clinic.

Juanita (to the family): Hello.

Juanita continues in a mixture of speaking to the camera and in voiceover.

Juanita (voiceover): Talofa, my name is Juanita To'o and I am the practice nurse for Health Star Medical Centre here in Glen Innes. It's very important to check sore throats. If the child with a sore throat has Streptococcus A, it could lead to Rheumatic Fever and heart damage. Don't wait, once they complain please bring them in to see the nurse.  When a child comes in with a sore throat, we assess him or her by taking his temperature, doing his weight and checking his lymph nodes.
Juanita (to patient): Okay, open wide and say ahh. Okay good boy. 

Juanita continues examining the patient and then sends them home.

Juanita: If the child presents with a temperature of 38 and he's got swelling of the tonsils we give them antibiotics straight away. So if your child has a sore throat, come in to the clinic.
Narrator: Sore throats can lead to rheumatic fever and heart damage.  If you're not sure what to do, call Healthline for advice.

Stop Sore Throats Hurting Hearts (English, 8 min 47 sec )

The story of the Rheumatic Fever Prevention Programme so far

‘Stop sore throats hurting hearts’. New Zealand’s cross government prevention programme to reduce the incidence of rheumatic fever.

[Kapa haka group performs on stage]

[Dr David Jansen] Rheumatic fever, the consequence that we're trying to prevent. Rheumatic heart disease will have somebody dying twenty or twenty-five years earlier than they need to.

[Footage of heart surgery]

And they will have had multiple cardiac operations. So there's a huge cost to society there, you know. The lost life years. The lost income. The effect on their family. The effect on our community.

[Melesiu Ula - Rheumatic Fever Prevention Programme, youth ambassador] If we had sore throats checked back then, when I was little in every school we had, everyone had to check their throats, I reckon I wouldn't have rheumatic fever.

[Melesiu's parents sitting at home]

[Veisinia Ula] We never know what's rheumatic fever until they explain to us.

[Footage of Auckland city]

[Melesiu] My name is Melesiu Ula and I'm 17 years old. I am Tongan, full Tongan.

[Footage of Melesiu at a Pasifika festival and jumping on a trampoline]

If you're child has a sore throat you gotta take them to the doctors. You can't just shake it off, like, "oh it's gonna be fine the next morning". But really it's a really big deal because you know it can sore throats can lead to rheumatic fever, rheumatic fever can lead to heart disease. Or more, like worse than that.

[Melesiu handing out flyers and talking to people about rheumatic fever]

[Dr David] We gotta get a whole lot of moving parts. It's not just this, there's no one single king hit in this. There's a whole lot of moving parts we gotta get going on it. Part of it is about community understanding of rheumatic fever. Part of it is understanding that it's sore throats that we need to intervene at.

[Duo 'Dramatic Fever' singing and playing guitar]

[Tony] Thank you everybody. We're the Rheumatic Fever Team. Please come and get some info. It could save your life one day. It could. If you've got a sore throat please go and see the doctor. Don't box it. Don't try and be Superman. Because you're not Superman.

And if you are feeling a sore throat and you don't know if it's worrying or not, you can call free phones at 0-800-611-116 and get it checked out, man.

[Tony]  What number was that again?

That number, Tony, was 0-800-611-116.

[Footage of a child having their throat swabbed by a GP]

[Dr David] Previously, we'd go, "Look, have some paracetamol, get over it, it's okay, it's likely viral, just go to school", and all the rest of it. Now we're saying, take sore throats seriously, get to clinic, get it swabbed, if it's Group A strep, get it treated, ten days, make sure you take the whole lot. Actually an enormous amount of work. And we have to do that consistently. Not once, we have to do it every time they get a sore throat during the year. We have to do it not just for one year, we have to do it for multiple years.

[Nurse] There we go, well done.

[At Te Rangi Aniwaniwa school in Kaitaia - Dr Lance O'Sullivan talking to kids in the school gym]

[Dr Lance O'Sullivan] I would far rather we got better at preventing this problem than becoming experts at treating the complications of it. You're in hospital for quite a long time when you have rheumatic fever.

[Lance sitting outside with Taame]

I remember when we came and saw you, how long were you in the hospital for?

[Taame] I think, eight, nine weeks or something.

[Lance] Eight or nine weeks. Was that hard?

[Taame] Uh, yep.

[Lance] Yeah. Why?

[Taame] Just wanted to go home (laughs).

[GPs preparing to swab childrens throats]

[Dr David] So we've got, you know, hundreds of GPs and we've got practice nurses and we've all of this health practitioner, capacity. And we've gotta shift that to doing the right time, the right thing, the right time, every time.

[TinaLee Yates-Bassett - Taame's mother] They're pretty good up here now. Like, they've advanced a lot to, to when he first was diagnosed. Like, now they have the mobile team in the school so he can just go there when, soon as he gets a sore throat. It's like getting him to self manage it, now.

[GPs swabbing childrens throats]

[Melesiu] I reckon it's just, like, the way we live affects... I think that's why I got sick.

[Melesiu's mother Veisinia stands outside her house]

[Veisinia Ula] We got, like, b-two bedroom. And four girls in one bedroom. Me and my husband in the other bedroom. And the boys in the lounge.

[Melesiu] We had a tight house, with two, with, there were like six kids.

[Veisinia] I think that, overcrowding affected it, that's why Melesiu got rheumatic fever as well.

[Melesiu parents sitting inside their house]

That's a big worry for us, so we were trying very hard to get a bigger house. Trying to get all those letters from doctors and specialists. So we get a strong point for the
housing so we can move to find us a bigger house. But once we move here, yeah, we find it, yeah, very easy for our family now.

[Shots of Melesiu families new house]

[Malia Hamani - Auckland-wide Healthy Homes Initiative (AWHI)] This program is designed to, is going all out to try and make a difference to the lives of people, mainly about the well-being of children in terms of preventing, re-occurrence or having children susceptible to rheumatic fever.

[Veisinia and Malia looking at the window drapes]

The cold air still comes through, because it's really not closing properly. Drapes go here can be hung up.

[Dr David] I think we've got a program that is working. And the evidence that it's working is around the reduction in rheumatic fever and the age group and the populations that we're serving. And the reduction in skin infections admissions to hospital.

[Dr Lance O'Sullivan talking and working with kids at Te Rangi Aniwaniwa school in Kaitaia]

[Dr Lance] I'm seeing it working on a daily basis here in Kaitaia both in the community of, children and the schools that we're working in and also in the clinic. Where we're seeing people coming in and saying "hey, look, my child's got a sore throat. I think they need a throat swab. I want to check for strep throat." Kids saying, "hey I need a throat swab", you know, without telling their parents this. So I think the message is getting out there.

[Prof. Nigel Wilson - Paediatric cardiologist] Research is very important, because we, don't know the answers. So some of the, so primary prevention for example, it has been successful in Cuba, in the Caribbean, even in the United States of America.

[GPs swabbing a childs throat]

But the components of it, was it the sore throat swabbing? Was it the public awareness? Were the health professionals more aware of rheumatic fever? The individual components of that is very hard to, to tease out. And I think New Zealand's taken the bold step of just implementing the primary prevention program.

[Melesiu recieving a rheumatic fever injection]

[Melesiu] Because I have rheumatic fever, I have to take injections every 28 days so I can have a healthy heart. She's taking, like, one each month.

Like I keep up to date with my injections because I don't want to get a surgery. Because I still want to wear dresses, you know. I don't want to wear dress with a scar.

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