Summing up years of concern about lack of awareness about strongyloidiasis, Wendy co-wrote a landmark article for GP’s entitled ‘Chronic strongyloidiasis - don’t look, and you won’t find’, outlining their important role in early diagnosis, treatment and prevention of life-threatening complications.
The worm can remain undetected in the small intestine for decades, but when a patient has cancer treatment or other interventions that affect the body, its response is to multiply and spread rapidly through the body.
Wendy moved to Nhulunbuy with her husband in 1993, undertaking to stay five years – and has stayed for decades. One of the reasons was the satisfaction of working with Miwatj.
“When you look at most hospital environments, you see hierarchies as a triangle, with doctors at the apex, determining how things are managed and making the decision, but Aboriginal Community Controlled Health Organisations reverse that triangle, so the doctor is required to listen to patients and respect the community’s priorities,” Wendy says.
“We have lots of interaction with individuals and find out their relationship to their family, so often you might see three or four generations of a family in one day, which is really important if you want to treat something like Strongyloides, as you have to trace contacts – just as we do now with COVID.”
After seeing the impact of the worm on many communities in East Arnhem Land, Wendy was galvanised to become an outspoken advocate for Strongyloides recognition and treatment when a much loved colleague died.
“In 1999 our colleague, an Aboriginal Health Worker from Miwatj, a beautiful person and queen of her people needed to go to Adelaide for treatment and she passed away while she was there, from disseminated strongyloidiasis,” Wendy says.
“It had a huge impact on so many people in the community and she was so missed, we decided that many others could die in similar circumstances, but we had the drugs to treat the disease, once it was diagnosed – this was an issue we could do something about.
“In 2000 we introduced Ivermectin, a relatively new drug which has a wonderful effect in controlling the Strongyloides stercoralis, and we found we were able to reduce the rate of infection from 60% to under 10% in some communities.
“Strongyloidiasis is one of the most neglected tropical diseases – affecting so many, and treatable, but traced and eliminated far too infrequently.
“It is high time it is recognised as a notifiable disease because it can affect not just people in the far north of Australia, but anyone who has been on holiday to a sub-tropical location, as well as many people who migrate to Australia.”
Wendy and colleagues have now formed a group Strongyloides Australia to campaign for the disease to be recognised as notifiable.
In the meantime, she will continue to treat patients and welcome new Flinders students to Miwatj.
“It’s great to see the students come through and I am sure to tell them about Strongyloides stercoralis,” Wendy says.
“We need to be passing the baton on, with more people having the word (and not the worm) on the tip of their tongue. It’s remarkably persistent, so we need to be as well!”
