Coalition of the willing

In the first of a four-part series on community efforts to defeat poverty, REBECCA MACFIE visits Hastings, where locals and state agencies have joined forces to give children a better start in life.

- REBECCA MACFIE

Three-year-old Te Awhenga leans into her mother's lap and coughs a wet, phlegmy cough, delivered from lungs permanently damaged by repeat infections.

Just before Christmas last year, after 2½ years of GP and emergency department visits with upper respiratory tract infections, Te Awhenga had a CT scan under general anaesthetic. She was diagnosed with bronchiectasis, a disease that will afflict her for life.

Te Awhenga and her mother, Rarangi Matiaha, are with nurse Nora Dunphy, a specialist in childhood respiratory disease at Hawke's Bay Hospital, when they welcome me into the consultation room. Dunphy explains the damage that has been sustained by the little girl's lungs: "The bronchi - the tubes in the lungs get infected, and become saggy and enlarged, and that becomes an area where mucus builds up. That creates a cycle of infection that goes around and around." Te Awhenga will need ongoing treatment - two-week courses of antibiotics probably three or four times a year, daily chest physio at home to help clear the build-up of mucus in her airways, three-monthly check-ups by paediatricians until she is 18, and ongoing care into adulthood. It's likely she will need intravenous antibiotics at times.

Last month, Matiaha was told she would need to take Te Awhenga to Auckland's Starship Hospital for a bronchoscopy. The procedure involves another general anaesthetic so a specialist can insert a scope down her windpipe and into the lungs to investigate the state of her airways, wash out secretions and check what infections may be lingering.