Rheumatic heart disease (RHD) is a devastating condition that affects an estimated 34 million people worldwide, with sub-Saharan African countries bearing the heaviest burden. Caused by an autoimmune response that follows a Group A β-haemolytic streptococcal infection of the throat, and probably of the skin, the valves in the heart become progressively damaged following repeated bouts of acute rheumatic fever, subsequently resulting in RHD. Rheumatic heart disease destroys children's lives by taking away their ability to exercise normally, play football, walk to school or even to lie flat in bed to sleep at night and it does so at an age when they should be bursting with life and energy. The tragedy is that this is an entirely preventable disease. Prevention is easy and simply requires treatment of sore throats and skin infections with penicillin - one of the cheapest and oldest antibiotics available. It is, therefore, devastating to see so many young children's lives destroyed by this disease.

As there are currently no cardiac services in The Gambia, Chain of Hope partners with the MRC Unit The Gambia, to care for many Gambian children in need of cardiac intervention. Almost 40 young Gambian children and adolescents have benefitted from cardiac surgery, funded through the Chain of Hope charity, UK. Chain of Hope sends specialist cardiologists to conduct teaching sessions and carry out follow-up cardiac clinics in The Gambia. As part of a longer-term vision, Chain of Hope is also training Gambian physicians and healthcare professionals in echocardiography and paediatric cardiology with the help of a grant from the European Heart for Children. Last week the Clinical Services Department at MRC Unit The Gambia hosted a team from the Chain of Hope charity lead by Dr Giselle Rowlanson, a paediatric cardiologist from Royal Brompton Hospital, London and Jennie Wightman. Dr Giselle Rowlanson assessed some of the children with heart disease that are being treated in our clinic in Fajara and at the Edward Francis Small Teaching Hospital, in Banjul.

During their visit, the team urged all to help prevent more young people developing RHD and advised parents and staff present to stay alert and spread the word. “ if your child develops a sore throat please take them to the clinic to get antibiotics and advise your friends and neighbours to do the same for their children.”