SIMS Medical Bureau Blog

Patient’s search for a solution sparks novel treatment in SA

Tue, 21 Apr 2026 06:21:27 GMT

Dr Gercois Human (Photo: Facebook / Cape Town Interventional Radiology)

Highly specialised, minimally invasive expertise guided by international collaboration

When all surgical options to remove cancerous nodes near a man’s trachea had been exhausted, he was determined to find another way. His deep dive into international research online led him to a team of pioneering interventional radiologists with the rare expertise to perform this highly sophisticated, minimally invasive treatment at Netcare University of Cape Town (UCT) Private Academic Hospital.

“In 2012 I was diagnosed with papillary thyroid carcinoma, and first I had a partial thyroidectomy, then, after recurrence a few years later, a full thyroidectomy plus an oral radioactive iodine treatment. However, regular recurrences continued and in total I had nine surgeries on my neck over 12 years,” says Martin Horn, 62, of Somerset West. The very first of these surgeries severed a nerve to one of his vocal cords, forever changing the pitch of his voice.

“Recent blood tests and ultrasound identified that there was still a small tumour growing close to my windpipe, but more surgery was not considered a good option for me. So, I started researching for myself what could be done,” he says.

This led Mr Horn to learn about cryoablation, a less invasive option for treating small tumours deep within the body by freezing the tissue, which can be done without the need for open surgery. “I discovered a 2023 US research paper with 10 papillary thyroid cancer patients in a very similar situation to mine, where cryoablation showed a significant success rate. I showed this study to my own oncologist to ask if we could explore this for me.

Interventional radiologist Dr Gercois Human is one of only a handful of sub-specialists in South Africa with the necessary expertise to perform the highly specialised minimally invasive procedure Martin Horn required. Dr Human performed the procedure assisted by South Africa’s first interventional radiology fellow Dr Jateel Kassim at Netcare University of Cape Town Private Academic Hospital.

“We didn’t know whether anyone in SA could perform this minimally invasive cryoablation so close to my trachea. I learned that cryoablation is gaining ground for treating certain breast cancers in Johannesburg, however the location of my tumour required a different set of sub-specialised expertise, and it was beginning to look as though travelling overseas for the procedure was my only option. It would, however, be considerably more expensive for me, as my medical scheme would likely not cover the costs,” Mr Horn says.

His search led him to schedule an appointment with interventional radiologist Dr Gercois Human, who practises at Netcare UCT Private Academic Hospital. Dr Human undertook advanced international fellowship training in minimally invasive, image-guided therapies at McGill University in Montreal and in abdominal imaging at the University of Toronto in Canada.

Together with Dr Dale Creamer and the Cape Town Interventional Radiology team, Dr Human is one of only a handful of subspecialists in South Africa with the necessary expertise to perform the highly specialised procedure for Mr Horn at Netcare UCT Private Academic Hospital. Their rare interventional radiology expertise also enhances the options available for treating liver, gallbladder, and pancreatic conditions percutaneously and via the peripheral vascular system through the multidisciplinary Liver Centre SA.

“The considerable build-up of scar tissue from previous surgeries meant that it would be extremely difficult for surgeons to distinguish a tumour of this size, and traditional surgery so close to the trachea comes with additional risks. Essentially, surgical options for this patient had been exhausted when he turned to us for assistance,” Dr Human says.

Interventional radiologists use real-time, detailed imaging to perform intricate, highly targeted procedures from within the blood vessels. These less invasive procedures can, in appropriate instances, offer a crucial alternative to open surgery, significantly reducing the associated physical trauma while cutting recovery times from weeks to days in many cases.

“Through interventional radiology, cryoablation freezes the tumour and a small margin of tissue around it to destroy the cancer. Overseas, this has been used to treat this type of cancer, but in South Africa, it was quite novel. Historically, interventional radiologists who trained internationally in procedures such as this did not return to practise in South Africa,” Dr Human says.

Affiliated with the European Society of Interventional Radiology, he explains that the Cape Town Interventional Radiology team collaborates with multidisciplinary teams at Netcare UCT Private Academic and Netcare Greenacres hospitals, and maintains close ties with international experts in the field.

“Our Canadian mentors shared valuable insights before this procedure, and this ongoing collaboration ensures our patients benefit from years of collective experience,” Dr Human notes.

Mr Horn says he was conscious, although sedated for the procedure, and he drifted off to awaken back in the ward with only a small puncture in his neck.

“This was worlds away from the experience of surgeries I have had before. I was able to return home the same day, and the next day I was back to my normal life. I’ll have regular check-ups with my oncologist to monitor my progress, but I want others who may be in a similar situation to mine to know that these options are now available in our country,” he says.

Dr Human points out that interventional radiology can be helpful for many conditions, but it should only be used when clinically appropriate and supported by evidence-based benefits.

“We aim to strengthen the availability of world-class cancer treatment options and minimally invasive procedures locally. These skills are scarce in South Africa, and to address this, Dr Jateel Kassim has joined our team as the first interventional radiology fellow in South Africa,” he says.

“Through developing these additional treatment options, our country is taking its place at the forefront of advanced medical practices,” Dr Human concludes.

For more information, visit the Cape Town Interventional Radiology website www.CTIR.co.za .

Liquid nitrogen saves teen’s leg in SA medical first

Fri, 17 Apr 2026 07:10:22 GMT

Dr Herman Breet, Dr Jadine Du Plessis, and Dr Jaco Viljoen (left to right) performed South Africa's first liquid nitrogen limb salvage surgery at Netcare Unitas Hospital.

Patient’s own bone treated and reimplanted in breakthrough procedure

In a South African first, a Centurion-based surgeon has successfully performed a hip and limb salvage procedure using a liquid nitrogen dipping technique.

This pioneering approach, performed at Netcare Unitas Hospital in Tshwane this week, could significantly expand treatment options for certain patients with orthopaedic cancers, particularly those who would typically require removal of the affected bone and its replacement with a large prosthesis.

The operation saved the leg of a 15-year-old boy with Ewing’s sarcoma, an aggressive bone cancer. Standard treatment usually involves removing the cancerous section of bone and replacing it with either a large metal prosthesis or the patient’s own bone after irradiation to destroy cancer cells.

“When I explained that conventional surgery meant no more contact sports, I saw the devastation in his eyes – and in his father’s. That’s when I knew we had to try something different,” recalls Dr Jaco Viljoen, an orthopaedic surgeon with a special interest in orthopaedic oncology.

Dr Jaco Viljoen, orthopaedic surgeon specialising in oncology, who performed South Africa's first liquid nitrogen limb salvage procedure at Netcare Unitas Hospital.

“I’d been prepared for this exact scenario for ten years. When I mentioned there might be another way – a chance he could play sport again – their faces lit up,” says Dr Viljoen.

During the four-and-a-half-hour procedure, Dr Viljoen led a skilled team in removing a 24-centimetre section of the teenager’s femur (thigh bone) where the cancer had developed. Working alongside Dr Viljoen were assistants Dr Jadine Du Plessis and Dr Herman Breet, anaesthetist Dr Bianca Brits, and scrub nurses Registered Nurse Gloria Kgwete and Enrolled Nursing Assistants Leah Lekoane and Mahlatse Motheta.

The team treated the removed segment by immersing it in liquid nitrogen at -179°C to destroy cancer cells. The bone was then reimplanted, marking the first time this technique had been performed in South Africa.

“This kind of complex surgery is only possible with an exceptional team. Every person in that operating theatre played a crucial role in giving this young man his future back,” Dr Viljoen said.

Ewing’s sarcoma is the second most common bone tumour in children and adolescents, according to a recent study in The Lancet Oncology. This aggressive cancer primarily affects individuals aged 10 to 20, with about 80% of cases diagnosed before the age of 20. It most commonly arises in the long bones of the legs and arms, as well as in the pelvis and chest wall, accounting for 10 to 15% of all bone cancers. Without treatment, the disease progresses rapidly, making early intervention critical.

“A day after surgery, the patient was alert and showed good neurovascular function in the affected leg – promising early signs. He even managed a few assisted steps with his physiotherapist, Leonie De Lange. Follow-up tests will monitor how well the treated bone integrates, and we’re cautiously optimistic about his progress,” comments Dr Viljoen.

“This technique marks a significant departure from standard treatment. The traditional approach would have involved the complete removal of the affected bone, followed by a complex prosthetic reconstruction of the hip, which often limits long-term mobility and rules out a return to contact sports. A second alternative – irradiating the patient’s bone before reimplantation – can compromise bone integrity and increase the risk of non-union, often requiring further surgery. For this keen young rugby and cricket player, preserving his natural bone and joint function was a critical consideration,” he adds.

The ideal solution stemmed from a Japanese technique Dr Viljoen had been holding in reserve. The sophisticated procedure, though developed by specialists in Japan more than a decade ago, is rarely performed worldwide – particularly not in patients with Ewing’s sarcoma – and requires exceptional precision. The extreme cold destroys cancerous tumours while preserving the bone’s architecture, allowing it to heal naturally once reimplanted and secured with surgical pins.

“We’ve effectively preserved his bone and hip joint. His own bone will regenerate and integrate with the surrounding tissue. For a young person, that’s game-changing, as his leg can continue to develop normally.

By preserving his natural anatomy, this procedure offers him the possibility of returning to full activity once healed. This technique offers hope of avoiding amputation in other clinically appropriate patients,” explains Dr Viljoen.

Dr Viljoen previously headed the Tumour, Sepsis and Limb Reconstruction Unit at Steve Biko Academic Hospital. A graduate of the University of Pretoria, he completed his orthopaedic specialisation in 2015 and now practises privately at Netcare Unitas Hospital and Netcare Montana Hospital.

“Dr Viljoen and his colleagues have added another chapter to South Africa’s legacy of medical excellence. But, this is about more than innovation – it’s proof that worldclass orthopaedic care happens right here at home, offering hope to patients facing life-altering conditions such as Ewing’s sarcoma,” adds Dr Erich Bock, managing director of Netcare’s hospital division.

“This is what sets exceptional healthcare apart – seeing the whole person, not just the disease. Dr Viljoen and his team haven’t just treated cancer – they’ve preserved a young man’s dreams. That is the true essence of person centred healthcare,” concludes Dr Bock.

On World Health Day and every day, take care of your health

Tue, 07 Apr 2026 16:58:48 GMT

Dr Cathelijn Zeijlemaker

Here’s what you need to know about your family’s medical and dental needs

When last did you see your GP or dentist? If you’re struggling to remember, you’re not alone, but you may well be missing some important health signals.

Ahead of World Health Day on 7 April, Netcare Medicross highlights a truth that surprises many patients: your dental check-up isn’t just about your teeth, and your GP visit isn’t just about obvious illness. The value of evidence-based medical and dental care for a person’s overall wellness cannot be underestimated.

“This year, the World Health Organization’s theme for World Health Day is ‘Together for health: Stand with science’, which resonates with primary healthcare services as the first point of call when seeking help for any of the full range of possible concerns,” says Dr Cathelijn Zeijlemaker, medical director of Netcare Medicross.

I feel fine, so why bother?

“From treating common illnesses or troublesome symptoms to prevention and management of long-term conditions, general practitioners’ first concern is for your wellbeing. Our goal is to help our patients get the best out of today’s medical knowledge for their specific health needs, so that you can enjoy a good quality of life not only now but well into the future,” she adds.

Dr Rahul Gathiram, dental director of Netcare Medicross, adds that oral health is a critical component of overall health.

“Tooth decay affects most people, approximately 90% of the population, but often oral health is an afterthought until pain develops. Dental treatment should be sought early, or preferably preventatively, to prevent further damage,” he says.

“Research shows clear links between oral health and many major systemic diseases. Recent scientific studies confirm that poor oral health, especially periodontal or gum disease, is associated with conditions such as cardiovascular disease, diabetes, and adverse pregnancy outcomes, further emphasising the connection between oral health and overall wellbeing.

“Gingivitis, or gum disease, and periodontitis, an infection that erodes the soft tissue and bony sockets supporting the teeth, are unfortunately extremely common, affecting a large portion of the population. These conditions often progress silently, which is why it’s essential to book a check-up with a dentist every six months,” Dr Gathiram says.

Netcare Medicross medical and dental centres offer conveniently accessible private primary healthcare services, including GP and dentist appointments, health checks, and immunisations, with clinics across eight provinces.

Dr Zeijlemaker says that immunisation against common health risks is an important and empirically proven means of preventing serious illness and disease outbreaks.

As the influenza season approaches, Dr Zeijlemaker highlights the evidence-based recommendations of the World Health Organization and the National Institute for Communicable Diseases (NICD) for immunisation, especially for those who are considered at higher risk of more severe illness.

Who should consider the influenza vaccination?

Anyone with a chronic medical illness or weakened immune system
Anyone older than 65
Those who have been diagnosed with cancer
Women currently pregnant or planning a pregnancy
Babies and young children

“If you are living with someone who may be at risk of influenza complications, it is also advisable to consider vaccination, as this will help prevent the spread of flu and protect your loved ones. Be sure to inform your doctor about your recent medical history before your vaccination, or if you are feeling unwell, as you may be advised to postpone the vaccination,” she says.

The bottom line is your wellbeing

“Prevention isn’t just about avoiding disease – it’s about optimising your quality of life. When your medical and dental teams work together with complete information, we can help you not just survive, but thrive.

“This World Health Day, and all year round, make a commitment to integrated healthcare. The doctors and dentists practising at Netcare Medicross centres are here to support you and your family, not only in times of illness, but to help you achieve optimal health and wellbeing,” Dr Zeijlemaker concludes.

Doors open at Netcare Akeso Polokwane

Tue, 31 Mar 2026 16:09:29 GMT

Caring, evidence-based private mental healthcare in Limpopo

Mental healthcare capacity in Limpopo has received a considerable boost with the opening of the 87-bed Netcare Akeso Polokwane.

Netcare Akeso Polokwane marks the culmination of a strategic partnership between the mental health division of the Netcare Group, Netcare Akeso, and local doctors, Dr Rhulani Khosa and Dr Peters Mathebula.

“Depression, burnout and challenging times leading to mental health crises can happen to anyone. Confidential, multidisciplinary professional support and treatment programmes are available to help people regain their sense of self when life may seem unmanageable,” says Mmoni Aphane, manager of the new facility.

“With the increasing demand for vital psychiatric services, our aim is to provide compassionate, evidence-based care within a safe environment that is fully dedicated to the mental health and wellbeing of the individuals who entrust us with their care.”

Mmoni Aphane, Manager at Netcare Akeso Polokwane

Strengthening mental health in Polokwane and beyond

The well-appointed Netcare Akeso Polokwane has been designed with future expansion, comfort and energy efficiency in mind, with the first phase comprising 72 adult beds and 15 adolescent beds for inpatient admissions. Outpatient services are also provided, with consulting rooms for psychiatrists, psychologists and allied professionals.

Within 1.5 km of Netcare Pholoso Hospital, a Level II trauma centre, Netcare Akeso Polokwane’s location in the provincial capital makes psychiatric services more accessible to surrounding communities and provides the advantages of synergy between the facilities and their disciplines.

“Previously, healthcare practitioners in the region referred their patients to Netcare Akeso Arcadia and Netcare Akeso Nelspruit, yet now mental healthcare is available closer to their homes and families. We anticipate referrals from the region and further afield, including neighbouring countries, given the prevailing shortage of mental healthcare facilities equipped to this standard,” Aphane says.

