Three paediatricians shared their shocking experiences and concerns in a recent article following up the Child and Youth Mortality Review Committee (CYMRC) report released earlier this year.

The CYMRC report found that children and young people living in the most deprived areas were three times more likely to die in childhood or adolescence than those living in the least deprived areas.

MidCentral DHB paediatrician Dr Jeff Brown, writing in the latest issue of the Association of Salaried Medical Specialists (ASMS) magazine The Specialist, said no matter how good the inpatient care in hospital, he was discharging three in every four kids back to cold and damp homes “which is the main reason they ended up in hospital in the first place”.

“I see coughing and wheezing kids from damp and cold houses,” says Brown. “I see rotting teeth when I lift the lip of pre-schoolers, if they have not already had a full dental clearance of all their carried teeth. I see matted hair on maggot-infested scalps needing general anaesthetics just to clean and shave.”

“I see primary school kids growing up in food swamps whose morbid obesity, hypoventilation and metabolic syndromes used to be the domain of adult physicians. I see rheumatic fever and bronchiectasis, ‘third world’ diseases of overcrowding and poverty, filling hospital beds and clinics.”

A provincial paediatrician, writing anonymously, says they try to do their best and families they work with try their best too but it is an “unending struggle”. For example, the parents of a “wheezy infant” needing oxygen now smoking outside, but the child spends the weekends at their smoke-filled grandmother’s home.

“A child with complex medical needs has a mum who looks distracted,” writes the paediatrician. “She is malnourished, front teeth missing. Couldn’t come to the last appointment because she was in hospital… As I walk in town, I pass a thin, dishevelled, ill-looking young man in his 20s, clutching a tattered bag. I recognise him as one of the graduates from the paediatric diabetes clinic.”

Dr Julian Vyas, an Auckland respiratory paediatrician, says the CYMRC report makes for sobering reading.

“If you set out to design a ‘perpetual engine’, you could do a lot worse than use poverty as your model. Many specific poverty-related problems will impinge on other poverty-related problems to reiterate and reinforce a cycle of systemic disadvantage.”

Ian Powell, ASMS Executive Director,said the impact of poverty on some of the most vulnerable members of our society was chilling.

“Poverty is a challenging, complex issue to fix, but as a society it’s imperative we find ways to address the underlying causes to improve the health and quality of life for people in our communities. This obviously means addressing problems with cold, damp housing, access to cheap, good food, and social supports that nurture children into capable adulthood.

“Senior doctors and other front line health professionals are dealing with the consequences of poverty on children’s health every day, and what they see and hear is distressing.”


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