Children with maggot-infested scalps and pre-schoolers with rotting teeth are among the horror stories that are being revealed by New Zealand doctors.
In a bid to address child poverty, paediatricians have opened up about distressing cases that have left them feeling helpless.
"I see rotting teeth when I lift the lip of pre-schoolers...I see matted hair on maggot-infested scalps needing general anaesthetics just to clean and shave, MidCentral DHB paediatrician Dr Jeff Brown said.
He said for paediatricians around the country these horror stories were "business as usual" and it's getting worse.
"It makes me feel sick that I am turning these children away into damp houses just to have them come back in an even worse state."
He said he saw primary school kids growing up in food swamps whose morbid obesity, hypoventilation and metabolic syndromes used to be the domain of adult physicians.
"I see rheumatic fever and bronchiectasis, 'third world' diseases of overcrowding and poverty, filling hospital beds and clinics."
Brown said no matter how good he was as a paediatrician, no matter how good the inpatient care in hospital could be, he was discharging three in every four kids back to cold and damp homes.
"Which is the main reason they ended up in hospital in the first place."
Association of Salaried Medical Specialists (ASMS) executive director Ian Powell said the impact of poverty on some of the most vulnerable members of our society was chilling.
"Poverty is a challenging, complex issue to fix but as a society it's imperative we find ways to address the underlying causes to improve the health and quality of life for people in our communities.
"This obviously means addressing problems with cold, damp housing, access to cheap, good food, and social supports that nurture children into capable adulthood," Powell said.
Another paediatrician from a provincial town, who could not be named, said families he worked with tried to do their best but it could be an unending struggle.
"We are privileged to have the chance to help. But we are limited in what we can do.
"In a developed country like New Zealand, we can make choices – do we pursue economic growth and enable a small section of the community to accumulate wealth.
"Or do we adopt a caring philosophy where government policy is aimed at improving the education, welfare and health of its poorest...we can't do both."