The new facility offers a core team of experts, including psychiatrists, psychologists, occupational therapists and social workers, supported by skilled and experienced nursing staff.

Comfort and sustainability

The design of the facility incorporates several sustainability initiatives aimed at reducing Netcare Akeso Polokwane’s environmental footprint and improving resource efficiency without compromising comfort, adds Matthew Scott, Netcare Akeso’s infrastructure programme manager.

“Advanced temperature regulation includes a heat recovery system that converts excess heat from the air cooling process to help warm the hot water for showers and taps, thereby reducing the facility’s overall energy demand for water heating. A Variable Refrigerant Flow (VRF) air-conditioning system further enhances energy efficiency with improved control of ventilation, heating, and cooling, exactly where it is required,” Scott says.

Renewable energy is generated with a solar photovoltaic (PV) installation, helping to reduce the facility’s reliance on grid-supplied power and lowering associated carbon emissions.

“The new facility includes a reverse osmosis filtration plant to treat borehole water to drinking water standards, reducing pressure on municipal resources, further demonstrating Netcare Akeso’s commitment to sustainable operations and responsible resource management,” Scott says.

Dedication to person centred care

“Our message to the community is that mental health is an essential part of overall wellbeing. Seek professional support early if you are concerned about your own mental health or that of a loved one. Early intervention can make a long-term positive difference in a person’s life, and the stability of their relationships and commitments to friends, family and employers,” says Aphane.

To make an appointment with a psychologist, psychiatrist or occupational therapist, contact Netcare Akeso Polokwane on +27 (0)15 324 0040 or download the Netcare app. In the event of a psychological crisis, call Netcare Akeso’s 24-hour crisis line on 0861 435 787, where experienced registered counsellors are available to listen and advise on support options.

“We are grateful to partner with a dedicated community of psychiatrists and healthcare professionals who share our commitment to improving mental health outcomes in our province. Together we look forward to making a positive difference to many lives,” Aphane concludes.

Child head injury: "My baby girl is back"

Fri, 27 Mar 2026 08:50:46 GMT

Hannah-Grace, her mother and aunt recently visited Dr Palesa Monyake and the multidisciplinary paediatric intensive care unit (PICU) team at Netcare Waterfall City Hospital.

Specialised care in Hannah-Grace’s triumph over tragedy

The medical care in the immediate aftermath of a head injury, combined with rehabilitation therapies in the weeks that follow, can make all the difference in the life of the survivor – particularly when a child’s future is at stake.

“We never thought something like this could happen. The accident came without warning. Another vehicle hit us at high speed. We were far from home, as we had been visiting friends in Mpumalanga,” recalls Megan Hefer, of Fochville, Gauteng.

Three and a half year old Hannah-Grace Hefer’s life hung in the balance following a tragic car accident in the first week of 2026 that cut short the life of her devoted father and left her mother, Megan, with an injured arm and a badly swollen eye.

“At the scene of the accident, Hannah-Grace’s eyes were fixed and unfocused: I knew that was a bad sign,” Megan recalls.

“Hannah-Grace was in such a bad way, we hardly dared to hope for the kind of recovery she has made,” recalls Dr Palesa Monyake, paediatric intensivist at Netcare Waterfall City Hospital’s specialised paediatric intensive care unit.

Yet, just two months after the accident, the little girl described as a ‘go-getter’ is returning to her lively, active self and surpassing everyone’s expectations for a recovery after brain injury.

“She was airlifted from Ermelo in a critical condition with severe head injuries, and when she arrived Hannah-Grace kept having seizures and could not even breathe on her own.”

“As a mother myself, I knew how difficult it must be for Mrs Hefer to be separated from her injured child without knowing who was looking after her. The next morning, I visited her in the hospital to introduce myself and promise her we would take care of Hannah-Grace just as if she were our own child,” Dr Monyake says.

After several days, Hannah-Grace’s condition slowly began to improve under the diligent care of doctors and paediatric intensive care unit nurses, whom Megan describes as ‘angels doing God’s work’.

“On 7 January, they extubated Hannah-Grace and I had to leave her in the hospital to identify my husband’s body. On the same day, I received two blessings. Firstly, Hannah-Grace woke up for the first time since the accident, and secondly, my sister safely delivered a healthy baby. There were so many emotions, but for me, it was the Lord’s way of supporting me through this terrible time.”

Dr Palesa Monyake, paediatric intensivist at Netcare Waterfall City Hospital’s specialised PICU, is pictured with Hannah-Grace Hefer and her mother, Megan.

Megan Hefer reflects on her daughter’s progress ahead of World Head Injury Awareness Day on 20 March, following the family’s tragic car accident in early January.

WATCH: Hannah-Grace and Charne Cox: At Netcare Rehabilitation Hospital, Hannah-Grace learnt to walk again with the support of a multidisciplinary team, including physiotherapist Charne Cox. This video captures her milestone first steps after the accident.

At last, Hannah-Grace could breathe on her own, but the extent of the neurological effects remained unclear. Scans revealed areas of bleeding in Hannah-Grace’s brain, which can indicate damage to areas of the brain responsible for movement, language and other crucial functions.

“Her eyes were only staring to the right, but we didn’t know if she could see or hear. She didn’t talk, and she didn’t show any signs that she recognised me,” her mother remembers.

Megan, her mother, sister, Dr Monyake and the PICU nurses prayed for Hannah-Grace’s recovery. “As time went on, she started speaking a few words. One day, she said, ‘Ek is Hannah Grace,’ and she seemed to know herself for the first time. I cried out, ‘My baby is coming back’.”

Dr Monyake describes Hannah-Grace’s mother as “a pillar of strength,” whose love, support, and faith at her daughter’s bedside were invaluable. With Hannah-Grace medically stable at last, she was ready for the intensive therapies that would aid her recovery at Netcare Rehabilitation Hospital.

Dr Anrie Carstens, a general practitioner with a special interest in physical and rehabilitation medicine, said that when Hannah-Grace arrived, the most prominent feature of her injury was pronounced weakness on the left side of her body, in keeping with a stroke in the basal ganglia of the brain.

“Hannah-Grace’s brain had to relearn how to recognise the left side of her body so she could learn to walk again. When she came in, her expressive and receptive language skills were also delayed. Her initial assessment anticipated she would need eight weeks of intensive therapy at Netcare Rehabilitation Hospital, but she was so eager to get going with her therapy sessions and progressed so quickly that we were amazed when she needed less than half this time.”

According to Dr Carstens, brain injuries in children often have a greater potential to heal and regain lost functionality, provided there is prompt and appropriate emergency care, as well as the required specialised care after the injury, followed by neurologically informed intensive multidisciplinary therapy.

“The neuroplasticity of children’s brains means they often have the most to gain from rehabilitative therapies as soon as possible after injury. In Hannah-Grace’s case, although she was withdrawn at first, she grew in confidence and showed progress in important functional areas – engaging in symbolic play, initiating activities and improving her social skills. Most poignantly, she showed tender attentiveness and empathy for one of the children she befriended in the ward,” Dr Carstens says.

Given the trauma of the accident and the loss of her father, psychological support and play therapy were provided as part of the multidisciplinary care Hannah-Grace received at the hospital.

Physiotherapist Charne Cox helped Hannah-Grace develop her balance, coordination and mobility during her rehabilitation admission. “At first she couldn’t crawl or walk, but she tried so hard from the beginning that we could see she was going to do well. Every week, we realised she was making such rapid progress that she would not stay as long as we expected,” Cox says.

Making therapy fun and engaging is crucial for capturing children’s attention, and activities such as baking, making necklaces and movement games on a big screen TV featuring Hannah-Grace’s favourite cartoon characters were just some of the tools used in her therapy.

“Hannah Grace’s mom was a true champion, supporting her daughter every step of the way and helping to keep her attention focused on the therapy while also maintaining the boundaries of parenthood that can often be hard to maintain when a child has suffered a brain injury. She also asked the right questions to prepare for Hannah-Grace’s return to the home environment,” Cox says.

Dr Carstens says that after just three weeks at Netcare Rehabilitation Hospital, Hannah-Grace’s functional testing score rose dramatically. “She arrived with a score of 35 – far below the average of 91 for her age – but improved to 85. With additional fine-tuning and continued outpatient therapy, we fully expect Hannah-Grace to continue improving, just as she thrived during her time with us.”

Megan says that Hannah-Grace is making great strides – literally. Her walking is almost back to normal, she’s talking in both English and Afrikaans, and she’s spending time with Buddy, the Yorkshire terrier she and her late husband bought for their daughter for Christmas just before the accident.

“She is doing so well, and she is so eager to play and run around that I have my hands full trying to keep her from being a little gymnast. The doctors advised that another bump to the head could be serious for Hannah-Grace, so I have to remind her to be careful when she is playing.

“It was God’s grace that restored her to us, and now I fully realise the significance of why we named her Hannah-Grace. Every nurse, every doctor and therapist, every person who had a role in the miracle of her recovery and showed us such care and kept us in your prayers throughout, we are so grateful for each one of you,” Megan concludes.

Point of view: Life without kidney function

Wed, 11 Mar 2026 06:09:40 GMT

Alexis Chapell shares his personal journey of kidney failure and the life-sustaining dialysis therapy of National Renal Care that he has relied on since 2009.

Prevention, people and planet prioritised in renal care

Music lover and style aficionado Alexis Chapell’s days are full – from shopping for his elderly father to travelling for business and tending his flower garden. Three days a week, he wakes up extra early to attend four hours of dialysis therapy at 4am before starting his day – his life depends on it.

“I live a normal life. I go to dialysis like some people go to the gym,” says Alexis, aged 62, who has been living with kidney failure since 2009.

“Acceptance is the worst part of the kidney failure journey. It is rare that a person feels any symptoms of kidney disease approaching, and at that time I felt healthy and strong. I knew I had chronic high blood pressure, it is a family illness, but it didn’t bother me much. I partied a lot – I’ve always had a love of music, and even now that I’m older and living clean, I never turn down a social invitation,” Alexis says.

“When I was first diagnosed after landing up in hospital in 2009, I asked the doctors why would I have kidney failure? The answer shocked me – my blood pressure got so high that it destroyed my kidneys. Blood pressure silently harms other parts of your body, and in my case without warning my kidney function was destroyed.”

Dr Chevon Clark, chief executive officer of National Renal Care (NRC)

“Diabetes and hypertension are consistently identified as the leading causes of chronic kidney disease globally, and family history is also a well-established risk factor,” says Dr Chevon Clark, chief executive officer of National Renal Care (NRC), which operates as a joint venture between Adcock Ingram Critical Care and Netcare Limited.

NRC provides the vital dialysis service that replaces the function of the kidneys for people like Alexis, whose kidneys have failed. In addition to haemodialysis, where a dialysis machine and semipermeable membrane artificially filter blood, and peritoneal dialysis, which uses the patient’s peritoneal membrane as the filter, NRC units countrywide offer a range of additional services for all stages of kidney disease.

“The primary goal of dialysis is to sustain life by substituting the excretory function of the kidneys. Dialysis artificially removes metabolic waste products, excess water, and rebalances electrolytes from the person’s blood when their kidneys are no longer able to perform these functions adequately,” Dr Clark explains.

Alexis usually has his dialysis at NRC Arcadia, based at Netcare Jacaranda Hospital in Pretoria. He often travels to Cape Town on business, where he attends dialysis at NRC Cape Town CBD, based at Netcare Christiaan Barnard Memorial Hospital.

“Although the unit in Cape Town is bigger, I prefer my familiar unit at NRC Arcadia because it feels like family. Between the technicians, staff and patients, we have a real sense of community. We spend a lot of time together, and it’s not unusual for me to have a coffee in the canteen and chat with members of the NRC team. For them, it’s not just a job; they really care about us, and we care about them too,” he says.

“Early identification of at-risk individuals, especially those with diabetes, hypertension, or albuminuria, which is protein in the urine, can help slow or prevent the progression to kidney failure with evidence-based pharmacologic and lifestyle interventions,” Dr Clark says.

“Through providing personalised early clinical support for renal patients, it is often possible to avoid the need for dialysis, or delay it by years,” she explains.

Other risk factors for chronic kidney disease may include exposure to nephrotoxic medications, which can have side effects that may damage the kidneys, recurrent urinary tract infections, kidney stones, smoking and dietary factors, as well as older age, congenital anomalies, polycystic kidney disease, low birth weight or premature birth, or a history of certain pregnancy complications.

“Exposure to environmental factors, such as pollution, heat stress, dehydration and extreme weather events, is also emerging as a concerning potential contributor to renal failure. Within NRC, environmental sustainability is therefore a priority,” Dr Clark says.

“Dialysis is essential for survival, yet it is water intensive. With the strictest safety standards for our patients, we have invested in water saving technology and reduced our reliance on the municipal water supply,” Dr Clark says.

The carbon footprint of patients’ transport to units for multiple dialysis sessions each week is also being reduced with the convenience of home dialysis for clinically appropriate patients, who, along with their caregivers, are thoroughly trained by NRC staff and carefully overseen by clinicians to ensure the safety and comfort of patients.

“Among our other water, waste reduction and energy efficiency design and engineering initiatives, the most environmentally sustainable renal treatment is ultimately preventative care for people for whom kidney failure can be delayed or avoided. By prioritising prevention, early detection and greener therapies, we can protect both kidney health and the planet.”

With the support of his wife and the NRC Arcadia team, Alexis says dialysis does not define his life. “I am still the breadwinner for my family, and I don’t let my life stand still because of dialysis. I enjoy my time there talking to the people, and when I am finished, I carry on with my day. I have an eye for nice clothes, and sometimes I treat myself to a stylish new shirt to wear to church on Sunday – and I feel good,” he says.

“I wanted to share my personal story so people can be more aware of the risks of kidney failure, which I wasn’t aware of. I know how difficult it is to come to terms with this new way of life, and I want to show people who are newly diagnosed that it is possible to live a full life on dialysis,” Alexis concludes.

Visit www.nrc.co.za for more information.

Preventing Cervical Cancer Starts Early

Wed, 04 Mar 2026 09:13:26 GMT

Human Papillomavirus (HPV) Awareness

As South Africa marks the global Human Papillomavirus (HPV) Awareness Day on 4 March, the Cancer Association of South Africa (CANSA) is highlighting the importance of early prevention in reducing the burden of cervical cancer – one of the country’s most preventable yet life-threatening cancers affecting women.

Cervical cancer remains a major public health concern in South Africa, with more than 10 000 new cases and nearly 6 000 deaths estimated each year.¹² In line with the World Health Organization’s (WHO) global strategy to eliminate cervical cancer as a public health problem by 2030, South Africa has committed to a comprehensive national approach focused on prevention , early detection and timely treatment.³

South Africa has adopted the WHO-recommended single-dose HPV schedule following strong evidence that one dose provides protection comparable to multi-dose schedules in immunocompetent girls aged 9–14 years.⁵ For those aged 15–20 years, one or two doses are recommended, while women living with HIV should receive three doses, or at least two where three are not feasible.⁵ The Department of Health will continue to monitor opportunities to introduce next-generation vaccines and, when feasible, extend vaccination to boys.

“Vaccinating girls before they are exposed to HPV is one of the most powerful tools we have to prevent cervical cancer,” says CANSA’s Lorraine Govender, National Manager: Health Programmes. “It’s a simple, safe intervention that protects girls long before they face any risk — giving families one less worry for the future.”

