Dr Toakase Fakakovikaetau (or Dr. Toa, as she is known to her patients), is a pediatrician, community health adviser, mother of four children, and founder and developer of Tonga’s first Rheumatic Heart Disease prevention program. For eight years, until July 2008, Toakase was the only pediatrician in Tonga, a small country of only some 100,000 people, where almost 40% of the population is under 14 years old.
As a pediatrician, Toa, who studied medicine at the Fiji School of Medicine and did her pediatric training at the University of New South Wales and Prince of Wales Hospital, in Sydney, was struck by the number of cases of rheumatic heart disease she encountered.
In 2003, she set out to tackle this issue with the development of Tonga’s first Rheumatic Heart Disease prevention program. The program reaches out to the most remote island groups in Tonga and screens and detects children suffering from cardiac-related conditions. Under Toa’s leadership, the program has grown significantly, with teams of doctors, nurses, and technicians attending to primary schools and clinics across the country.
Despite the limited financial support and resources, Toa and her team managed in 2003-04 to screen 5,000 primary school children for rheumatic heart disease and provided early, effective treatment through penicillin injection to those who were identified with problems. The basic preventive program was significant in reducing the burden of heart disease as well as liberating precious resources in a country where the cost of sending one child abroad for treatment matched the cost of upgrading preventive services in primary care facilities to systematically provide the care that keeps children with rheumatic fever from getting heart damage.
As recognition of the pioneering impact of her work, Toa was recently awarded the Louise Lown Heart Hero Award. The award is given annually by ProCor, a program of the Lown Cardiovascular Research Foundation in New York, who chose Tonga as the winner from among 14 countries.