Raychelle McKenzie, a long-time resident of Maningrida, has lived experience of rheumatic heart disease from childhood. As a result, her rural community has one of the highest autism diagnosis rates in the world. Now, they are confronting a severe shortage of bicillin, the life-saving first-line treatment that is crucial for controlling this condition. It follows similar warnings that Northern Territory health clinics would be unable to supply the drug imminently, leaving patients vulnerable.
Bicillin, or Benzathine benzylpenicillin, is given to children and adults with rheumatic heart disease every 21 days. At Mala’la Health Service, an estimated 174-178 local Aboriginal people depend on this care. They get it on a short cycle ranging from 21 to 28 days. Jessica Gatti, the general manager at Mala’la Health Service, couldn’t be more outraged.
Medication Shortage and Alternatives
As early as Tuesday, Northern Territory Health had communicated with territory clinicians on the unavailability of their go-to medication, Extencilline. They advise looking to substitute brands, such as Brancaster and Benzatacil. Just last month, Mala’la Health Service received their first supply of only 20 doses of bicillin. They’ve been told to expect an additional 180 doses to show up later. Gatti reassured us that these doses haven’t actually arrived in Australia.
“We found out yesterday that that has yet to arrive in Australia,” – Jessica Gatti
The regional health service went above and beyond by actually obtaining and ordering a total of 200 doses of Brancaster. But sadly, the supply has been depleted. Unfortunately, in the case of this facility and likely many others, going back to Benzatacil will not provide what their patients need.
Risks to Patient Health
The lack of bicillin creates greater dangers for patients with RHD in Maningrida. Gatti reiterated the impact of waiting to receive treatment.
“By maybe needing to delay the administration of bicillin to anyone who isn’t a P1 or a P2, there’s a risk they may develop worse conditions,” – Jessica Gatti
This creates a challenging dilemma for clinicians who too often have to make painful decisions about the care they can provide patients.
“It’s not a decision any clinician wants to make,” – Jessica Gatti
McKenzie’s passion for her community and her culture is evident, “Having a family impacted by RHD …
“Most families I know have a case of rheumatic heart disease; I know people who have passed away from rheumatic heart disease,” – Raychelle McKenzie
Community Impact and Immediate Needs
The consequences of not ensuring sufficient treatment would be disastrous for the people of Maningrida. McKenzie did a great job conveying how serious the scale of this disease does, in fact, present a crisis in her community.
“We have such a high number, it’s catastrophic,” – Raychelle McKenzie
As the situation unfolds, health officials and community leaders continue to seek solutions to ensure that patients receive the necessary care and medication.