CANSA encourages parents and caregivers to sign consent forms and ensure eligible girls receive the HPV vaccine during the campaign. By choosing vaccination, families play a direct role in protecting their daughters’ long-term health.

Alongside vaccination, regular cervical cancer screening remains essential. HPV DNA testing, the preferred WHO screening method, and Pap smear screening enable early detection of precancerous changes, when treatment is most effective. This is particularly important for women living with HIV, who face a significantly higher risk of developing cervical cancer.⁶⁷

Govender adds, “As part of our screening programme, CANSA makes use of the most trusted and clinically proven liquid-based cytology method when collecting a sample during a Pap smear. Pap smears help us identify abnormal cells on the cervix (lower womb) caused by HPV which can lead to cancer. Should the result indicate an abnormality, CANSA can help with a referral within the public health care sector or to a medical practitioner.”

Eliminating cervical cancer will require coordinated action across communities, schools, health services and families. This HPV Awareness Day, CANSA urges South Africans to support vaccination , prioritise screening , and join the global #OneLessWorry campaign — helping ensure that fewer women face cervical cancer in the years to come.

References:

Sung H et al. Global Cancer Statistics 2020. CA Cancer J Clin. 2021.
Shing JZ et al. HPV-related cancers in South Africa. Lancet Glob Health. 2025.
World Health Organisation. Global strategy to accelerate the elimination of cervical cancer. 2020.
Wei F et al. HPV genotypes and invasive cervical cancer. 2024.
World Health Organisation. Human Papillomavirus: WHO position paper. 2022.
Stelzle D et al. Cervical cancer and HIV. Lancet Glob Health. 2021.
World Health Organization. Guidelines for screening and treatment of precancerous lesions. 2021.

Cancer screenings essential for a healthy lifestyle

Fri, 27 Feb 2026 12:25:01 GMT

Clinical and radiation oncologist Dr Trenton Oliver. Photo: Netcare

With cancer rates on the rise, make time for early detection

There is more to long-term health than keeping fit and eating right. Two oncologists are urging the public to become more aware of lesser known ways to reduce the risk of common cancers and how new technologies are improving the treatments available today.

“Anyone who values their health cannot turn a blind eye to the fact that in South Africa, one in eight women and one in seven men are expected to be affected by cancer in their lifetime, with cancer rates increasing globally,” says Dr Trenton Oliver, a clinical and radiation oncologist at Oncology Health Centre.

“Too often, the preventative and screening tests appropriate for our age and personal risk factors are not prioritised – losing the valuable opportunity for early detection of many of the most common cancers before they can progress to become more serious,” he points out.

“Making time for recommended screenings in our busy lives is so crucial to our overall health – it could literally save your life,” adds radiation oncologist Dr Lucille Heslop, who also treats patients at Netcare Parklands Hospital, the only private facility in KwaZulu-Natal equipped to deliver the full range of radiotherapy treatments available in South Africa.

“For the most common cancers diagnosed in South Africa, testing has advanced to such an extent that changes associated with cancer in the body can often be detected much earlier, before they have a chance to become life-threatening,” she says.

The most commonly diagnosed cancers among women in South Africa are breast and cervical cancers, while prostate cancer and a form of skin cancer known as basal cell carcinoma top the list for men.

“In most cases, breast cancer is very treatable these days, yet a concerning trend we are seeing is that, while in the past we mainly saw older people being diagnosed with breast cancer, nowadays we are increasingly seeing younger women being diagnosed too. Please take the time to discuss your risk factors with your doctor as part of a routine check up,” she says.

The doctors emphasise that a simple check-up with your GP can make all the difference by enabling earlier detection and intervention and therefore better outcomes.

“There is less reason to fear screening than ever before, because if something is detected, more can be done through multidisciplinary collaboration on treatment plans centred on the person’s needs and individual treatment goals,” Dr Oliver says.

Significant advances in radiotherapy, chemotherapy and other cancer treatments, used either individually or in combination, are leading to more targeted, personalised therapies, such as those available at Netcare Parklands Hospital’s upgraded radiotherapy unit.

A state of the art Varian Halcyon linear accelerator (linac) and a surface guided radiotherapy (SGRT) system, installed on the existing Varian Trilogy system used for complex stereotactic radiosurgery, are already reducing treatment times while offering highly specialised treatments.

The facility also houses KwaZulu-Natal’s only private high dose rate (HDR) brachytherapy system, offering an important treatment modality for cervical, endometrial, and oesophageal cancers, among many others.

HDR brachytherapy provides highly precise, rapid verification of treatment positioning, ensuring that a high radiation dose can be delivered with minimal impact on surrounding healthy tissues. Treatment sessions are often shorter and more convenient for patients.

“With the more advanced techniques available, such as Deep Inspiration Breath Hold [DIBH] radiotherapy for breast cancer, it is now possible in many cases to treat cancer effectively while limiting treatment side effects – but this does not replace the need for early detection through regular screening,” Dr Heslop says.

“Cancer is not a distant issue. There are few South Africans who do not know someone whose life has been impacted by cancer,” adds Dr Chris G Mathew, managing director of Netcare Cancer Care.

“Across our cancer care network, no one facing cancer walks this path alone. Our multidisciplinary medical teams, radiotherapy professionals, and caring, experienced staff support each person who turns to us on their unique cancer and survivorship journey,” he concludes.

Personalise your pre-pregnancy preparation

Mon, 16 Feb 2026 13:31:58 GMT

Seven pointers for planning ahead

Smart lifestyle choices, the right supplements and sound emotional support are crucial for a healthy pregnancy, but there is another step that can make a real difference before those two little lines appear on the test strip – a pre-conception check-up.

Dr Mohamed Ghodhbani, an obstetrician and gynaecologist practising at Netcare Park Lane Hospital, says that if pregnancy is on your horizon, a proactive doctor’s visit can go a long way towards addressing any underlying issues, optimising your health, and helping you feel prepared in advance.

“You may not know you are pregnant until a few weeks in, so it is a good idea to already be following general guidelines, such as eating a balanced diet, getting plenty of rest, managing your weight, avoiding alcohol and smoking, and taking the necessary supplements, such as folic acid.

“More than this though, a pre-conception visit is recommended as it provides an opportunity to address any potential risks such as medical or lifestyle concerns, and helps further optimise the body’s readiness for pregnancy,” he says.

Dr Ghodhbani recommends discussing these seven pre-pregnancy points with your doctor, along with any other questions you may have.

Before the test turns positive, take a proactive step. Dr Mohamed Ghodhbani, an obstetrician and gynaecologist practising at Netcare Park Lane Hospital says that a pre-pregnancy check-up can help you address risks, optimise your health and feel better prepared.

1. Underlying health concerns

A physical examination and selected tests can help determine whether any medical issues need to be addressed before conceiving. Even something as seemingly minor as a urinary tract infection, if ongoing or recurring, can increase the risk of complications such as premature birth and low birth weight. Ensuring that conditions are properly treated before becoming pregnant provides a better baseline from which to begin.

2. Screening for STIs and infections

Screening for sexually transmitted infections (STIs) should take place before conception as some STIs can affect fertility, increase the risk of miscarriage, lead to pregnancy complications, and in certain cases, be passed on to the baby during pregnancy or delivery. The good news is that many of these infections are treatable, and identifying them early is far easier than dealing with them later.

3. Current medication and supplement use

Be sure to tell your gynaecologist exactly which medications, vitamins, herbal products, and supplements you are taking – even if only occasionally. Some medicines may need to be changed or adjusted before or during pregnancy or breastfeeding. When it comes to mental health medication, it’s important not to stop treatment abruptly. Medication planning should be done with the treating psychiatrist or doctor to ensure your mental wellbeing continues to be supported in a way that is safe for both mother and baby.

4. Immunisations and travel vaccines

Talk to your doctor about any international travel plans you have, as well as immunisations that may be recommended before pregnancy and those that are safe during pregnancy. This can help protect you and your baby, including during those delicate first few months of life, when babies’ immune systems are still developing.

5. Oral health matters… more than you might think

A dental check-up is a surprisingly important part of pre-pregnancy planning. Hormonal changes can make you more susceptible to gum disease and inflammation. Maintaining good oral health helps reduce the risk of painful flare-ups during pregnancy when treatment may be less straightforward.

6. Financial preparation

Discuss the anticipated costs of your pregnancy and delivery with your doctor so that you are fully prepared. If you are a medical scheme member, contact your scheme to clarify what you are covered for and explore gap cover options if needed.

7. Establish trusted sources of information

There is a wealth of valuable pregnancy-related information available, but proceed with caution. Not all platforms are reliable, and it is crucial to be mindful of misinformation and personal opinions, particularly on social media. Choose trusted medical sources and reputable pregnancy resources, and always consult your doctor about any uncertainties.

Confidence, not perfection

Dr Ghodhbani emphasises that while it is only natural to want to do everything in your power to ensure the best possible pregnancy, the idea is not to subject yourself to unnecessary pressure by aiming for the impossible.

“A pre-conception check-up isn’t about being ‘perfect’ before you have even begun. In many cases, the first check-up is during pregnancy, and that is perfectly okay, too.

“Booking a pre-pregnancy consultation with your doctor is simply a proactive, practical first step intended to help you feel informed, supported, and prepared – while putting a few sensible safeguards in place if needed,” he concludes.

What your obstetrician sees that an online search can’t

Fri, 06 Feb 2026 04:45:43 GMT

Dr Miems Kleynhans, an obstetrician and gynaecologist practising at Netcare Pretoria East Hospital, says that misinformation, particularly on social media and opinion-based sites, can leave expectant parents anxious and uncertain about choices that are best made with a trusted healthcare professional.

Tips for an informed, confusion-free pregnancy

Pregnancy comes with many firsts – the first scan, the first flutter that makes you stop mid-sentence. That first late-night panic when you Google “Is this normal?” and fall down a rabbit hole of conflicting advice. While the internet is often the first place people turn for answers, pregnancy is a time when what is trending online is not necessarily the right advice for you.

“Search engines are designed to show you generalised results based on what is popular, what is programmed to rank higher, and what is paid to be prioritised,” says Dr Miems Kleynhans, an obstetrician and gynaecologist practising at Netcare Pretoria East Hospital.

“Your doctor, on the other hand, knows your history, has studied your test and scan results, and draws on evidence-based medical information and clinical experience to provide you with the most accurate advice possible. It’s a dedicated, one-on-one conversation that is specific to you, rather than a one-sided online interaction.”

Keep it real, keep it safe:
Practical ways to stay informed

Dr Kleynhans recommends simple, practical steps for managing information during pregnancy.

Choose a trusted gynaecologist and obstetrician you feel comfortable with.
Attend an antenatal class for reliable, practical guidance.
Keep a running list of questions and bring them to your next appointment.
Be cautious with pregnancy content on social media, where opinions can sound like facts.
Ask your doctor about recommended preventative care, including vaccinations.
If you are really worried, call your doctor or the labour or maternity ward at your chosen hospital.

The hidden cost of online advice

Dr Kleynhans says one of the biggest challenges she sees in modern pregnancy care is the overload of online information and the anxiety it can trigger.

“The more you read, the more you feel like you need to control every detail of your experience – especially around a birth plan. It is important to remember that while birth is a very special moment, it is still a medical event. No two births are the same, and it is impossible to predict precisely how yours will unfold. We will always respect your preferences where we can, but it’s also important to manage your expectations and be mentally prepared for change if needed.

“Your birth plan is not a test that you pass or fail. The goal isn’t the perfectly curated delivery – it is taking a healthy baby home. Our main focus is on that and on making sure that you are safe and well too,” she says.

Tangible, definitive trust

Dr Kleynhans points out that online searches and social media feeds often amplify negative experiences, unintentionally escalating fear rather than providing fact-based information women can rely on.

She says that a strong relationship with a healthcare professional, such as a gynaecologist or obstetrician, creates a safe space to ask questions, raise concerns early, and receive trusted advice.

“When you know your doctor, and your doctor knows you, it becomes much easier to separate normal pregnancy changes from warning signs and to make good decisions calmly,” she says. “It also means you’re not alone with your questions at 2 am, combing through multiple search results and trying to guess which one applies to you, if any.”

Avoiding internet-induced panic

Dr Kleynhans says that bleeding is one of the symptoms that can cause immediate panic early in pregnancy and is one of the most common triggers for urgent online searches.

“Spotting during pregnancy can understandably be frightening, but it is common in early pregnancy, and it’s better to contact your doctor for guidance rather than spiralling into fear.”

She adds that while every pregnancy is different, there are situations where women should not delay seeking care. “If bleeding is accompanied by pain, or if it occurs after 26 weeks and if you cannot establish contact with your doctor, go straight to the maternity ward rather than the emergency room. They will be able to contact the doctor and provide you with the most appropriate healthcare support,” she says.

Why ‘trending’ isn’t the same as ‘true’

Dr Kleynhans says misinformation, particularly on social media and opinion-based sites, can leave expectant parents anxious and uncertain about choices that are best made with a trusted clinician.

“We see this around vaccination, for example. Parents are trying to do the right thing, but they’re exposed to content that’s designed to provoke strong reactions, not to provide balanced medical guidance.”

She notes that respiratory syncytial virus (RSV) is a grave concern for babies, and that prevention is often discussed online in ways that can create confusion.

“RSV can make very young babies seriously unwell, yet some patients are hesitant about recommended prevention measures because of what they’ve seen online. This is exactly why a trusted relationship with your gynae and obstetrician matters – you deserve information that’s evidence-based, up to date, and specific to you and your baby.”

“Don’t let the internet have the biggest say in your pregnancy – find a doctor and facility you feel comfortable with. As healthcare professionals, we have your best interests at heart, and we want to see you leave with a smile and a healthy baby. It’s an honour for us to play our part in that journey,” concludes Dr Kleynhans.

Concerning skin cancer trend reflects urgent need for prevention

Wed, 28 Jan 2026 12:20:16 GMT

Sun safety a year-round concern for all population groups, says healthcare administrator

One of the country’s largest medical scheme administrators is urging South Africans to be mindful of sun safety year-round and to have regular screenings, following a significant and concerning trend in the number of skin cancer cases recorded.

Universal Healthcare, which administers numerous closed and open medical schemes across a broad and diverse member population, is reporting a 130% increase in members with non-melanoma skin cancer over an eight-year period.

“This upward trend over a relatively short period may be attributable to a growing awareness about skin cancer screening following various forms of member education among the schemes we administer,” says Dr Odwa Mazwai, Managing Director of Universal Care.

“Regular skin cancer screening enables early diagnosis and effective treatment, which is positive. However, these figures highlight a longstanding problem in our country that urgently needs to be brought under control.

Dr Odwa Mazwai, Managing Director of Universal Care

“South Africa has the highest incidence of non-melanoma skin cancer in Africa. Furthermore, it is predicted that the number of new non-melanoma skin cancer cases identified here will increase by 28% by 2030 and by 73% by 2040,” he notes.

There are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Non-melanoma refers to basal cell and squamous cell carcinomas, which can be more easily treated if diagnosed early. Melanoma is listed among the top ten most frequently diagnosed cancers in South Africa, as reported in the 2023 South African Cancer Registry.

While the prevalence of melanoma has remained relatively constant in both the Universal scheme population and in the South African general population, it is predicted that the number of new melanoma skin cancer cases identified in South Africa will increase by 24% by 2030 and by 62% by 2040.

A long-term view

Dr Mazwai points out that a proactive approach to sun protection and skin cancer screenings could reduce the toll of skin cancer over time, both in terms of human life and healthcare costs.

