Five years ago, clinician-researchers from the Wal-yan Respiratory Research Centre, Dr Pamela Laird and Professor André Schultz, uncovered a significant health concern in four remote Kimberley communities. Their study found that more than one in 10 children had protracted bacterial bronchitis (PBB), a low-grade bacterial infection of the airways characterised by a chronic wet cough.
This groundbreaking research was the first to assess the prevalence of chronic wet cough and PBB among Western Australian children. The team reviewed 94 per cent of all children under seven across the four communities, 203 children in total, and found that 13 per cent had a chronic wet cough while 10 per cent had PBB.
In 2022, a follow-up study involving nearly 400 children aged 0-18 years in the same communities revealed even more concerning statistics. The study showed that 17.9 per cent of the children screened had a chronic respiratory disease - either PBB, chronic suppurative lung disease (CSLD), bronchiectasis, or asthma. Both PBB and CSLD, if left untreated, can lead to bronchiectasis—a severe, progressive lung disease that causes irreversible, life-shortening damage.
The primary symptom of these conditions is a wet cough that lasts for four or more weeks. Early identification and treatment of chronic wet cough are crucial to halting disease progression.
These studies have filled a critical information gap regarding the prevalence and severity of chronic lung diseases in Aboriginal children. They underscore the need for culturally appropriate information and education to help Aboriginal families and health practitioners recognise and address chronic wet cough in children.
In response, culturally secure community campaigns about chronic wet cough have been developed and implemented in several Western Australian Aboriginal communities. Additionally, teaching modules for medical staff on the culturally appropriate management of PBB and chronic lung disease in Aboriginal children have been created in collaboration with the The Kids Research Institute Australia, Aboriginal communities, and Aboriginal health services.
Dr Laird emphasised that the key to improving the lung health of Aboriginal children lies in establishing strong community connections.
Recently Dr Laird and a team from the Wal-yan Respiratory Research Centre - including Mikayla Garstone, Julia Casella and Emily Wray - returned to one of the original study communities, to assess the current health status of the children.
“During our visit in June, we partnered with Sarah Thomason, a physiotherapist from Broome Hospital, the Kimberley Aboriginal Medical Service, and local community navigators, including Eva and Verna, who have both participated in the studies,” Dr Laird said.
This collective community effort and the relationships we've built are making a real difference in improving the lung health of children in these communities.
Dr Laird highlighted the importance of ongoing community involvement and collaboration in addressing health issues and fostering better outcomes for Aboriginal children.
This year, in response to a direct community request, Dr Laird’s team also conducted screenings for middle ear disease among children. This initiative was carried out in partnership with Associate Professor Chris Brennan-Jones’ Ear Health team from the Wesfarmers Centre of Vaccines and Infectious Diseases at the The Kids Research Institute Australia.
This effort resulted in a record screening of nearly 150 children, representing 96 per cent of children in the community.
“Such high recruitment rates are achievable thanks to the local expertise and knowledge of community navigators like Eva and Verna,” Dr Laird said.
Dr Laird recently spoke to Eva and Verna about their community and the work everyone is doing to improve the lung health of the kids:
What is it like living in your community?
Verna and Eva: Well the shop is very expensive and it’s far from Broome, but we do have all the necessities here. The clinic is great so we can get medical help. We would much rather live here because Broome is more hectic. Here it is – how would you say - more peaceful. It’s hard to explain, but it just feels like home, and it feels safe. We have support of our families. If we want to go fishing, we can borrow a car. With our kids – all our family, my sisters, the aunties, my parents, grandmothers and cousins – they will all be here, or some will come to visit and they will help out with the kids so I can cook. We love to go fishing.
What do you remember about being a part of the lung health study in 2021?
Eva: I remember you came, and you were talking about wet cough. I didn’t know before you came about the story. It was really good because most people just thought that it’s just a cough and that kids will get over it. So, it helped my family understand how important it was. I didn’t have a problem with a wet cough though, but lots of kids did.
Can you tell me about your little one?
Verna: Well, it was really good that you came. Because I had been going to the clinic for her, and I didn’t really know about the cough for more than 4 weeks was a problem. The clinic had given me the medicine. But they didn’t explain how the cough was so serious. And you asked me how long? And when I found out that it was over a month, and she needed medicine, it was very helpful. Because when I saw how the coughing could hurt and damage her lungs and make her very sick, I understood. The diagram in the flip chart really helped me see.
Why did you choose to help the The Kids team by doing the navigating?
Verna: Well people don’t always like to come to the clinic. They feel more comfortable at home. And you come out to the homes, so I think that is a good way of helping families. You see them in their place. And I know where all the kids live. I can work out which kids are in the one street and coordinate a good way to group the families and save time so we don’t go back and forth. So, we can locate where the kids are. Sometimes for instance, the child might live with the auntie, so we have to go to aunties place instead, not the mothers. We also know if there is sorry business going on and if we should not go to some families.
What would you like to see happen in the future with The Kids coming to your community?
Verna: In the future, I hope the community don’t need me to navigate because they trust you mob and they know you so well. I like that you come back and follow up. That is important.
What have you learned by working with our team?
Verna: Well, I am really bossy with kids, and you have taught me to be calm. You guys ask and explain to the kids and families. And I can see that helps us trust and understand. Some people are not used to being spoken to nicely. They worry they’ll get growled. But you are kind and I watch the way you talk with them and you play with the kids and you really care. So that makes a big difference watching how you do things.
Learn more about wet cough and view a range of wet cough resources on our Wet Cough web page here
The Wal-yan Respiratory Research Centre is a powerhouse partnership between the The Kids Research Institute Australia, Perth Children’s Hospital Foundation and Perth Children’s Hospital.
Photo captions:
Top photo: Pictured is Indie (right), daughter of Broome Hospital Physiotherapist Sarah Thomason, with Layla (left), daughter of Verna, a local community navigator. Indie and Layla have both taken part in the lung health study.
Second photo: Pictured is (left to right) Dr Pamela Laird (study lead), Janine Schoveller (from The Kids Kulunga Aboriginal Unit in the Kimberley), Eva Baksh (local community navigator), Verna Baksh (local community navigator) holding Layla-Faith, Sarah Thomason (Broome Hospital paediatric physiotherapist), Mikayla Garstone (The Kids Aboriginal Project Officer), Emily Wray (The Kids physiotherapist researcher) holding baby De’Andre, and Julia Casella (The Kids Research Assistant).