Whitney Palmer is one of many Northlanders living with rheumatic fever.
And a Northland District Health Board paediatrician says Northland's rate of rheumatic fever is comparable to those of a Third World country.
Statistics released to the Northern Advocate by the Northland District Health Board (NDHB) show fewer admissions to hospital of first-time episodes of acute rheumatic fever were recorded in 2014 than 2013. However, NDHB paediatrician Roger Tuck said Northland's situation had not improved.
"These numbers don't really mean anything. Last year was one of the worst years I've seen for rheumatic fever," he said. "These numbers are comparable to rates in the Indian subcontinent."
Rheumatic fever is caused by a group A streptococcal infection such as a sore throat. Statistics from NDHB showed in 2014 15 cases of first-episode rheumatic fever requiring admission to hospital were recorded, the third-highest rate in the country. All but one of those cases were people who were Maori and all but two were kids aged up to 14 years.
Miss Palmer, of Pipiwai, was diagnosed last year with rheumatic fever. She said after having an "extremely sore throat" she went to get it swabbed but she did not receive a call back letting her know it was strep throat.
"I broke out in a rash all over and it was really itchy. My partner told me I should go to the hospital. I did and I didn't come out [for two weeks]," she said.
Miss Palmer now has to get penicillin injections every 28 days for 10 years and said she was now unable to play sports.
"I used to play rugby and basketball. I can't now because if I get bumped I'll swell up," she said.
She was now "overly conscious" when her kids, and the kids she teaches at kohanga, have sore throats. "If they've got a sore throat I say to their parents, 'Hey go get their throat checked now. It's not worth waiting'," she said.
Dr Tuck said rheumatic fever was a disease of social deprivation. "This is not a disease of race. It is a disease of overcrowding and poor living conditions. If we all lived in the same conditions, we'd have the same chance of getting rheumatic fever."
While initiatives like the sore throat programme in schools and free GP visits for under-13s were "genuinely really great" he said they didn't get to the root of the problem. "They're the fence at the top of the cliff," he said "We in the health system are very good at diagnosing and preventing further episodes.
"We're really good at treating the heart disease. But we have no impact on the primordial causes of this disease. These circumstances [overcrowding, social deprivation] in which our whanau live result in poorer health," he said.
NDHB has a Rheumatic Fever Prevention Plan to try to combat those numbers that includes partnerships with iwi, advertising, and programmes in schools. Manaia PHO will soon implement a health and housing programme aimed at whanau with high increased risk of rheumatic fever.