“Looking at the age profile of non-melanoma skin cancers, it tells a clear story about the repercussions of lifestyle behaviours as far down the line as 60 or 70 years on. Just 11.6% of skin cancer patients are between the ages of 18 and 49 years, 41.9% are aged 50 to 69, and 46.5% are older than 70 years.

“Skin cancer can happen at any age, but most patients are diagnosed only after the age of 50, even though the majority of sun exposure occurs earlier in life. Sun safe practices are crucial throughout life.

Year-round awareness

“South Africa has a rich history of outdoor sports and activities throughout the year due to our fine weather. We also have a growing interest in outdoor and social fitness events, which often coincide with sun exposure. It is vital to be aware that the risks associated with sun exposure continue throughout all seasons, particularly as we have so many days of sunshine in a year,” he notes.

Dr Mazwai adds that South Africa has an average ultraviolet (UV) radiation index of 10, which is considered very high, with particularly high levels in December and January. The UV radiation index is an international standard measurement that reflects the strength of the sun’s radiation. Effective protection measures are essential in areas where the average index is above 8.

“There is an urgent need to reduce the risks of skin cancers by making a daily habit of protecting yourself from the damaging effects of the sun’s ultraviolet A (UVA) rays. UVA rays can penetrate through glass, umbrellas, and clouds and are responsible for long-term skin damage, the ageing process and potential skin cancers,” he explains.

All population groups affected

According to Dr Mazwai, all South African skin tones are at risk of skin cancer. Despite common misconceptions, all South Africans should take the necessary safe sun precautions.

“Fortunately, preventative measures are simple enough to implement. Reduce UV exposure by seeking shade between 10h00 and 16h00, avoiding sunbeds, correctly using an effective sunscreen and UV protective clothing when working or enjoying recreational activities in the sun. Regular skin cancer screenings with your physician should automatically form part of your scheduled preventative healthcare checks.

“Educating and protecting the next generation is one of the most important jobs of every parent, caregiver, and community influencer. We can turn these numbers around and continue to enjoy the sunshine, but it requires sun safe practices as part of your daily healthy habits,” he concludes.

International recognition for Africa’s Cardio-Oncology Centre of Excellence

Wed, 14 Jan 2026 10:58:03 GMT

Image: www.netcare.co.za

IC-OS certification renewed for pioneering heart health in cancer care centre

Africa’s first and only Cardio-Oncology Centre of Excellence at Netcare uMhlanga Hospital has once again been recognised by the International Cardio-Oncology Society (IC-OS), renewing its certification for a further three years.

“We congratulate Dr YT Singh on this major achievement that underlines the importance of evidence-based, data-driven interventions for protecting the heart health of people during cancer therapies,” says Dr Erich Bock, managing director of Netcare’s hospital division.

Cardiologist and certified cardio-oncologist, Dr YT (Trishun) Singh, established the world class cardio-oncology centre at the hospital in 2019 to fulfil the need for a multidisciplinary approach to cancer treatment requiring close collaboration between cardio-oncologists, oncologists and haematologists, to achieve the best possible outcomes for cancer patients.

“Dr Singh has been instrumental in upskilling our local clinicians and building South African expertise in the field, emphasising heart health within cancer care, which is essential for the best and safest standards of health and care aligned with international guidelines,” says Dr Bock.

Nearly all classes of chemotherapy and radiation to the chest may cause cardiovascular complications, known as cardiotoxicity, which puts patients at greater risk of heart problems. “Cardiotoxicity does not just involve the heart muscle, but may also include heart rhythm disturbances, arteries and veins, heart valves, pericardium, and conduction system,” explains Dr Singh, founder of the Cardio-Oncology Society of Southern Africa (Cososa), who leads the Centre of Excellence.

Cardiologist and certified cardio-oncologist, Dr YT (Trishun) Singh, established the world class centre at Netcare uMhlanga Hospital in 2019. It is the first and only Cardio-Oncology Centre of Excellence in Africa recognised by the International Cardio-Oncology Society (IC-OS).

Recently, Cososa, in collaboration with IC-OS, hosted the Global Cardio-Oncology Summit 2025 in Cape Town, bringing together healthcare professionals from cardiology, oncology, haematology, internal medicine, surgery, pharmacy, radiology, nursing, and research.

This was the first time that Africa has hosted an international summit on cardio-oncology. While this discipline is well established internationally, there is a significant need for more cardio-oncology Centres of Excellence to care for cancer patients here in South Africa and across Africa. “This summit offered an opportunity to highlight our nation’s contribution to this vital field,” Dr Singh says.

Cardiotoxicity in people being treated for cancer is aggravated if underlying cardiac disease already exists, or if the patient has comorbidities such as diabetes, hypertension, high cholesterol, smoking history and obesity associated with increased cardiovascular risk. “Anyone due to have potentially cardiotoxic cancer therapy should therefore have a baseline cardio-oncology assessment by an appropriately skilled cardiologist with cardio-oncology training,” Dr Singh says.

In terms of the guidelines and protocols of recognised cardio-oncology societies such as IC-OS, ongoing cardio-oncology assessment during cancer therapy and post-therapy surveillance is considered essential.

“The earlier people undergoing cancer treatment are identified as being potentially at risk for cardiotoxicity, the sooner we can begin interventions to help prevent or minimise damage to the heart,” says Dr Singh. “At the Centre of Excellence, we also recognise that damage to the heart muscle, valves, coronary arteries, and pericardium may occur secondary to radiation therapy to the chest, which can manifest a few years after completing chest radiation, thereby requiring a plan for careful ongoing surveillance.”

Thea Janse van Rensburg, general manager of Netcare uMhlanga Hospital, commended Dr Singh and the team at the Cardio-Oncology Centre of Excellence on the renewal of the international certification. “This achievement is testament to the expertise, hard work and dedication of the team in upholding consistency of care in this highly specialised field of medicine,” she says.

“Thanks to Dr Singh’s pioneering work, the home of world-class South African cardio-oncology is on the doorstep of the communities our hospital serves, and we thank Dr Singh for lighting this torch of hope for better outcomes, right here on KwaZulu-Natal’s North Coast.”

Listen to your body, urges brain tumour survivor

Wed, 03 Dec 2025 03:23:59 GMT

How surgeons reach brain tumours without opening the skull

When a senior communications professional started experiencing visual disturbances and dizziness, especially while exercising, the symptoms at first seemed completely unrelated. The last thing he expected was to be diagnosed with a brain tumour known as a pituitary adenoma.

“Since my duties centred on writing, editing, and proofreading stories, working on the computer became a daily challenge. The screen appeared to shine and flash, and I constantly had to force my eyes to focus. Headaches, sweating, lapses in concentration, and dizziness became part of my everyday routine. Then one day, I collapsed at work and had to be rushed to hospital,” says Samson Mabunda.

Mr Mabunda was stabilised and discharged, yet his symptoms persisted. “I was 60 and at retirement age, and although I would have liked to carry on working, my health was changing drastically, and so I called it quits,” he recalls.

“I went to my optometrist, who also happens to be my uncle, for a check-up on my eyesight because I thought I needed stronger prescription spectacles. He said something else needed to be investigated and referred me to ophthalmologists in Centurion.”

After a thorough examination and MRI, Mr Mabunda was referred to Dr Stevens Hlahla, a neurosurgeon practising at Netcare Unitas Hospital.

“Pituitary adenomas are non-cancerous tumours, however the condition affects pituitary function and, if the tumour grows it can compress the optic nerve and the person can eventually go blind if it is not treated,” says Dr Hlahla, who harnesses minimally invasive endoscopic techniques to operate deep within the brain.

“The pituitary gland in our brain is known as a ‘master gland’ because it releases hormones that regulate the body’s functions. When things go haywire in the pituitary gland, the body doesn’t function properly,” he explains.

Pituitary adenomas, such as the one Mr Mabunda was diagnosed with, vary in size. A micro tumour can cause problems affecting the person’s hormones, and this can lead to issues such as hypertension and diabetes, and is strongly associated with Cushing’s disease, while larger tumours can cause complete blindness if not treated in time.

“The symptoms of micro tumours are often vague and non-specific, and may include tiredness, food intolerances, and weight gain. In very rare cases, in children, pituitary tumours can cause gigantism due to too much growth hormone.

“The tumours tend to be slow growing, with symptoms that are insidious yet progressive – they start gradually and become more prominent over time. Sadly, these signs are often missed in initial medical consultations. It’s really upsetting to hear some patients being dismissed as ‘imagining’ their condition. Patients are treated for individual conditions like diabetes or high blood pressure, but no one identifies the pituitary adenoma as the underlying cause,” Dr Hlahla says.

Larger tumours, like the one Mr Mabunda had, cause more than endocrine problems such as diabetes; they can also damage a person’s vision. “The majority of people are nearly blind by the time they present to me. Often, they have had symptoms for a long time, but previously, open brain surgery was the only option, or they were told their tumour was inoperable because it was too deep in the brain. Tragically, it’s frequently due to a lack of awareness that many suffer needlessly, simply because no one told them something can be done to help with this condition,” he says.

“It is amazing how technology has advanced in recent years, because endoscopic techniques have made it possible to remove these tumours at the base of the skull and behind the eyes much less invasively. As we don’t need to touch the brain, we also avoid many of the complications associated with transcranial brain surgery,” Dr Hlahla says.

The endoscopic approach is suitable for most patients. Instead of cutting through the skull, an ear, nose and throat (ENT) surgeon carefully guides the endoscope – a slender tube with a tiny light, high-definition camera, through the person’s nostril and nasal passages to gain access for this ‘keyhole’ procedure. As an added benefit for those who snore, the ENT surgeon can correct their deviated septum on the way through the nasal passage to the base of the skull.

“There is a high probability of cure with the endoscopic approach, and compared with traditional surgery, usually hospital time is halved. For larger tumours, functional vision can often be restored, although if the optic nerve has been damaged or compressed for too long, this may not always be possible. This emphasises the importance of early diagnosis and treatment, as it can rob people of their eyesight and their livelihood if not caught in time.”

Since his operation in August 2023, Mr Mabunda has noticed a significant improvement in his quality of life. “Today, I am living my life to the fullest. I can drive again, and it feels as though a heavy weight has been lifted from my body. My best advice to others is to listen to their bodies. The signs and symptoms we feel are messages about our state of health, and we should never ignore them,” he says.

“Above all, I thank the Almighty God whose hand guided Dr Hlahla, my ENT surgeon, and the entire team to perform a successful operation. If nursing is truly a calling, I witnessed its fullness at Netcare Unitas Hospital, especially during my post-surgery recovery,” Mr Mabunda concludes.

Whooping cough is back: Protect your family

Mon, 24 Nov 2025 09:57:11 GMT

Highly contagious pertussis coughing fits can crack ribs

The distinctive high-pitched sound of someone gasping for air in the severe coughing spasms associated with pertussis explains why it is commonly known as ‘whooping cough’.

“Pertussis is a highly contagious respiratory infection, and most people recover after a prolonged period of coughing, but for some it can lead to pneumonia and other potentially life-threatening complications – especially for young children, pregnant women and older people,” says general practitioner (GP) Dr Rubena Sathar, who practises at Netcare Medicross Cape Road.

After a few quiet years, pertussis cases have increased slightly in 2025, according to the National Institute for Communicable Diseases (NICD). “While the numbers are relatively low, it’s the highly contagious nature of pertussis that makes it potentially concerning, and for this reason, it is a notifiable condition. Prevention is always better than cure, because you never know when pertussis might lead to complications,” she says.

“It is reassuring that we can protect our families and communities and prevent more severe illness through immunisations, which are safe, widely accessible and recommended by local and international health authorities as the best means of protection against pertussis.”

NICD’s pertussis vaccination schedule for South Africa includes a primary series of three doses given to babies at six, 10, and 14 weeks of age. A fourth dose is given as a first booster at 18 months. Later boosters include doses at six and 12 years of age.

“Immunity wanes over time and protection from the booster doses lasts approximately five to six years. For anyone seven years and older who is in contact with at-risk individuals, such as newborn babies or older individuals, and has not received a recent pertussis-containing booster, a Tdap-IPV booster is recommended, particularly if more than five years have passed since their last dose,” she notes.

The acellular pertussis-containing vaccine is also recommended during pregnancy to help protect young infants in the first weeks of life before they can be immunised.

Pertussis symptoms start slowly

“Initially, pertussis produces mild respiratory symptoms for the first week or two that may be hard to distinguish from a common cold. During this phase, pertussis is most likely to spread to others through droplets when the person coughs or sneezes,” notes Dr Sathar.

“It’s only from the second or third week that the cough becomes more severe and those characteristic loud, high pitched whooping cough spasms take hold. Although there is little to no fever, the bacterial infection in the respiratory tract causes a productive cough and coughing spells can be so extreme that they cause vomiting and severely disrupt sleep.

“Weight loss or sleep apnoea – that is obstructed breathing that disrupts sleep – can be a real concern for children with whooping cough, and parents should take careful note and report this to their doctor too,” she says.

“By four to six weeks after the initial onset, symptoms should gradually start to improve for most people, however this is one of the respiratory illnesses that’s commonly referred to as a ‘100-day cough’ because it takes time for the airways to clear and heal,” Dr Sathar says.

She points out that, since people with pertussis can sometimes develop severe complications that may progress to be life-threatening, it is especially important to seek medical attention early for respiratory symptoms.

The professional and approachable GPs practising at Netcare Medicross facilities countrywide are on hand to assist with all primary healthcare needs, including booster vaccinations for pertussis, all year round.

“Instead of dealing with complications later in the course of the illness, rather see your local GP early, get tested if necessary and self-isolate with plenty of rest and fluids,” Dr Sathar recommends.

“Better yet, book an appointment if you haven’t had a pertussis booster in the last 10 years and ensure your family is protected. Vaccines are safe. There’s a lot of misinformation about vaccines on social media, so rather discuss any concerns you may have with a medical professional to make an informed decision.”

Visit https://www.netcare.co.za/search?path=medicross_medical_dental to find your closest Netcare Medicross and make an appointment.

Identifying hidden head injuries and tips for healthy brain ageing

Mon, 17 Nov 2025 12:41:33 GMT

Neurosurgeon on an awareness mission

Signs of head or brain injuries can be more difficult to detect in older individuals; however, with simple awareness and preventive measures, the toll of these often unseen injuries can be reduced.

Neurosurgeon Dr Denis Mutyaba, who practises at Netcare Unitas Hospital in Pretoria, says the number one thing that the elderly and their caregivers can do to prevent them from needing surgery is a straightforward thing to do. “Be extra vigilant about removing the risks associated with slipping, tripping and falling, because injuries from these often avoidable accidents can have life-changing consequences,” advises Dr Mutyaba.

One of the leading causes of older people needing neurosurgery is a result of simple falls at home.

Neurosurgeon Dr Denis Mutyaba practises at Netcare Unitas Hospital in Pretoria.

“We see many people who have suffered subdural haematomas, a bleed on or near the brain, which is a serious injury. We also see brain trauma cases and spinal fractures because of osteoporosis, even from seemingly minor falls,” says Dr Mutyaba.

He explains that there is an extra reason to be cautious when older adults take anticoagulants, also known as blood thinners, because these medications can make bleeding worse even after a relatively minor fall.

