Aim
Australia has among the highest rates of acute rheumatic fever and rheumatic heart disease (ARF/RHD) in the world, primarily affecting Aboriginal and Torres Strait Islander children in remote communities. The Deadly Heart ‘Trek’, launched in 2021, started as an active case finding project and grew into a comprehensive RHD prevention program that listens, learns and responds to communities.
Method
The Trek complements ARF/RHD diagnosis and medical intervention through empowering First Nations communities. The program is based on critical reflection and action by listening and learning from community and educating on heart and skin health. It is more than traditional active case finding echocardiogram and skin screening and diagnosis models, with culture being at the heart. Teams include First Nations Leaders, Paediatric Cardiologists, Infectious Disease Specialists, and health professionals. Community consultation ensures cultural safety, with mixed-resource education. Qualitative feedback informs continuous improvement.
Results
3,907 children in 37 remote communities received heart screenings, skin checks, and education (2021–2024).
Improvement in RHD awareness, community trust, and empowerment.
Mentoring of First Nations health professionals
Post-surveys confirmed positive impact, with communities inviting future Treks.
Cultural education for teams enhanced trust, increasing participation.
The Trek facilitated multilingual health literacy content through Take Heart documentary.
Conclusion
RHD remains endemic in remote First Nations communities. Deadly Heart Trek successfully delivers prevention and intervention, prioritising First Nations leadership, cultural safety, and consultation. Sustainable public health responses must integrate First Nations community empowerment, education, early detection and prompt treatment to address the burden of RHD and skin disease.