Dr Thilini Basnayake was one of many local doctors who attended the 2016 Northern Territory Rheumatic Heart Disease Education Workshop, on the 20th and 21st October.  She was kind enough to sit down with RHDAustralia and answer a few of our questions.

Can you tell me a bit about yourself and how you ended up in Darwin?

I am a Respiratory and Sleep Physician originally from Melbourne. I graduated from Monash University in Melbourne and have worked in various metropolitan and rural hospitals throughout Victoria. Darwin caught my eye due to the unique and valuable clinical experience it offers for physicians, including the exposure to tropical illness, respiratory infections and severe presentations of disease. My specific interests within respiratory medicine include bronchiectasis and chronic disease.

How did you learn about acute rheumatic fever (ARF) and rheumatic heart disease (RHD)?

I learned about ARF in medical school and was encouraged to study details about the disease for exam purposes, but was forewarned that I was unlikely to come across it in Melbourne. I had some teaching regarding RHD as a student and junior doctor.

Have you treated people with ARF and RHD?

Prior to moving to Darwin, I had never treated a patient with ARF. I had come across a number of patients with RHD, but in rarity compared to the Northern Territory (NT) and in a much older cohort of patients than is seen here. In my first month of ward service in General Medicine at Royal Darwin Hospital, we diagnosed and managed at least 4-5 cases of ARF, and many more had pre-existing RHD. In the respiratory patients reviewed both at Darwin and in rural and remote outreach visits, a significant proportion of patients have RHD as a co-morbidity, which often affects their level of dyspnoea and exercise tolerance.

Do you see a need for more training on diagnosis and awareness?

I think there is a definitely a need to educate doctors about ARF/RHD, especially in the NT. This is particularly important to staff who are moving here from other states or countries who may not have come across these conditions before. The stakes are so high when the condition is misdiagnosed or inappropriately managed and for those reasons alone education is essential. I felt quite unprepared to diagnose and manage ARF/RHD when I initially moved to the NT and I hope the transition for future staff can be made more comfortable.

Why did you decide to attend our workshop?

The reason I signed up for the ARF/RHD workshop was to become fluent and competent in the management of these conditions and overall I wanted to understand the conditions better. From the outset, I was impressed by clinically relevant presentations and the organisational structure. For instance, this is the first time that it was made abundantly clear to me that RHD is 100% preventable, which was a shocking statistic to hear when compared to the prevalence of the condition in the NT. I also attended the Q&A session at Parliament House, which was important in keeping policy makers aware and educated on the conditions.

What was the takeaway message from the workshop?

I think it is essential for any health professional working in the NT or other areas in Australia with vulnerable populations to be very familiar with and competent in recognising and managing patients with ARF/RHD. Therefore, I think it is vitally important for staff moving to these areas to learn about these conditions prior to commencement. The RHDAustralia website and Guideline and Diagnosis Calculator App are great starting points and if they are able to attend the workshop, it would further allow them to expand their knowledge further. Through raising awareness and ongoing education of all sectors involved we may be able to reduce the burden of disease in the NT.

I have shared the clinical pearls I learned from the course with our junior doctors and medical staff and encouraged them to participate in the course in the future. I have also referred them to the website and App. I found many speakers’ messages to be very valuable; however, the most memorable aspect of the workshop for me was hearing the stories from patients and carers who have experienced this arduous journey first hand.

The main benefit of the workshop is that it allows for the most experienced and relevant people working in the ARF/RHD field to share their knowledge with the attendees in an intensive learning environment.