When to get medical help

“Sometimes it can be tricky for a caregiver or family member to tell how serious a fall was, and whether the person needs medical treatment, especially where there are no visible injuries. There may not be a visible bruise or cut, but those nearby may start to notice signs that something is not normal,” says Dr Mutyaba.

The biggest indicator is when the person appears confused, or if they have existing dementia or are more confused than usual, he explains. “This means they need medical attention straight away and must either go to an emergency department at a hospital or to their general practitioner. It is important to have them examined by a healthcare practitioner without delay.”

Other signs that there could be a hidden injury include sleepiness or a reluctance to eat. New or worsening back pain can also indicate that an injury has occurred, warranting a medical examination. “Many older individuals may have osteoporosis, which means they are more likely to experience spinal fractures when they fall.”

While the thought of oneself or a loved one having to undergo neurosurgery can be daunting, Dr Mutyaba says he reassures those under his care and their families that he only ever operates as a last resort, especially when treating older people.

“We try every other method of intervention first and often get good results from non-surgical treatment. For example, as we age, our brains atrophy and lose volume, so sometimes they can accommodate a blood clot without the need for us to intervene and remove it. I try to be as conservative as possible with older people.

“For example, there are questions that need to be answered, such as whether I will improve their condition or potentially make them even more dependent. We do the least surgery for the condition, always to the maximum benefit.”

Brain volume and healthy brain ageing

Dr Mutyaba explains that as we age, it is a given that we will naturally lose brain volume. “But there are certain things that can accelerate this, like poorly controlled blood pressure leading to multiple strokes. Excessive alcohol consumption and genetic factors also play a role in shrinking brain volume.

“Because healthy brain volume correlates with healthy brain function, it’s critical that we give ourselves the best chance to maintain brain volume by managing our diets and choosing to live a healthy lifestyle. Those with diabetes must work to control it properly, with better nutrition choices. If you have high cholesterol, get advice from your general practitioner and dietitian to lower it to reduce your chance of strokes.”

While Dr Mutyaba describes himself as an all-rounder in the field of neurosurgery, he has a special interest in paediatric cases, oncology, craniofacial surgery and trauma cases. For him, seeing a patient recover well after he has intervened with major surgery is hugely rewarding. “As a surgeon, it makes you feel good knowing you’ve taken an active step in improving the outcome for someone’s life. When they do well, I look forward to seeing them in my consultation room again and again. It really brightens my day.”

Five tips for preventing falls for the elderly

Based on his experience, Dr Mutyaba shares these practical tips for avoiding surgery in older people.

Don’t live alone – This can sometimes be a difficult one, because many older people value their independence and can be stubborn about recognising when it is time to live with family, or move into an environment where caregivers are available to them. “But really, the number one factor is, please don’t live alone.”
Pick up rugs – He urges older people and their carers to avoid placing loose rugs on their floors, as these can be a major tripping hazard.
Stay away from stairs – Stairs are an obvious hazard for older people, and Dr Mutyaba says he has treated many older people who have sustained serious injuries on stairs.
Contact is key – Dr Mutyaba urges caregivers and family to ensure older people can easily contact them should they experience a fall. “But it’s also up to them to contact the elderly often to check in on them.”
Install handrails and good lighting – “Make sure they can see where they are going and have something to hold onto to stabilise themselves.”

Quicker, clearer MRI imaging with less stress for children and adults

Thu, 06 Nov 2025 09:06:24 GMT

The exceptional image clarity and patient comfort features of the recently installed Magnetom Flow Ace MRI system at Netcare Garden City Hospital are complemented by tranquil beach scene decor and caring radiology staff. Pictured are the head of MRI at ImagePro Radiology, Comfort Matamela, and MRI radiographer, Emily Ramotsehoa.

A closer look inside the body with state-of-the-art AI enhanced MRI

The latest in magnetic resonance imaging (MRI) technology for the diagnosis of innumerable health conditions and treatment monitoring has a new home with the installation of a state-of-the-art system at Netcare Garden City Hospital, one of only a handful in Africa.

“Every clinical discipline requiring a highly detailed view of structures within the human body, from audiology, cardiology, gynaecology and orthopaedics to neurology, surgery and urology, can benefit from higher resolution MRI scans,” says radiologist Dr Trevor Nefale, of ImagePro Radiology based at the hospital.

“For patients and parents of children needing an MRI, the introduction of the Magnetom Flow Ace system significantly improves the experience and MRI scans take just minutes, while providing consistent optimal quality imaging for treating specialists to guide their diagnosis and treatment options better,” he says.

Enhanced image clarity in focus

“MRI is used for various diagnostic purposes, including brain and neurological conditions such as multiple sclerosis, evaluating spinal injuries or conditions such as disc herniation, and is often used in neurosurgery planning. It is also invaluable for diagnosing injuries and tumours throughout the body, especially diseases of the soft tissue, which the new flagship MRI technology, incorporating Deep Resolve AI image reconstruction software, allows us to visualise and distinguish more clearly than ever before,” Dr Nefale explains.

The high resolution MRI scans produced by the new multimodality system, supplied by Siemens Healthineers, have particular value for acute stroke diagnosis at Netcare Garden City Hospital’s World Stroke Organization (WSO) certified Essential Stroke Centre where every minute is precious for preserving brain function. Rapid, evidence-based treatment protocols are the hallmark of WSO certification, as these directly impact stroke survival and outcomes. As of October 2025, Netcare Garden City Hospital is one of only 34 hospitals from 17 countries that have achieved this full certification, or are actively pursuing it.

Fellow radiologist Dr Dharmesh Kessow adds, “The higher resolution musculoskeletal imaging also brings a new level of clarity for visualising sports injuries, as well as non-invasive abdominal-pelvic investigations, providing the treating doctor with more detailed information to assist with reaching treatment decisions that support better outcomes.”

The extreme clarity of the imaging, enhanced by scientifically developed neural networks that provide a much sharper definition of tissues and structures than previously, is significant for breast imaging, prostate cancer diagnosis, treatment monitoring, and active surveillance.

Comfort and reassurance

In further improvements on the prior MRI generation, the new system design incorporates comfort features, including contour coils with integrated sensor technology that gently support the head, neck, and spine, adjusting to each person’s unique body shape and, where needed, their breathing throughout their scan. This also allows for subsequent scans to exactly replicate the positioning for precise comparison over time.

Unlike X-rays and CT scans, MRIs do not involve radiation exposure, making them a safe option for repeat imaging, such as when monitoring a tumour’s response to treatment.

The MRI room’s tranquil, beach-inspired theme is designed to be a calming setting. “The radiographer remains at the person’s side while they are registered and positioned before starting the scan, providing reassurance for paediatric and nervous individuals. The system is also equipped with ComfortSound wireless audio, which helps block out the sound of the scanner, which can otherwise be a bit noisy from inside,” Dr Kessow explains.

In terms of environmental sustainability, the Magnetom Flow Ace uses significantly less power than previous generation MRI systems, and its closed design does not require helium refilling.

Zeyn Asmal, general manager of Netcare Garden City Hospital, congratulated the radiology practice on the emphasis it places on person centred MRI and other medical imaging solutions. “We appreciate the value this technological advancement in MRI adds, both in terms of the experience of healthcare and the potential for guiding treatments to achieve better medical outcomes,” Asmal concludes.

Breakthrough for African stroke care

Thu, 30 Oct 2025 13:14:47 GMT

Lisa Hawksworth, unit manager, Netcare Linksfield Hospital emergency department (left) and Zasskia Wiese, Netcare trauma programme manager and national stroke coordinator (right).

Two South African hospitals achieve groundbreaking WSO accreditation

In a breakthrough for African healthcare, Netcare Garden City Hospital in Johannesburg and Netcare Blaauwberg Hospital in Cape Town have become the first healthcare facilities in southern Africa, and among the first on the African continent, to receive World Stroke Organization (WSO) certification.

This milestone comes during National Stroke Week (28 October to 3 November), when the devastating impact of stroke comes into sharp focus: 75 000 South Africans experience strokes annually, with 25 000 proving fatal. The survivors face a collective 95 000 years lived with disability.

“Becoming one of the first African countries with WSO-certified stroke centres is monumental for South Africa,” comments Zasskia Wiese, Netcare trauma programme manager and national stroke coordinator. “As of October 2025, only 34 hospitals from 17 countries have either achieved full certification or are actively pursuing it.”

The significance becomes clear when considering that sub-Saharan Africa records the world’s highest stroke incidence at 316 per 100 000 people. In South Africa, where rural areas carry at least half the stroke burden, the need for world-class treatment has never been more urgent.

“During a stroke, the brain loses 1.9 million neurons every minute. That is why rapid, evidence-based treatment protocols – the hallmark of WSO certification – have a direct impact on whether patients survive and regain their independence,” notes Wiese.

What the WSO certification means for patients

The WSO-certification programme establishes rigorous, evidence-based standards that have been proven to reduce mortality and disability rates globally. To achieve certification, hospitals must demonstrate:

Rapid assessment protocols that ensure patients receive treatment within a critical window of time
Specialised stroke teams trained to international standards
Advanced imaging capabilities and treatment options
Comprehensive rehabilitation services
Continuous quality monitoring and improvement systems

Zasskia Wiese, Netcare trauma programme manager and national stroke coordinator (left), photographed here with Wendy Zimkhitha Mandindi, Angels initiative consultant for Gauteng South, North West and Botswana (right).

"WSO-certified centres achieve dramatically better outcomes through meeting crucial time targets for clot-busting medication. When someone arrives at our emergency department with stroke symptoms, every second counts," explains Wiese.

For patients at Netcare Blaauwberg and Netcare Garden City hospitals, these standards translate into tangible benefits: faster treatment times, access to the latest therapies, and teams equipped with protocols proven effective worldwide.

Building on a foundation of excellence

“This achievement represents years of systematic improvement in stroke care at Netcare. Netcare hospitals and Netcare 911 have been awarded more than 100 WSO Angels Awards since 2023,” notes

Dr Erich Bock, managing director of Netcare’s Hospital Division.

“The WSO Certification differs from these awards in that it evaluates the entire stroke care system. It is not just a badge of recognition; it is a continuous quality improvement framework that transforms hospital systems and measurably reduces the stroke burden.

“The certification process examines every aspect of stroke care, from emergency response times to long-term rehabilitation outcomes. This comprehensive approach ensures that certified centres maintain excellence across the entire patient journey,” he adds.

A catalyst for continental change

The implications extend far beyond these two hospitals. As models for other African healthcare facilities, they demonstrate that world-class stroke care is not limited by geography.

“This creates opportunities for international collaboration and knowledge exchange. The economic argument is equally compelling. With stroke-related disability creating massive financial burdens on families and healthcare systems, improved treatment standards could significantly reduce these costs while preserving patients’ independence and quality of life,” says Dr Bock.

The path forward

The certification positions South Africa alongside developed nations in stroke treatment capabilities. While countries like the United States, Germany, and Japan have numerous certified centres, Africa is just beginning this journey.

"This achievement reflects the tireless dedication of our entire team," says Dr Bock. "From Mande Toubkin, Netcare's general manager of emergency, trauma, transplant and corporate social investment, to Zasskia Wiese, who spearheaded the certification process, to every healthcare professional and staff member who embraced these rigorous standards – they've all proven that African hospitals can compete on the world stage. The question isn't whether we can achieve global excellence anymore. It's how quickly others will follow our lead."

According to Wiese, plans are already well underway to expand the programme. “Netcare aims to have many more hospitals certified within the next year, while we are hoping to share best practices with public sector facilities to improve stroke care nationwide. We are also working to launch the Fast Heroes programme in schools across the country. ”

“For the 205 South Africans who will suffer strokes today, and every day, these two hospitals represent hope. They prove that receiving stroke treatment in Africa doesn’t mean accepting second-best outcomes.

“As stroke care transforms across the continent, one thing is clear: Netcare Garden City and Netcare Blaauwberg hospitals haven’t just achieved a certification – they’ve lit a path that could save thousands of lives across Africa,” concludes Dr Bock.

About WSO certification

The World Stroke Organization's Stroke Centre Certification program helps hospitals worldwide implement evidence-based practices that improve patient outcomes. Participating centres report average reductions in mortality of 20-30% and significant improvements in functional recovery rates.

Consider this before conception: Ob-gyn’s advice

Mon, 27 Oct 2025 06:00:06 GMT

Your healthiest pregnant self, child spacing and risk assessment

Bringing a new life into the world can feel daunting at any age, yet when pregnancies are planned, there are more opportunities to give a baby the best possible start, beginning well before conception.

“Before stopping contraception, there are a few things that couples should be informed about that could profoundly influence the future of the child they are planning for,” says Dr Mokgohloe Phasha, an obstetrician-gynaecologist (OB-GYN) practising at Netcare Park Lane Hospital.

“A pre-conception visit offers the chance for women to enter pregnancy as their healthiest self, and lay the optimal foundation for their future baby. Although pre-conception appointments have an important role in ensuring a healthy pregnancy, sadly, few people fully appreciate the value this holds both for mother and baby and for managing potential risks before falling pregnant,” she says.

In addition to a physical examination, the specialist would ask questions during the appointment to establish whether there are any particular risk factors for your pregnancy and to assess and discuss the potential risks that may be relevant.

Assessing potential medical risks

“While many women have healthy babies well into their 40s, pregnancy after the age of 35 is associated with increased risk for genetic abnormalities. We are born with all our eggs, so our eggs are as old as we are.

“Over time, the number and viability of a woman’s eggs wane, which may also increase the risk of miscarriage. Advanced maternal age during pregnancy may pose a few extra health risks for the woman, but the good news is that these pre-conception assessments allow us to identify and mitigate risks wherever possible before the baby is even conceived,” Dr Phasha says.

For parents of any age, pre-conception assessments are an opportunity to determine whether the couple are known carriers of certain genetic abnormalities, discuss the risks of passing the condition to the next generation, and explore options to mitigate those risks if they are present.

Other tests are performed at a pre-pregnancy appointment to ascertain whether the mother-to-be has new health conditions, such as type 2 diabetes, that could have an impact on the pregnancy. “If the woman has a known medical condition, we assess if it is well controlled and check whether the medication she’s on is suitable for pregnancy and advise on adjustments if necessary, with multidisciplinary collaboration to ensure that her medical condition is well managed in preparation for hosting her baby.

In a pre-conception consultation, the need for vaccinations is assessed. “German measles is especially of concern, as when contracted in pregnancy it may result in minor symptoms for the mother but can lead to abnormalities in the foetus, including growth restriction and poor brain development. Hearing, sight, and the heart may also be affected. Being vaccinated before pregnancy can prevent these serious risks to the baby. We recommend not falling pregnant for 6 to 12 weeks after vaccination, so continuing contraception is imperative around that time.”

Child spacing, maternal health and bonding

Dr Phasha adds that another important aspect of pre-conception consultations is to discuss child spacing with the woman or couple. “Pregnancy takes a toll on a woman’s body, and child spacing refers to the length of time, in months or years, between a woman’s pregnancies. Generally, it is recommended that pregnancies are spaced at least 18 months to two years apart to allow the woman’s body sufficient time to recover and replenish stores before the next baby’s gestation period begins,” she explains.

“Spacing pregnancies out also allows sufficient bonding time with the older child, which helps create a secure attachment, rather than an anxious attachment with the arrival of the new sibling, making for a more harmonious home dynamic,” Dr Phasha says.

