An increase in poverty-related illnesses and "Third World diseases" among Christchurch children is worrying health professionals and community workers.
Skin conditions such as scabies and ringworm are cropping up at city medical centres and primary schools as hundreds of families continue to live in overcrowded, damp homes almost two years after the Canterbury earthquakes.
In 2011, there were almost 38,000 hospital admissions for children with poverty-related medical conditions nationwide, and more than 230,000 children are now living in poverty, The Children's Social Health Monitor says.
Some children are being sent home from school with contagious infections, and health professionals fear low-income families are shying away from medical treatment because they cannot even afford food.
The problem appears to have hit the city's Maori and Pacific Island communities hardest.
Cathie Morton, chief executive of Linwood's Piki Te Ora Health Centre, said she had seen a rise in scabies and poverty-related illnesses in children.
Diseases such as impetigo, respiratory disorders, bronchiolitis, scabies and sudden infant death syndrome were prevalent among families living in overcrowded homes, and it was the children or the elderly who suffered first, she said.
Te Puawaitanga Ki Otautahi Trust general manager Suzi Clarke said the trust's eight community outreach nurses had seen a "noticeable" increase in skin conditions among children in the past year.
"Scabies, head lice, asthma and those types of illnesses are a real concern at the moment."
Pacific Island Evaluation registered social worker and trauma counsellor To'alepai Louella Thomsen-Inder said many families were "still living in Third World conditions that I have only ever seen in Samoa".
Thomsen-Inder often visited clients at home and said that in the past six months she had seen an increase in the number of families living in squalor with seriously sick children.
She knew of a family of 15 living in a five-bedroom house where the children crawled around on mouldy carpet and had rashes on their arms and legs.
She had also seen children held back from school with scabies and ringworm scabs on their necks.
Communal living within Maori and Pacific communities often exacerbated poverty-related illnesses, she said.
Aranui Primary School principal Mike Allen said scabies, school sores and head lice were "anecdotally getting worse".
Jo Barlow, principal of Aranui's St James School, had also seen a rise in scabies.
Pre-earthquake, the disease was uncommon, but in the past two years at least five families had contracted it, she said.
Canterbury District Health Board (CDHB) chief of child health, Nicola Austin, said hospital admissions for children suffering from poverty-related illnesses had not increased.
However, healthcare for children under 6 was free and medical centres would often treat respiratory illnesses and skin conditions rather than the hospital.
Christchurch Hospital had seen a slight rise in bronchiolitis and respiratory infections, but the board did not record whether an illness was a direct cause of impoverished conditions, so she could not link the rise to poverty.
Austin is also chairwoman of the CDHB-supported child and youth work stream and said some members had anecdotally reported concerns about overcrowding and poor-quality homes.
Poverty-related illness in children was "definitely" a concern and would be discussed by the work stream this year, she said.
Partnership Health Canterbury community liaison manager Donna Ellen said some families with children over 6 could not afford medical treatment or transport to get to GP appointments.
"We see people every day who don't have adequate means to get by day to day," she said.
"We are seeing people whose health is being compromised because it becomes a secondary thing when you don't have enough food."
The Government established the Canterbury Earthquake Temporary Accommodation Service (Cetas) after the February earthquake to help people find affordable accommodation.
Housing New Zealand announced this month up to 5000 earthquake-damaged Housing NZ homes in Christchurch will be repaired or rebuilt by 2015.
The agency's plans include repairing or rebuilding about 5000 homes within the next three years, with 2000 of those being repaired in the next 12 months.
It also plans to build up to 700 homes in the city by December 2015.
A FAMILY IN CRISIS
A 22-month-old toddler living in a cold and damp Christchurch state house had to be taken to hospital three times in one year for bronchiolitis.
Samoan mother Loreta, 27, who did not want her surname used, sat in a musty, dark bedroom juggling her twin daughters and 5-month-old son as she spoke of her fears for her children's health this winter.
One of the twins, Shammah, who has had a history of respiratory illnesses, clung to her mother's side, crying.
Loreta, her husband and their three young children moved into the Housing New Zealand (HNZ) home in Hoon Hay in June 2011.
After two months living in the house her twin daughters, Shammah and Shaddai, were admitted to Christchurch Hospital for bronchiolitis at 10 weeks old.
Shaddai was kept overnight but Shammah spent three weeks in the neonatal intensive care unit and wound up back in hospital twice more for the same illness that year.
The three-bedroom house has one heat pump, and Loreta said the carpets were damp and mouldy when they moved in.
She scavenged pieces of carpet from a nearby firm's scrap heap before she allowed her children to crawl on the floor, but Loreta believes the "smelly, old carpet and cold house" landed her children in hospital.
Shammah has had health problems ever since and her infections often spread to her twin sister and brother Tsidkenu.
The family of five sleep in the same room for warmth and because Loreta feels it is not safe for her children to sleep on their own.
Last winter, the children came down with the flu together about five times, and Loreta's husband, who works fulltime cleaning crates, had to take time off to help her care for the children.
"When they all get sick together it can be a real handful. It's a lot of work and a lot of pressure and I don't get much sleep," Loreta said.
The family received Working for Families payments, but by the time rent, bills and loan repayments were deducted, Loreta said, they often struggled to afford food, let alone medication.
If the children needed new winter clothes or medication they would have to borrow the money from the community, she said.
HNZ said Loreta's house was fitted with insulation in 2010 and that it had received no complaints about the property.
"We are always concerned when we hear about potential health and safety issues, and a member of our tenancy services team will visit the tenant," a spokeswoman said.
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