When a six-year old indigenous child presented to surgeon Kelvin Kong with a maggot in his ear it wasn't in a remote part of Australia.
It was in Newcastle, the harbour city north of Sydney with five major hospitals nearby.
"You look at the notes and the medical history and it was really disparaging to see on every admission to hospital there was a problem there that it wasn't addressed," Dr Kong told a gathering at Parliament House in Canberra on Wednesday.
The family had tried to get help on more than six occasions, including at a hospital emergency department.
"Because it's not a heart attack, it's not a car crash, it's a low priority - yet to this kid it's a high priority," Dr Kong said.
And while he wasn't saying that emergency department had failed, he was pointing out the disparity between treatment for indigenous Australians and others in the community.
"It broke my heart that this kid had been diagnosed with autism, with aspergers, with other kind of behavioural issues when no-one bothered to do a simple thing as a hearing test."
Dr Kong used the example to highlight the prevalence of chronic otitis media, a group of inflammatory conditions of the middle ear - the focus of this year's Australian Medical Association's report card on indigenous health.
The report card cites research from Northern Territory indigenous communities showing only seven per cent of children assessed have normal ears.
Estimates generally show an indigenous child will suffer middle ear infections and associated hearing loss on average for 32 months from the age of two to 20 years - compared to just three months for non-indigenous children.
AMA president Dr Michael Gannon said everyone at the launch had probably experienced such ear inflammation at some point, but rates in indigenous communities are reported to be the highest in the world.
"For most non-indigenous Australian children otitis media is readily treated with a short course of antibiotics," he told the launch.
But for indigenous children it can mean a "life sentence" of hearing harm, troubles at school and behavioural issues.
"You can see how a potentially harmless bacterial infection can, if unchecked, if untreated, literally ruin someone's life," Dr Gannon said.
The association calls for a co-ordinated national response to be developed by a National Indigenous Hearing Health Taskforce under indigenous leadership for the Council of Australian Governments.
Indigenous Health Minister Ken Wyatt said it was the responsibility of everyone that otitis media was addressed, but it was important changes were made in partnership with local communities.
Labor spokesman Warren Snowdon said workforce shortages were biting in Northern Australia and he encouraged doctors to head to the bush.
"We won't get improved outcomes unless we get the services in those areas," he said, calling on state and territories to also lead the way.