Golden window of opportunity

Dr Phasha points out that a healthy lifestyle underpins wellness before and after pregnancy. “The first three months of pregnancy are crucial for organ development, and women planning to conceive should avoid alcohol and quit if they are smokers well in advance. Women need to know we are here, there is non-judgemental help available that remains absolutely confidential,” she says.

The benefits of folic acid supplementation during pregnancy are well known, but often women only realise they are pregnant after their first trimester, missing a golden window of opportunity to prevent neural tube defects. “This inexpensive intervention has proven to significantly reduce the risk of spina bifida, which can lead to paralysis of the baby’s legs. The mom-to-be’s folic acid requirements are met ahead of conception,” Dr Phasha advises.

As a specialised maternity facility, Netcare Park Lane Hospital includes one of the country’s most respected neonatal intensive care units alongside caring and experienced obstetric teams. For high risk deliveries, these integrated services provide an additional layer of reassurance for expectant parents.

“Our children are our legacy to the world, and taking the time to prepare well before the patter of tiny feet is an extremely worthwhile investment in your family’s future,” Dr Phasha concludes.

Be informed about breast cancer – it could save your life

Fri, 10 Oct 2025 06:32:08 GMT

Person centred multidisciplinary breast centre at Netcare Parklands Hospital

Breast cancer does not only affect women, men can face it too, meaning this is a health concern everyone needs to understand. Spotting the early signs can save lives, and today’s advanced diagnostics, combined with cutting-edge treatments, offer hope like never before. This is a fight we all need to understand, because knowing what to look for could make a significant difference.

“The sobering fact is that, depending on the population group, breast cancer is the top or second leading type of malignancy detected among South African women according to the 2023 National Cancer Registry,” says Dr Sanjeev Hariparsad, a breast surgeon practising at Netcare Parklands Hospital’s Breast Clinic, who gained international perspective as an Honorary Fellow of the Breast Unit at Cambridge University and in a Breast Unit in Hong Kong, before returning to KwaZulu-Natal.

Dr Sanjeev Hariparsad, Specialist Surgeon and Breast Surgeon

Cancer is an uncontrolled growth of cells that start multiplying in a disordered manner. Cancers in the breast ducts and lobules are called carcinomas, while breast cancers of the supporting tissue are referred to as sarcomas.

“The most common symptom people notice first is a painless lump. We need more public awareness to break the misconception that pain is the main symptom of breast cancer when, in fact, pain is a very late symptom that may only present once the cancer is significantly more advanced,” he says.

Other signs that should be investigated include any changes to the shape of the breast, skin changes or bloody nipple discharge. “It is essential to check your breasts, armpit and chest area regularly and address symptoms or swelling as soon as they are noticed by visiting a doctor with experience in breast disease. In general, the earlier breast cancer is diagnosed – before it has had a chance to spread, the less complicated it is to treat.

“Anyone can get breast cancer, even men, although it is more common in women. If left untreated, breast cancer will usually spread through the body to sites such as the lymph glands, lungs, bones and liver. These can result in bone pain, difficulty breathing, and many other complications that become more complex to treat. This is why self-examination and screening, including mammograms and ultrasound, are crucial.”

Self-examination simple steps

All women should perform self-breast examination from the age of 20 years onwards, at the same time each month when the breasts are least sensitive.

“In the shower, standing in front of a mirror, feel your breast with the palm of your opposite hand, and make sure to include the breast in the armpit. Examine one breast at a time and look out for any lumps or changes in the appearance of the breast, skin or nipples. Repeat this lying down,” Dr Hariparsad explains.

If you find something concerning, visit a doctor or clinic with experience in working with breast disease.

Newer treatments are increasing the options for breast cancer care at Netcare Parklands Hospital, adds radiation oncologist Dr Lucille Heslop.

“While chemotherapy and radiotherapy to the chest are effective for treating cancer, these can cause cardiovascular side effects. Deep Inspiration Breath-Hold (DIBH) radiotherapy aims to reduce exposure leading to cardiac toxicity for patients with left breast cancer who have already been exposed to cardiotoxic chemotherapy and targeted antibody therapy, such as Herceptin.”

DIBH is now a firmly established technique, which helps to more clearly define the coronary vessels and heart, allowing more precise planning to deliver the radiation dose safely where needed and offering protection to the heart and lungs. The method requires patients to breathe in deeply and hold their breath for a few seconds, guided by the radiotherapists.

“Before treatment, an MRI or CT scan is performed to identify the area the radiation beam should be focused on and the position of the heart, chest wall and other critical structures nearby that we need to avoid radiation exposure.

“When positioned on the treatment bed, the patient breathes in, causing the lungs to expand. As the chest rises, the heart drops into a lower position in the chest cavity, away from the targeted burst of radiation, while the patient holds their breath for 15 to 20 seconds. The person usually needs to be repositioned several times, but the treatment itself is delivered in these very short bursts,” Dr Heslop says.

“In the past, we saw mainly older people being diagnosed with breast cancer, but nowadays, it is a wide spectrum of age groups. Breast cancer is very treatable these days, and with the more advanced techniques available, such as DIBH radiotherapy, we can treat effectively while limiting the side effects of treatment,” Dr Heslop says.

To book doctors and specialists’ appointments conveniently according to your location and preferences at any Netcare Hospital or Netcare Medicross facility nationwide, call Appointmed on 0860 5555 65 during office hours or visit https://www.netcare.co.za/netcare-appointmed.

Black men at higher risk for prostate cancer – more reason to test

Fri, 26 Sep 2025 12:17:12 GMT

Regular screening a must for better outcomes

After skin cancer, prostate cancer is the most common cancer among men. Yet locally, not enough men of African descent – who are at higher risk for the disease – are regularly screening to catch the disease early and take advantage of the treatments available.

“International research indicates that black African men are 60% more likely to develop prostate cancer. There are different types of prostate cancer, and the majority are completely silent – when advanced symptoms like swollen lymph nodes, leg weakness and weight loss are noticed, it may be too late for curative treatment,” says Dr Steven Cornish, a urologist practising at Netcare Sunninghill Hospital.

Urologist, Dr Steven Cornish

“We need greater awareness that prostate cancer does not have to be life-threatening when men know their risk factors and make screening part of their healthcare routine. Considering where the prostate gland is located, men would not usually notice if prostate problems were developing. This is why blood tests, called prostate-specific antigen (PSA) tests, and a digital rectal examination by a doctor are needed.”

“This simple test takes just a moment and may be lifesaving. In South Africa we are still trying to build solid national statistics on prostate cancer, however, there still seems to be a noticeable taboo surrounding this vital men’s health priority.

“To improve prostate cancer outcomes across all communities, we need men to have open conversations with their doctors about screening, particularly black men, as their incidence of prostate cancer internationally is higher than for other population groups.”

Netcare Sunninghill Hospital is hosting a prostate cancer public awareness event on Saturday, 20 September 2025, where men can have PSA blood testing free of charge sponsored by Astellas pharmaceuticals, and learn more about this crucial men’s health issue. PSA levels can point to a number of prostate-related issues, including an enlarged prostate, which is a normal part of ageing, infection of the prostate or prostate cancer.

“Higher PSA levels simply mean there is something worth investigating with your doctor, it does not necessarily mean prostate cancer is present. Even if there is a need for a small biopsy, and the results lead to a diagnosis of prostate cancer, there is no need to panic. These days, prostate cancer is usually highly treatable if it is picked up earlier,” Dr Cornish explains.

Men with a family history of prostate cancer in male blood relatives or breast or ovarian cancer in female relatives have an increased genetic risk of developing prostate cancer, and they would require earlier or more frequent screening.

It is recommended that all men be screened for prostate cancer at age 45; however, black men and those with a close family history, which includes a parent or sibling, should start earlier at age 40.

“Men should continue to screen, either annually or every five years, depending on individual risk factors and previous PSA results, until they are in their anticipated last 10 years of life. Sometimes, prostate cancer may not even require treatment, and an approach of ‘active surveillance’ is used because prostate cancer usually does not progress as quickly as lung or liver cancer, for example. This means that if you are diagnosed, you do have time to think about your options and ask questions – you have the right to be informed about your health status,” he says.

“The need for regular screening starting in a man’s 40s is tied to the observation that prostate cancer appears to be occurring earlier in succeeding generations. Also, the small percentage of prostate cancers that are more aggressive are often detected in younger men,” warns Dr Cornish.

“As men, we never know when this common male cancer could strike us, but we can be prepared for better outcomes by making screening part of our health routine and by helping to protect our loved ones by having these important conversations with the men in our families.”

Scarring of the lungs can be treated if detected early

Wed, 10 Sep 2025 05:35:32 GMT

Exposure to bird droppings, asbestos or smoking can increase risk

Past lung infections, autoimmune diseases and prolonged exposure to small particles like dust, smoke, asbestos – commonly used in building materials up until the 1980s – feathers or bird droppings, can cause scarring in the lungs. With medical advances, there is now new hope for people living with pulmonary fibrosis, particularly if the condition is identified early.

“Pulmonary fibrosis means scarring of the lungs. Over time, normal, healthy lung tissue that is soft, stretchy, and sponge-like to help us absorb oxygen, is gradually replaced by scar tissue, which makes the lungs stiff and thick,” explains Dr Shikar Mothilal, a specialist physician sub-specialising in respiratory medicine who practises at Netcare Christiaan Barnard Memorial Hospital.

“When this happens, the scar tissue prevents your lungs from expanding properly. They hold less air, and oxygen has trouble passing into the bloodstream when you breathe. It’s essential to recognise that although pulmonary fibrosis often begins slowly, it worsens over time. It is not contagious, and so it can’t be passed from one person to another, and the rate of progression also varies from person to person.”

Dr Shikar Mothilal

Symptoms

Early signs

Shortness of breath that starts mildly when walking fast or climbing stairs and progresses to daily activities, such as dressing or showering.
Often described as feeling like “my lungs just can’t keep up”
Chronic cough that’s often dry or sometimes productive
Persistent, hacking cough that doesn’t produce much phlegm
May worsen with talking, laughing, or exertion

Advanced signs

Fatigue and low stamina, a constant feeling of “running on empty”, are tied to low oxygen delivery and the extra effort needed to breathe
Unexplained weight loss due to high energy use and reduced appetite
Muscle and joint aches, especially if linked to autoimmune causes

“Notably, symptoms of pulmonary fibrosis usually start subtly and progress slowly. Fatigue, weight loss, and signs of low oxygen such as finger clubbing — a swelling and rounding of the fingertips — appear as the disease advances,” Dr Mothilal explains.

It’s essential to recognise that pulmonary fibrosis refers to lung scarring resulting from various causes and is therefore not a singular, specific disease. There are multiple causes that may lead to the development of pulmonary fibrosis, and often the particular trigger is unknown – this is called idiopathic pulmonary fibrosis (IPF).

“This type of pulmonary fibrosis is more common in men, although women are increasingly affected. People over the age of 50 are also at higher risk. It is believed to involve genetics with an abnormal healing response, where the body ‘over-repairs’ minor injuries in the lungs by producing excess scar tissue,” Dr Mothilal says.

“The development of fibrosis in the lungs can also be secondary due to autoimmune and connective tissue diseases, where the body’s immune system mistakenly attacks the lungs, leaving scars and reducing a person’s ability to breathe over time. Conditions that could cause this include rheumatoid arthritis, scleroderma, lupus and Sjögren’s syndrome, among others,” Dr Mothilal says.

Long-term exposure to irritants like pollution, acid reflux, and workplace dust can silently damage lung tissue over time. While smoking remains a key culprit, substances like asbestos and silica dust—common in certain industries—also pose serious threats, underscoring the importance of protective measures and early detection.

“Other common environmental factors include coal dust, tiny particles of sawdust, grains or metals. Exposure to mould and animal proteins, notably bird excrement or feathers, may cause forms of hypersensitivity pneumonitis that can lead to scarring, depriving the body of vital oxygen if left untreated. Farmers, bird breeders, or those who keep or handle poultry may be especially at risk.

Long term use or high dosages of certain medications, forms of chemotherapy or radiation therapy may increase the chances of a person developing pulmonary fibrosis.

“Although there are some risk factors that we can’t control, such as our genes, there are things we can do to help reduce our risk for pulmonary fibrosis. Smoking is the most critical modifiable risk factor, as smokers are at significantly higher risk of pulmonary fibrosis and faster disease progression. Avoiding triggers and exposure to irritants is also crucial.”

The good news is that with awareness and close medical follow-up, it is possible to reduce risk and better manage fibrosis if needed. “Pulmonary fibrosis isn’t curable yet, but treatments and lifestyle steps can help slow it down and improve quality of life for those affected. It’s vital to treat any underlying causes. Antifibrotic therapies can slow the rate of scarring, and while they don’t reverse the damage, these can buy time by reducing how quickly the lung tissue stiffens,” he says.

Palliative and supportive care can be integrated early alongside active treatment. “Palliative care in this context is not end-of-life care; rather, the aim is improving comfort, symptom control, and life quality,” Dr Mothilal emphasises.

“If oxygen saturation is low, oxygen therapy helps provide more ‘fuel’ for the body to reduce shortness of breath and fatigue while also improving sleep and protecting vital organs. The availability of portable devices means that people with fairly advanced fibrosis can travel and stay active. There is a persistent myth that in the presence of hypoxia, or low oxygen saturation, supplemental oxygen will be addictive or that inhalers or nebulisers may be addictive and weaken the lungs. This is untrue,” he says.

“Pulmonary rehabilitation, including a structured programme of exercise training, breathing techniques, education, physiotherapy and healthy nutrition, can make the most of remaining lung function and improve quality of life. For advanced disease when other treatments no longer help, a lung transplant may be an option for selected patients. This is not for everyone, but for the right person, it can potentially add years of better quality to their life.”

“Pulmonary fibrosis is not a normal part of ageing, and there is often much that we can do. Early recognition and proactive care make a huge difference. Support networks – from doctors to family to peer support groups – are crucial. Medicine has already shifted from having ‘nothing to offer’ patients to medications that slow scarring and transplants that can extend life. Ongoing research is a source of even more hope for the future,” Dr Mothilal concludes.

Let’s talk about cervical cancer

Fri, 29 Aug 2025 10:03:11 GMT

Awareness is power – getting vaccinated and screened can save your life

A collaborative partnership is set to spark a vital conversation among students at Tshwane University of Technology (TUT) – Soshanguve Campus, about the vaccine that can protect against cervical and other cancers and save thousands of lives every year.

On 14 August, multinational healthcare company Universal Healthcare teamed up with the National Department of Health (NDoH), the South African Vaccination and Immunisation Centre (SAVIC), and Merck Sharp & Dohme (MSD) for a dedicated awareness day on campus.

“More than just spreading information, our goal is to inspire young people to take real action – vaccinating themselves and their communities against the human papillomavirus (HPV), the leading cause of cervical cancer and other devastating illnesses.

“Cervical cancer continues to take too many lives in South Africa – about 10 700 new cases and over 5 800 deaths annually,” says Dr Nono Ledwaba-Mweli, Medical Director of Universal Care.

“This is a preventable disease, yet far too many women lose their lives because they don’t have access to the right information about HPV and the vaccine. Breaking through fear and misinformation is essential. Students have the power to protect themselves and influence others to do the same,” she adds.

“Young people are the heartbeat of the future. Awareness is the first and most critical step in prevention. When students understand HPV and cervical cancer, they gain the knowledge to make life-saving decisions, not just for themselves, but also for their families and wider communities,” Dr Nono notes.

