Preventing heart disease amongst children in rural Cambodia

Chris with the local Cambodian children

In October last year, I took part in a research project like no other. We spent a week in rural Cambodia evaluating Cambodian children aged 5-15 years for evidence of rheumatic heart disease. The initiative, supported by The University of Sydney, saw a team of researchers from around the world, including locals from Cambodia, visit the small village of Sophi, approximately 2.5 hrs drive west of Siem Reap on the Thai border. For me, it was a total eye-opener in every way!

At the age of 45 years, I had never stayed in a place with such poverty. No electricity, no clean water, the lowest of living standards. Yet, meeting the children and families was amazing. The smiles were heart warming. The love and appreciation they showed us was infinite. We clinically evaluated and performed heart checks on a total of 500 Cambodian children in just over 4 days. We set up our “medical centre” at the local school. The project was named “500 Hearts” (

What were we looking for? We wanted to determine how frequently children get rheumatic heart disease (RHD), a totally preventable disease if treated and prevented with antibiotics. While rare in affluent countries, RHD is a major public health problem in the developing world in populations living in poverty with low socioeconomic status and limited access to adequate healthcare. Current estimates suggest 15.6 million people worldwide have RHD with 282,000 newly diagnosed cases and 233,000 deaths each year.  RHD causes damage to the structures of the heart including the valves. Our former prime minister, Mr Kevin Rudd, has required heart valve surgery because of RHD as a child. Importantly, early case identification of RHD in children is critical to reduce the risk of advanced valvular disease by implementing effective programmes of prevention and control.

We were able to provide stocks of antibiotics to the local hospital so that children with early rheumatic changes could be treated. We helped educate the community, including local medical students and doctors. It’s a small step, but the journey has only just begun. We are now planning our next visit in October this year! We will visit a different village in Cambodia, closer to Siem Reap. We hope to be able to identify more children at risk of developing heart problems and initiating early prevention therapy, such that they don’t develop heart disease. Like the previous visit, there will also be “extra bits”… providing the locals with over 200kg worth of clothes, toys, dental hygiene kits, books, colouring pencils, soccer balls and many other fun stuff!

I must confess that in all the research I have conducted to date, our initiative amongst the children and families in rural Cambodia has touched my heart more than any other. Perhaps it’s the smile of the Cambodian children, or maybe the eyes of appreciation and hope amongst their parents. Maybe it’s the awesome team I was a part of, with professors, medical students, nurses, archeologists, and many locals all working together with a common goal to serve a community. Whatever it is, I have developed a real passion for this important initiative to help prevent heart disease in the children of Cambodia.

Prof Chris

More info and photos at


A year of sadness for Norway continues: the tragic sudden death of a world champion swimmer

Within the space of 6 weeks, a third elite athlete has had a cardiac arrest. Bolten footballer Fabrice Muamba survived a cardiac arrest during an FA cup match, while Livorno midfielder Permario Morisini died during an Italian second division match. From elite footballers, today we heard the tragic news of , a world champion swimmer who was one of Norway’s top medal hopes for the London Olympics, who died from cardiac arrest after collapsing in his bathroom during a training camp in Flagstaff, Arizona. He was 26. At this time, the cause of death remains unclear and results of the post-mortem are pending.

As I wrote in my recent blog, a very likely cause of Alexander’s death is an underlying genetic heart disorder, such as a hypertrophic cardiomyopathy or a primary arrhythmogenic disorder. The death again highlights the unpredictable nature of genetic heart diseases. People with these diseases can reach the highest levels of sporting excellence, in this instance, at the Olympic level, yet on a particular day, at a particular time, cardiac arrest occurs and death strikes. On this occasion, the death occurred not during sporting activity, but essentially during very light effort having a shower. Sudden death in the young can occur during exercise, but we have also seen in our clinics that many young deaths occur with minimal exercise or at rest. In some young people, death occurs during sleep. The reasons why sudden cardiac death in the young can occur at any time remain unclear.

After the tragic terrorist attack in Norway on July 22, 2011 that killed 69 innocent civilians, Alexander Dale Oen gave a grieving and hurting nation great hope and a reason to smile with his outstanding efforts in the swimming pool. He was marked as a possible gold medallist in the London Olympics. As with all sudden cardiac deaths in the young, Alexander Dale Oen’s death is a terrible tragedy. We await news of the cause of his death. Norway, and indeed the world, mourns.