Poor treatment of gout crippling Māori communities

A Māori pharmacist is on a mission to break the myths around gout - an arthritis Māori are almost three times more likely to suffer from.

Gout is the second-most common arthritis in New Zealand, and causes painful swelling in joints like the big toe, wrist and elbows, and is triggered by high uric acid levels.    

Prescribing pharmacist Leanne Te Karu has sought better treatment of gout in Aotearoa for the last 20 years.

Gout is often called the diseases of kings because of its links to diets high in rich food. However, Te Karu says myths around diet being the major contributing factor for it aren't true.

"We do know that there is this genetic variance in the way that Māori and Pacific Island people handle this thing called uric acid."

Te Karu says having high uric acid levels was an advantage in the times of Polynesian sea voyage - because it allowed people to store salt and food.

"That was an advantage all those years ago -  but in 2019 is not an advantage anymore."

Tairon Rikki is one of Leanne's gout patients in Turangi - and first experienced a gout attack when he was just 18 years old. The 32-year-old lives on a cocktail of painkillers to manage his pain.

His gout became so bad he developed a mass of uric acid crystals built on his big toe. 

Living with the pain he says is at times unbearable.

"You feel useless you feel like you can't do anything you know. And then what's the point in life if you can't do anything."

Recent data from the Health Quality and Safety Commission shows Māori were less likely to receive urate acid-reducing medication like allopurinol compared to Pākehā groups - despite being more likely to develop gout.

Instead of pain-killers to manage gout attacks, Te Karu wants to see clinicians prescribing allopurinol - a medication which helps to reduce uric acid levels.

"We know lots about it - it's cheap as chips. 

"There are some provisos in that it needs to be stated at a really low dose - a dose that's right for a person's kidneys."

Since working with Te Karu, Tairon Rikki's had surgery to remove the mass - and will have further surgery later this year.

Thanks to Te Karu's support he's now starting to feel he can move beyond the pain of gout.

"She made me have a bit of hope that I can get better. 

"All I really want to do is work. I wanna go out and I wanna go and work for my kids."

The Hui