Tragic girl who should have lived

By ALISON HORWOOD

Looking back, little Phoebe Tautai's health was deteriorating rapidly in 1998.

At least one staff member at Wellington's Miramar North School had expressed concern that the 7-year-old seemed unusually quiet, lethargic, puffy about the face and short of breath.

When teacher Elizabeth Williamson asked her pupil what was wrong, she got a blank stare.

Matters got worse on June 11 and 12. Phoebe was absent for two days, apparently suffering stomach pains.

She returned on Monday, June 15, but by 9.30 am had collapsed between her classroom and the hall.

The child was yellow, feverish, and clutching her stomach by the time her stepfather, Timothy Lafoga, came to pick her up.

The school secretary told Mr Lafoga that Phoebe needed to see a doctor. She never did.

Within a week, Phoebe was delivered dead to Wellington Hospital.

At a hearing of the Coroner's Court in Wellington, evidence was given that Phoebe died of cardiac failure, the result of undiagnosed and untreated rheumatic fever.

Dr Jane Zuccollo said a post-mortem examination showed congestive cardiac failure due to rheumatic pancarditis, present in association with rheumatic pneumonitis.

It often occurs a few weeks after an episode of group A streptococcal throat infection, which Phoebe may have had in early 1998.

Rheumatic fever was a child killer early last century, but become less prevalent in developed countries with the advent of penicillin.

Dr Zuccollo said that although it was not possible to say whether Phoebe would have survived, if she had been seen by a doctor at the time, it was unlikely "clinical findings would have been missed".

The recently released findings of coroner Gary Evans show that Phoebe saw a doctor only once. As a six-week-old baby, she was vaccinated against diphtheria, pertussis, tetanus and haemophilus influenza B. Followup shots were refused.

Her clinical notes at the Newtown Union Health Service record "strong feelings in the family against Palangi (Pakeha) medical intervention".

According to evidence, Phoebe and two younger siblings were taken to a relative if they were sick.

Mr Lafoga told the court that on June 15, he took Phoebe home and put her to bed.

The next day she was up, and he wrote the sickness off as a tummy bug. "She never talked much any way, and now she wasn't complaining about being sick any more."

Phoebe's mother, Nive Tautai, said in her police statement: "She doesn't talk. I don't know why. She was brought up like that."

A few days later, Mr Lafoga rang the school to say Phoebe needed a few days off. He said she had seen a doctor but, according to evidence, "in fact, she hadn't".

By June 20, Phoebe was back in bed. Mr Lafoga said she wasn't complaining, but he could see her rubbing her stomach.

At 11.30 that night, she was feverish and Mr Lafoga put her into a cold shower. She collapsed.

He wrapped her in a blanket and drove to the hospital, stopping in Miramar to pick up his mother.

In his findings, Mr Evans described Phoebe's death due to an undiagnosed illness as "tragic".

On the evidence, it appeared that Phoebe's parents failed to provide the minimum level of care for her health that reasonable parents would provide to their children, he said.

Police investigated the death, but Wellington inquest officer Senior Constable Rob Gibbison told the Herald: "The police did not believe, and still do not believe there is, or was, enough evidence to substantiate any charges in relation to negligence on the parents' part".

Mr Evans has made recommendations for the Ministry of Health and Ministry of Education to work together to stop other children falling through the cracks as Phoebe did.

Although the primary responsibility for a child's health lies with its caregivers, teachers must also be alert to signs of illness, he said.

Phoebe's teacher, Mrs Williamson, had expressed concern orally, but no national guidelines existed for the school to take the concerns up with a Public Health Nurse.

While Phoebe seemed well cared for, Mrs Williamson had several concerns. The little girl had an absentee problem, and was late about three days a week.

Her mother said she was to blame because she couldn't get out of bed in time to get the children ready.

Her stepfather, Mr Lafoga, told the school if Phoebe was forced to go swimming she would be withdrawn from the school. No medical certificate was produced, but teachers were told that Phoebe had "nits".

Mr Lafoga told the Herald he did not want to talk about Phoebe's death, and the family just needed to "move on". As young parents at the time, they had learned a lot.

"We have three kids of our own now. If any little bits and pieces happen to their body, we rush them to the hospital."