Preventing HPV is about more than health – it is about protecting families, communities and even the economy. When more women are vaccinated, fewer cancer cases follow, more lives are saved, healthcare systems are less burdened, and everyone benefits says Dr Nono Ledwaba-Mweli , Medical Director of Universal Care.

HPV is a virus mainly spread through sexual contact and is extremely common. Of the many strains, around fifteen are high-risk for causing cervical cancer. “Types 16 and 18 alone cause nearly 70% of cervical cancer cases worldwide. The vaccine protects against these strains and others. Getting vaccinated and regularly screened are simple yet powerful steps that save lives,” explains Dr Nono

“Preventing HPV is about more than health – it is about protecting families, communities and even the economy. When more women are vaccinated, fewer cancer cases follow, more lives are saved, healthcare systems are less burdened, and everyone benefits,” she adds.

South Africa was a pioneer in Africa, introducing HPV vaccination into the national immunisation programme in 2014, targeting girls before their first sexual encounter. Yet, vaccine uptake remains disappointingly low.

“Stigma and myths still hold many back,” says Dr Nono. “Students can be the changemakers, shattering misinformation by sharing facts and encouraging one another to get vaccinated.”

Efforts to combat cervical cancer include vaccination programmes and screening initiatives, but challenges remain, especially in reaching enough people with the proper knowledge and follow-up care.

“This campaign, scheduled to be held in August at TUT and in September at SMU, is a chance for students to join a movement bigger than themselves. Awareness is not just information; it is power. Your voice can influence friends, family, and communities. By supporting this campaign, you are helping build a healthier future for South Africa’s women,” encourages Dr Nono.

“Cervical cancer does not have to be a death sentence, but we can only beat it if we expand understanding and act together. Students, this is your moment – get involved, spread the word, and help save lives,” she concludes.

Universal Healthcare and its partners will be on site at TUT on Thursday, 14 August, to provide information and answer questions. Students who participate can enter a competition by scanning a QR code for a chance to win a prize—a small thank-you for supporting this crucial cause.

What is cervical cancer?

Cervical cancer develops from infection with high-risk types of HPV; a virus mainly spread through sexual contact. Over 100 HPV types exist, but about fifteen are linked to cervical cancer. Types 16 and 18 account for approximately 70% of cases globally, while types 31, 33, and 45 comprise the remainder. Together, these five types account for over 82% of cervical cancer worldwide.

What every woman needs to know:

Cervical cancer claims the life of one woman every two minutes worldwide (WHO).
It is caused primarily by persistent infection with high-risk HPV types.
Up to 80% of sexually active women will get an HPV infection at some point; nearly half involve high-risk types linked to cancer (CDC).
The best prevention is vaccination against the most dangerous HPV strains.
Regular screening (Pap smears and HPV tests) remains essential for early detection and prevention.

Why vaccination matters:

HPV types 16, 18, 31, 33 and 45 cause over 82% of cervical cancer cases worldwide.
South Africa was the first African country to include HPV vaccination in its national immunisation programme in 2014.
Vaccination before the first sexual encounter offers the strongest protection, but benefits women of all ages.
Vaccination combined with regular screening provides the best defence against cervical cancer.

References

Cancer Association of South Africa (CANSA). Cervical Cancer. 2025. Available at: https://cansa.org.za/cervical-cancer/
World Health Organization (WHO) Africa Regional Office. Cervical Cancer. 2025. Available at: https://www.afro.who.int/health-topics/cervical-cancer
World Cancer Research Fund. Cervical Cancer Statistics. 2025. Available at: https://www.wcrf.org/preventing-cancer/cancer-statistics/cervical-cancer-statistics/
ICO HPV Information Centre. Human Papillomavirus and Related Disease Report. 2016. Available at: https://hpvcentre.net/statistics/reports/ZAF_FS.pdf

About Universal Care

Universal Care is an unconditionally accredited Managed Care Organisation with the Council for Medical Schemes (CMS), delivering personalised, patient-specific managed care services. With a track record spanning over two decades, Universal Care provides comprehensive and integrated solutions to financial and clinical risk management.

About Universal Healthcare Group

Universal Healthcare, the largest independent company of its kind in South Africa, has been one of the fastest-growing companies in the healthcare industry for more than a decade. Touching the lives of several million people worldwide, this specialist-integrated healthcare company has a multinational footprint with offices in South Africa and a presence in the Indian Ocean Islands and the United States.

Owner-managed and run by a hands-on entrepreneurial team passionate about delivering excellence and a strategic vision for sustainable, appropriate healthcare, Universal is a leader in third-party administration, integrated healthcare management, managed care, pharmaceutical benefit management, corporate wellness, insurance, and technology services.

Patients come first at Universal, and we always ensure they have access to the best and most appropriate care available. Our personalised healthcare management approach and patient care are what set us apart. This, together with our sophisticated and proprietary IT systems, patented transaction rules engine and international evidence-based medical protocols, is why more than thirty healthcare funds in South Africa have entrusted their members to Universal.

The company's innovation hub is based in San Francisco, in the heart of Silicon Valley, where we have access to the finest global talent. Our multi-national team of technology and healthcare experts operates from France, the United Kingdom, South Africa and the USA, among other countries.

Playtime in utero: Why pregnant moms have trouble sleeping

Wed, 20 Aug 2025 12:57:30 GMT

The importance of sleep for healthy development

When you are pregnant, especially during the third trimester, getting a good night’s sleep can feel like a game of hide-and-seek, frustratingly out of reach when you need it most. But quality rest is essential for the health of both mom and baby.

Dr Mokgohloe Phasha, an obstetrician-gynaecologist practising at Netcare Park Lane Hospital, stresses the importance of sleep during pregnancy. She explains that while sleep is vital for everyone’s health, new research suggests that there may be lasting developmental effects for children of mothers who are significantly sleep deprived during pregnancy.

“Sleep disturbance occurs commonly in pregnancy, although it is often under-reported as women tend to accept it as the norm and therefore simply persevere in the belief that it is part and parcel of pregnancy. While it is a common experience of pregnancy, some of the potential causes of disrupted sleep can be managed to help you get some much-needed rest during these crucial months,” she says.

Dr Mokgohloe Phasha is an obstetrician-gynaecologist practising at Netcare Park Lane Hospital

Some causes of insomnia are specifically pregnancy-related, such as severe nausea and vomiting, frequently needing to urinate because of the uterus pressing on the bladder, aches and pains associated with pregnancy, heartburn, and dyspnoea or difficulty in breathing – particularly in the third trimester.

“Some women may experience carpal tunnel syndrome, with swollen hands and painful wrists keeping them awake at night, while pregnancy-related hormones may also cause expectant mothers to feel drowsy and sleepy during the day,” Dr Phasha explains.

Dietary factors that could contribute to sleeplessness include too much caffeine, which is found in coffee, tea, and chocolate, as well as deficiencies in micronutrients such as magnesium, which can lead to restless leg syndrome.

“Pregnancy can be overwhelming for an expectant mother, and may worsen symptoms of anxiety for women who have a pre-existing anxiety disorder or may lead to new onset symptoms in women who have not previously been diagnosed with an anxiety disorder. This can significantly contribute to insomnia if not appropriately addressed in consultation with your obstetrician,” Dr Phasha notes.

Medical causes of insomnia, such as sleep apnoea, should also be investigated if sleep disturbance is persistent, as this can also potentially have a negative impact on the wellbeing of mother and baby.

“Studies have found that more women report insomnia in the third trimester than in any other. This can be explained by a surge in progesterone and an enlarged uterus, which pregnant mothers would notice makes it uncomfortable to sleep on either side,” Dr Phasha says.

“At this advanced stage of pregnancy, we discourage pregnant women from sleeping on their back or stomach – positions that might have felt most comfortable before pregnancy.”

Another obstacle to a good night’s sleep, according to Dr Phasha, is that babies in the womb do not follow the same sleep-wake patterns as their mother. “It may be night-time for the mother, but it may very well be playtime in utero for her unborn baby. Vigorous foetal movements during this time can often disturb a pregnant woman’s sleep,” she says.

“The value of sleep for foetal, pregnancy, and postpartum outcomes should not be underestimated, and there is some evidence to suggest that women who sleep for less than seven hours could be at higher risk of developing insulin resistance or gestational diabetes while their children could potentially be more at risk for neurodevelopmental delays in areas including social, emotional, behavioural, motor, cognitive, or speech skills.”

Five tips for pregnant women to help improve their sleep

Report symptoms of sleep disturbances to your obstetrician or healthcare team
Avoid taking naps during the day to help you sleep better at night
Steer clear of caffeinated drinks or hot, spicy food
Eat an early supper before 6 pm, to allow time for sufficient gastric emptying before bedtime, reducing the severity of heartburn
Keep physically active with moderate exercise throughout pregnancy

“Enough quality sleep is fundamental for everyone’s health and wellbeing, and pregnancy is no exception. Make a point of discussing any symptoms that may be disturbing your sleep to find a solution with your obstetrician or maternity team,” Dr Phasha concludes.

References and further reading

Alondwe freed from the weight of tumours

Thu, 14 Aug 2025 13:38:26 GMT

Alondwe ready for surgery: Before the procedure, Alondwe Ngwenya suffered with the extreme weight of the tumours.

All photos supplied by the family.

Help at last for young soccer fan thanks to medical teamwork

Ten-year-old Alondwe Ngwenya was, until recently, a child set apart by large, painful tumours disfiguring one side of his face and his foot, holding him back from his greatest passion in life: soccer.

“It has been a long time that we have been seeking help for Alondwe. We are very happy, and can see he is getting better already,” says Alondwe’s mother, Ntombifuthi Khumalo, who made the journey with her son from Bergville in rural KwaZulu-Natal for the operation in June.

“Alondwe is very passionate about soccer, especially cheering for his favourite team, Kaizer Chiefs. He also dreams of becoming a lawyer one day when he grows up, to fight for justice and protect the innocent,” she says.

Professor Anil Madaree, Head of Craniofacial Surgery at UKZN’s Nelson R Mandela School of Medicine, practises both at Inkosi Albert Luthuli Central Hospital and Netcare uMhlanga Hospital, where specialists performed the life changing procedure pro bono in association with the Netcare Foundation.

“I first heard of Alondwe after he appeared in the media, when his mother made a public appeal for medical assistance for her son’s condition. His condition caused him pain, kept him isolated, and stopped him from living the active life a child his age should enjoy,” Prof Madaree says.

“Several NGOs approached me to see what could be done to help young Alondwe. The real breakthrough came when the Netcare Foundation reached out to offer its support, making the procedure possible in the private sector, following his scans and workup in the public sector.

“Alondwe’s condition is known as neurofibromatosis, involving benign tumours of the nerve cells that continue growing, usually affecting multiple sites on the body. For Alondwe, the biggest were on his head, neck, and one foot. We were confident that it was possible to help alleviate the discomfort and some of the functional impact the tumours were having on him to significantly improve his quality of life,” he says.

Ear, Nose and Throat (ENT) surgeon Dr Mahommed Thandar, who practises at Netcare St Augustine’s Hospital and consults at the provincial hospital part-time, also learned of Alondwe’s plight in the media and made enquiries to see how the boy could be helped. He connected with Prof Madaree and plastic and reconstructive surgeon Dr Zama Khumalo of Inkosi Albert Luthuli Central Hospital to see how they could help.

“The very large mass of tumour was affecting Alondwe’s head, and his ear was quite distorted as a result. The bone of the ear, the canal and the pinna were distorted by the tumour, which affected his hearing in that ear.

“The tumour on his head was both a cosmetic and hearing issue, while the tumour on his foot was affecting his walking and was therefore a functional issue.”

Dr Khumalo adds, “The mass was putting serious strain on all the surrounding tissue, stretching the skin on Alondwe’s face, and we removed as much as possible in the debulking surgery,” she explains.

In addition to the specialised medical skills, a well-equipped surgical theatre and recovery time in an intensive care unit were needed. When Netcare Group chief executive officer Dr Richard Friedland read about Alondwe’s mother’s plea, he immediately set the wheels in motion for the healthcare provider’s corporate social investment (CSI) arm, the Netcare Foundation, to make the procedure possible.

The Netcare Foundation helps those who need it most to access quality healthcare, emergency medical services, specialised surgery, and support community projects, including human milk banks for the distribution of donated breast milk to premature babies, scholarships for future doctors, and donations to NGOs.

Dr Thandar says that the surgery also helped to restore the alignment of Alondwe’s ear, however the extreme distortion of his ear canal and the damage the tumour caused to the nerves could not be surgically repaired this time. “Fortunately, Alondwe’s hearing in the other ear is not affected, and perhaps a bone conduction hearing implant might be an option if needed in future,” he says.

After a few days in the ICU at Netcare uMhlanga Hospital and several more nights at Inkosi Albert Luthuli Central Hospital for observation, Alondwe was discharged home, to his relieved mother’s delight.

Prof Madaree adds that once Alondwe has healed, further check-ups will determine if a less extensive procedure may be required for minor adjustments, given the extent of the mass removed. “For now, we are pleased with the progress he has made, and we wish Alondwe the best for his continued recovery,” he says.

Alondwe’s mother, Ntombifuthi, says, “We are just so happy and grateful to the doctors, Netcare uMhlanga Hospital, and the Netcare Foundation for this opportunity to help Alondwe.”

“Working together, public and private healthcare can make a huge impact on a child’s daily quality of life and ability to participate to his fullest potential in school, in sports and in the activities that contribute to their development at this crucial age,” says Mande Toubkin, Netcare’s general manager of emergency, trauma, transplant and CSI.

“On behalf of the Netcare Foundation, we thank Prof Madaree, Dr Thandar, anaesthetist Dr Luxmi Pillay, Dr Khumalo and otorhinolaryngologist Dr Warren Kuhn, who all gave their time and expertise pro bono to assist Alondwe. This young man has been so brave, enduring his painful condition, and we are grateful to have been a part of relieving this burden for him.”

Tips for parents on recognising kids’ ear infections

Sun, 10 Aug 2025 18:43:17 GMT

Preventing complications with early diagnosis and care

Children are especially prone to ear infections, but the source of their discomfort can be difficult for parents to pinpoint in babies and pre-verbal toddlers.

“It all comes down to anatomy. The small passages which connect our middle ear to our nasopharynx, or upper throat, called the eustachian tubes, regulate pressure in the middle ear and facilitate fluid drainage,” explains Dr Muhammed Ra’ees Vally, a general practitioner (GP) practising at Netcare Medicross Roodepoort.

“In children, this tube is shorter, narrower, and more horizontal, which increases the risk of blockage due to impaired drainage and allows for nasal secretions to flow more readily back up the eustachian tubes. As a result, infections affecting the nose and throat of children can easily reach the middle ear.”

Dr Vally points out that when the eustachian tubes become blocked due to inflammation or mucus, fluid can build up, creating an environment that allows bacteria and viruses to thrive, causing pain, discomfort and, in severe cases, potentially leading to complications.

Dr Muhammed Ra’ees Vally is a general practitioner (GP) practising at Netcare Medicross Roodepoort

“We need to be able to recognise signs of ear infections in our little ones, which is a task unto itself as small children, especially those who have not yet learnt to walk, let alone talk, have a limited vocabulary, if any, and a simple phrase like ‘My ear is sore’ could be well beyond them.

“If we’re lucky, as parents we might see the child gesture to their ear, but we need to be alert to other subtle clues that a child could be experiencing the discomfort of an ear infection,” he says.

