Heart disease caused by untreated throat infections could kill tens of thousands of people in Kenya. A Notts charity wants to raise more than £100,000 to help. Winnie Agbonlahor reports...

HEART surgeon Raj Jutley has some unfinished and desperately urgent business to complete in Africa.

His skills saved the lives of two people with heart disease when he went to Kenya in November.

But now he is back in Britain and waiting to fly out again to operate on several people who still need his help.

Mr Jutley, who works at the City Hospital, Nottingham, set up the Pan Africa Heart Foundation in 2008 to tackle rheumatic heart disease in Kenya.

The disease, which can lead to heart failure, can be caused when a bacterial throat infection goes untreated in children.

The spread of such infections is more likely in over-crowded conditions, like, for example a neighbourhood in Nairobi called Kibera, which is the Kenyan capital's largest slum.

It is estimated up to 60 out of 1,000 school children are affected by the heart disease. And with the number of citizens in Nairobi totalling 3,138,295 the illness could be killing tens of thousands every year.

Symptoms don't usually kick in until at least 15 years after infection, which means many patients are unaware of their condition.

Mr Jutley, who is originally from Kenya and moved to the UK at the age of 20, said he founded the charity to give something back to his home country.

"Unlike most cardiac diseases which are acquired in this country, people out there are ill through no fault of their own," he said.

"And more importantly, they're in the prime of their lives. This disease allows people to die very early."

Patients are usually in their 20s or 30s when they experience the first symptoms.

As part of the trip to Nairobi, Mr Jutley and 14 health-care staff screened more than 1,600 children and young adults.

The screening showed 40 had the disease and needed a valve replacement, and 12 of them needed the operation within the next nine to 12 months.

Mr Jutley operated on two patients and wants to get through the rest this year.

However, the surgery is costly. "In this country, one surgery costs £15,000, which includes the doctor's rates, the hospital's charges to the operation theatre and equipment cost," Dr Jutley, 40, of Egmanton, near Tuxford, said.

"But we managed to get this cost down to £4,000, because all of our medical staff are doing the work for free, the hospitals are not charging us to use their theatres, suppliers are providing us equipment at reduced rates and we re-sanitise equipment where possible rather than dispose of it."

During the trip, Mr Jutley said, there were two cases where patients had to be turned down.

"There was one 12-year-old girl called Frida Wanjiku who probably didn't weigh more than 55 pounds and she only looked six years old," he said.

"I've never seen a patient as under-developed in my life."

The early onset of symptoms could be explained by Frida's weak immune system, her under-nourishment and the fact that she suffered from recurring throat infections.

"It would have been unfair to put her through the operation, not least because years later she would have out-grown the valve," Mr Jutley said.

It is also problematic to perform open-heart surgery on children, he added.

"These things are incredibly difficult, because normally I open up someone's chest, do what I am supposed to and don't interact much with the patient.

"And if I do, he or she will have already been prepared for surgery," he said.

However, in this case, Mr Jutley had to tell Frida's brother that all they could do was hold off further outbreaks of symptoms with medication and wait for the surgery until she was fully developed.

Over the course of 2012, the foundation wants to raise at least £100,000.

This money, Mr Jutley said, would be used to cover the cost of the operations, train local medical staff and raise awareness about the condition and screening.

Mr Jutley said another important objective was to prevent the so-called "brain drain" – the migration of skilled professionals abroad.

For more information visit www.panahf.com or contact the charity's CEO, Lisa Smal on 07572424699 or email Lisa@totalrecruits.co.uk.

• Risky operation which transformed Mary's life

Disease that's still a killer around the world

RHEUMATIC heart disease can develop as a result of letting a bacterial throat infection go untreated.

If a throat infection, known as a streptococcal infection, is not promptly treated with antibiotics, it can cause rheumatic fever, which can, in turn, cause rheumatic heart disease.

Permanent damage to one or more of the valves of the heart – including the aortic and mitral valves on the left and the pulmonary and tricuspid valves on the right – can result in heart failure, stroke and death.

Depending on severity, the treatment typically requires the repair or replacement of the valve with an artificial one.

Before the widespread introduction of antibiotics, rheumatic fever was one of the leading causes of acquired heart disease in England.

Now, due to antibiotics and improvements in public sanitation and living standards, the condition is rare.

However, it remains widespread in other parts of the world.

Symptoms include shortness of breath, difficulty breathing when lying down and tiredness.

To minimise the risk of a streptococcal throat infection developing into rheumatic fever it is important to promptly treat it with antibiotics. For more information, visit www.nhs.uk/Conditions/Rheumatic-fever.

How the numbers add up

600,000: Estimated number of healthcare workers who left sub-Saharan Africa in 2004.

15,000,000: The number of people affected by streptococcal bacteria sore throat infection.

15-20: The number of years it usually takes for the condition to cause symptoms.

280,000: The number of new cases of rheumatic heart disease detected every year worldwide.

£15,000: What it costs to carry out a heart valve replacement surgery in the UK.

£4,000: What the PAHF is spending on the surgery in Kenya.

1,600: The number of people screened as part of PAHF's last visit.

230,000: The number of deaths caused by rheumatic heart disease (one every 30 seconds) worldwide.