RHD screening has just started in Pohnpei’s District 2 but the results are already disturbing


By Bill Jaynes
The Kaselehlie Press
November 24, 2016
Pohnpei, FSM—Pohnpei is not letting any moss grow under their feet as they seek to screen all of Pohnpei’s children for Rheumatic Heart Disease (RHD). It’s too an important of a health matter. Screening for the disease began in Elementary Schools in Nett, U, Pingelap and Mwoakilloa on Monday of this week. It was funded by a Congress appropriation of $46,000 sponsored by Senator Esmond Moses for Pohnpei’s Election District 3. The screening is also supported by Mahi International.
In March of this year, Dr. Payne Perman made the startling announcement that Pohnpei’s Election District 1 (Sokehs and Kolonia) likely have the highest per capita rate of RHD in the world, or at least that have been recorded. That announcement came after 22 days of screening in District 1. Due to lack of parental consent, only 71 percent of students were screened. They still screened 1881 students and found 39 cases of RHD that required immediate treatment.
So far, the results in District 3 are even more staggering. Already they have found 42 definite cases of the disease that will require immediate but easy treatment. At press time, much less than half the number of students that were screened during the entire RHD screening in Election District 1 (Sokehs and Kolonia) had been screened at Nett Elementary School.
Today, RHD screening was happening at Awak Elementary School but at press time, those results weren’t yet in.
During the Nett Elementary screening, the team also found 20 cases of borderline RHD that will be monitored once a year. Three cases of Congenital Heart Disease—diseases children were born with rather than acquired were uncovered. There was one case of a child with a tumor within the heart that was confirmed by pediatric heart specialists at Children’s Hospital of Orange County in California who act as consultants for the team. Parents would not have known without the screening.

Money is an issue.
Senator Esmond Moses added $46,000 to a Congress project bill to help pay for the current screening. Senator Ferny Perman did the same for the screening in his district that happened in March. It’s what it costs to avoid the needless death of some of our children.
The cost is low both in terms of human life and economically. One surgery to repair heart valve damage that could have been treated early with inexpensive drugs like Penicillin costs approximately $50,000 in the Philippines, more than the cost of screening every elementary school child in one Election District in Pohnpei.
Dr. Payne Perman said that in countries with highly developed medical systems, the prevalence of the disease is low, but in countries like the FSM, which has never had a screening program, people die needlessly.
RHD is a disease that causes life threatening abnormalities in the valves of the heart that if left untreated will eventually lead to an irregular heartbeat, heart failure, and premature death. RHD is asymptomatic to the person experiencing it. Children won’t know they have a developing heart problem and parents won’t know by looking at their child. It can only be found by echo cardiogram ultrasound testing by specialists until after it’s so late that expensive surgery that may or may not be successful is required.
Acute Rheumatic Fever is an inflammatory disease that can develop after pharyngitis caused by Group A Streptococcal infection, usually during childhood. RHD is the result of heart valve damage caused by this inflammatory disease. The screening process can detect the disease early so that preventive measures can be taken to keep it from developing into RHD. The process of the echocardiogram that can detect the precursor to RHD is completely painless and harmless to the child but vitally important.
Two children we photographed while they were being evaluated at Awak Elementary school certainly seemed nonplussed about the completely harmless procedure.
The team evaluating the RHD status of children in District 2 consists of Mrs. Sera Rayasidamu, an echo technician from Fiji, Mahi International volunteer Mary-Rose Benjamin, an d Dr. Payne Perman.
Perman said that screening is expected to begin in Pingelap and Mwokilloa just over two weeks from now.