Often, ear infections are preceded by cold and flu symptoms, such as a poor appetite, nasal congestion, nausea, vomiting, and diarrhoea.

“When the infection spreads to the ear, look for additional symptoms of tugging or pulling on the ear, irritability, crying, difficulty feeding, restlessness at night, fever, loss of balance, and reduced hearing or response to sound,” Dr Vally advises.

“The most straightforward sign to spot may be fluid draining from the ear, which is a symptom that typically appears only at the end of the illness,” he points out.

If you notice any of these signs, seeking healthcare early allows you to receive appropriate advice quickly. The doctor can guide you on the need for treatment and the signs to watch for to help prevent complications from developing. To find your nearest Netcare Medicross medical and dental centre or to book an appointment with a general practitioner, simply download the Netcare mobile app.

“Ear infections are often caused by viral infections, which typically require only symptomatic treatment such as pain relief, hydration, and over-the-counter medications for flu and allergies. However, a doctor can identify early signs of more serious illnesses and provide a targeted treatment plan, including appropriate antibiotics when needed,” Dr Vally says.

Good hygiene practices, such as washing hands, covering the mouth and nose when coughing or sneezing, sanitising surfaces, and ensuring good ventilation, can significantly reduce the spread of colds and flu, which are the underlying cause of many ear infections.

“Other protective measures include keeping your child’s immunisations up to date and supporting a strong immune system with a healthy, balanced diet,” Dr Vally says.

“Parents should ensure their children stop using pacifiers by the age of six months, because as the child grows, this can increase the risk for infections reaching the ear via the eustachian tubes.”

“It is also important to keep children away from smoky environments and second hand smoke. Additionally, using humidifiers and controlling allergies are beneficial. Make sure to keep children's ears clean and dry, and avoid using cotton buds or fingers in their ears,” he says.

“ By recognising the signs of ear infections, taking simple preventive measures and educating ourselves as parents on these common childhood ailments, we can reduce the risk of infections and avoid more serious complications.”

Damp in the home can pose fungal health risk

Fri, 01 Aug 2025 06:01:40 GMT

Clues that lurking mould could be a concern

Fungal spores are all around us, and mould can quickly develop in damp areas of the home, often unnoticed and out of sight. Awareness and prevention should be a priority for all, as prolonged exposure to mould can potentially lead to long-term health effects, particularly for at-risk groups.

“Mould exposure, particularly in poorly ventilated indoor environments, can lead to a variety of health symptoms — especially for individuals with underlying respiratory conditions, allergies, or weakened immune systems,” warns Dr Raisa Bhikoo, a pulmonologist and specialist physician practising at Netcare N1 City Hospital.

“It’s important to note that while mould can trigger symptoms in many people, the severity and type of reaction can vary widely depending on an individual’s health status and level of exposure. Even without a formal diagnosis, constant low-grade symptoms like fatigue, coughing, or sinus pressure can take a toll on one’s daily functioning and mental wellbeing,” she says.

Pulmonologist and specialist physician, Dr Raisa Bhikoo

Common mould-related symptoms include:

Upper respiratory symptoms such as nasal congestion, sneezing, runny nose, sore throat, and sinus pressure.
Lower respiratory symptoms , including coughing, wheezing, shortness of breath, and chest tightness, are especially common in people with asthma or chronic lung disease.
Eye, skin, and throat irritation , which may feel like a burning or itching sensation.
Exacerbation of asthma or allergic rhinitis : Individuals with pre-existing respiratory allergies or asthma may experience worsened symptoms or more frequent attacks.
Fatigue and general malaise have also been reported in individuals with prolonged mould exposure, although this is often more difficult to attribute directly.

“Ongoing mould exposure can also lead to persistent inflammation of the sinuses or airways, resulting in chronic sinusitis, nasal polyps, or new-onset allergic rhinitis in susceptible individuals. Talk to your doctor if you are concerned that mould may be affecting your health. While there’s no single test that can definitively prove mould is affecting your health, there are several investigations we can do to support the diagnosis and rule out other causes,” Dr Bhikoo points out.

“In rarer cases, individuals with severely compromised immune systems, such as transplant recipients or people on chemotherapy, may be at risk for more serious infection, especially if they are exposed to certain species like Aspergillus, which causes aspergillosis – an invasive fungal infection which is a medical emergency requiring urgent treatment.”

“It can be difficult to tell whether your symptoms are specifically due to mould exposure, as the symptoms often overlap with those caused by colds, allergies, sinus infections, or other respiratory conditions. However, there are a few key clues that may suggest mould is contributing to your symptoms.”

Four clues that symptoms could be mould-related:

Where do symptoms strike? If your symptoms worsen when you're in a specific environment, such as at home, in a damp office, or an older building, and improve when you leave, mould exposure is more likely to be a factor.
When did it start? If you're experiencing persistent nasal congestion, coughing, sinus issues, or asthma-like symptoms that don’t resolve with usual treatment, especially during rainy seasons or in a damp setting, mould should be considered a potential factor.
Who else is affected? If others in the same environment are experiencing similar symptoms, this raises suspicion that something in the shared space — like mould, for example — could likely be the trigger.
Visible mould or dampness: Obvious signs, such as water damage, musty odours, or visible mould growth in your living or working space, support the likelihood that symptoms could be related.

“Individuals with certain underlying health conditions — particularly asthma, allergies, or weakened immune systems — are at higher risk of experiencing health issues related to mould exposure,” Dr Bhikoo points out.

Mould exposure can be worse for people with

Asthma: Mould spores can act as a trigger, causing increased wheezing, shortness of breath, coughing, or even asthma attacks. In some cases, chronic exposure can make asthma harder to control.
Allergic rhinitis or sinusitis: People with allergies, especially to airborne particles like dust mites or pollen, are more likely to develop symptoms like nasal congestion, sneezing, postnasal drip, and itchy eyes when exposed to mould.
Weakened immune systems: This includes individuals undergoing chemotherapy, those with HIV, transplant recipients, or people on long-term immune-suppressing medications.
Chronic lung conditions: Individuals with conditions such as chronic obstructive pulmonary disease (COPD) or bronchiectasis may also be more susceptible, as mould exposure can exacerbate inflammation and increase the risk of infections.

“Mould exposure can cause symptoms in sensitive individuals even when test results are not definitive. Management usually involves both medical treatment and addressing the environmental source,” she advises. We may sometimes recommend a home or workplace inspection for the presence of mould, humidity levels, or water damage if a person’s symptoms strongly suggest environmental exposure.

“If you suspect long-term exposure, it’s advisable to consult a healthcare provider for a thorough evaluation. The good news is that with early intervention, it is possible to prevent complications from mould exposure and significantly improve the quality of life for affected individuals,” Dr Bhikoo concludes.

Tips for tackling mould in the home

“Mould is more than just a cosmetic issue — it can have real health consequences, especially with long-term exposure. The most important thing is not to ignore the problem. If you suspect mould in your home, it's important to act promptly — both to protect your health and to prevent the problem from getting worse,” says Dr Bhikoo, recommending the following immediate steps.

Limit your exposure:

Stay out of the affected area, if possible, especially if you have asthma, allergies, or a weakened immune system.
If you must enter the area, wear a well-fitted N95 mask and gloves to avoid inhaling mould spores or touching contaminated surfaces.

Improve ventilation:

Mould thrives in damp, stagnant environments, so improving ventilation can help slow its growth. Open windows and use fans to increase airflow.
Use a dehumidifier if the air feels damp, ideally keeping indoor humidity below 50%.

Identify and stop the source of moisture:

Mould cannot grow without moisture. Check for leaks in roofs, pipes, windows, or walls, and address them immediately.
If there’s flooding or water damage, dry the affected areas within 24 to 48 hours.

Clean small areas safely (where appropriate):

For small mould patches on hard surfaces, you can clean them using soap and water, or a diluted bleach solution (1 cup bleach to 3.7 litres of water). Always wear protective gear and never mix cleaning products.
Avoid trying to clean porous materials, such as carpets or ceiling tiles — these often require replacement.

Consult professionals for extensive or ongoing problems:

If the mould covers more than about 1 square metre, or if it keeps coming back, it's best to call a qualified mould remediation specialist.
They can safely remove the mould and identify hidden sources of moisture or growth (e.g., behind walls or under floors).

Monitor your health:

If you develop respiratory symptoms, skin irritation, or worsening asthma, see a doctor. Early treatment and removal from exposure can prevent long-term effects.

What moms need to know: Weaning from breastfeeding

Wed, 23 Jul 2025 07:41:27 GMT

Paediatric neonatologist, Dr Letlhogonolo Sepeng

Paediatric neonatologist shares tips and what to expect

Breastfeeding is not only the act of a mother nourishing her baby; it is also crucial for bonding and development. Knowing how and when to wean, as well as the physical and emotional effects to be expected, can help ease this transition.

“For first-time mothers in particular, it can be daunting to start thinking about weaning your baby, and the World Health Organization [WHO] advises exclusively breastfeeding for the first six months,” says Dr Letlhogonolo Sepeng, a paediatric neonatologist practising at Netcare Park Lane Hospital.

“The timing of weaning is not set in stone, and often the mother’s breast milk supply gradually reduces over time. The WHO guidelines recommend that from the time the baby is six months old, you can start slowly introducing liquids to complement breastfeeding.”

Seven weaning tips for breastfeeding mothers:

Weaning should be a gradual process; breastfeeding should not be stopped suddenly.
From six months, start replacing one breastfeeding session per day with a bottle or cup of formula milk (for babies under 12 months) or cow’s milk (for older babies).
Over several weeks, progressively decrease the number of breastfeeding sessions.
Distract the baby with fun bonding activities, such as reading, playing, or going for a walk, to divert their attention away from missing the breastfeeding session.
Ensure that both mom and baby have time to adjust to the next stage of feeding.
It may be helpful to consider daytime or night-time weaning. Find the rhythm that works best for your little one.
Be aware that once you stop breastfeeding, there may be emotional and physical changes that may take some getting used to.

“Weaning too quickly can cause painful engorgement, clogged ducts, mastitis, and unpleasant hormonal shifts,” cautions Dr Sepeng.

“When a woman is lactating, hormones prolactin and oxytocin, known for their feel-good effects, are produced at higher levels. Therefore, when the baby is weaned and breastfeeding ends, the mother’s levels of these ‘happy hormones’ drop, and this can cause mood swings, sadness, and feelings of depression,” she says.

“It’s important to remember that the intensity of the symptoms can vary depending on individual factors, such as the speed of weaning, how long the mother has been breastfeeding, the baby’s developmental stage and the mother’s needs, among others.

“Once you stop expressing milk, your body also increases levels of the stress hormone cortisol, which may contribute to mood changes, night sweats, fatigue and headaches, or even migraines, which could become severe.

“Keep in touch with your maternity team and your loved ones about how you are doing, physically and emotionally. If you are struggling to cope, professional help is available to support you through this challenging time of transition. There is no need for you to feel alone.”

As a specialised maternity facility, Netcare Park Lane Hospital includes one of the country’s most respected neonatal intensive care units alongside caring and experienced obstetric teams.

Dr Sepeng says other changes to expect after breastfeeding are linked to the rise in the hormones oestrogen and progesterone, which trigger the return of fertility, ovulation, and the menstrual cycle.

What to expect from your baby:

Food refusal is quite common initially. Gently persist in combination with breastfeeding.
The transition from breast milk to other sources of nourishment may cause constipation. Keep in touch with your paediatrician and increase hydration by offering your baby water.
Some babies may experience an upset stomach. Seek medical attention if this lasts for three or more stools and take note if the same foods consistently cause irritation.
Regression in breastfeeding. Weaning may not be a straightforward linear process, as long as there is gradual progress this need not be cause for concern.
Challenges with chewing, swallowing, or learning new textures. Always monitor your baby closely to ensure there is no choking. Your paediatrician or maternity team may recommend a speech therapist if needed.
Potential changes in mood and sleep. The adjustment takes some getting used to, and this should improve in time.

What to expect from your body

Your breasts will usually return to their pre-pregnancy size.
You may have developed some stretch marks on your breasts, but these will fade with time.
As the milk-producing glands are replaced by fatty tissue, you may notice your breasts feeling less firm.
Stretching of the skin and ligaments supporting the breasts can also alter their appearance.
The colour of your areolae and nipples will return to pre-pregnancy tones.
Some women may experience hair loss due to hormonal changes.

“These cosmetic changes are nothing to be concerned about, although you can seek medical assistance if something is making you uncomfortable,” Dr Sepeng says.

“While breastfeeding is a precious, golden time of closeness between mother and baby, the next stage of development is equally rewarding and allows you to bond with your baby in new ways,” concludes Dr Sepeng.

When every breath counted, strangers stepped in to save Baby Kendreya

Tue, 08 Jul 2025 10:21:31 GMT

Dr Wilhelm Lichteberg Baby Kendreya and parents

Foundations and medical team unite for urgent heart operation

Baby Kendreya Pillay seemed like any newborn – until her tiny chest began rising and falling rapidly, and she quickly grew tired.

Born in October 2024 to Paroosha Naidoo and Kevin Pillay in Chatsworth, Durban, Kendreya’s dad remembers those early days vividly: “Her stomach would sink with every breath, like her little body was working overtime just to breathe.”

As the weeks passed, Kendreya’s breathing worsened. Kevin juggled night shifts, driving Paroosha and Kendreya between hospital appointments and tests. He would often sleep in the car while mother and baby waited to see the doctors and get the necessary medical tests done.

Then came the devastating diagnosis – a large hole in the heart was affecting Baby Kendreya’s blood flow. “Her heart couldn’t pump properly, causing fluid to build up in her lungs. That’s why her tummy caved in when she tried to breathe,” Kevin explains.

Surgery was initially scheduled for March 2025, when Kendreya would be six months old, but this was not to be, and it was unclear when a new date for surgery could be arranged in the public sector. The dedicated team of doctors at Inkosi Albert Luthuli Hospital did everything they could to help, but the resources at government hospitals are simply not able to keep up with the desperate need for such specialised procedures.

Parents Paroosha Naidoo and Kevin Pillay with Baby Kendreya

“It broke our hearts as the doctors had warned us that after eight or nine months, surgery becomes much riskier. Time was running out,” Kevin says.

Cardiothoracic surgeon and founder of the Young Hearts Africa Foundation, Dr Wilhelm Lichtenberg, has made it his life’s purpose to reach children with life-threatening heart defects like Kendreya’s before it is too late. Since its inception in 2023, the foundation has helped 30 children.

Faced with despair, Paroosha searched tirelessly for help for their daughter until she found Dr Lichtenberg and the Young Hearts Africa Foundation. “At first, it felt too good to be true, and we were almost worried it might be a scam. But Dr Lichtenberg responded, asking only for medical records, never money. It was a light in a dark time.”

Meanwhile, Kendreya’s condition worsened – she lost her appetite and started passing blood, prompting urgent scans.

“Baby Kendreya had been diagnosed with Atrioventricular Septal Defect [AVSD], which is a congenital heart defect. This means that she had a large hole in the heart's centre that affected the walls between the upper chambers and lower chambers of her heart. Because the valves that control blood flow between these chambers are malformed or shared, it allows oxygen-rich and oxygen-poor blood to mix inside the heart,” Dr Lichtenberg explains.

“Babies with AVSD often experience rapid breathing, difficulty feeding, excessive sweating, and poor weight gain. If left untreated, the extra blood flow can damage the lungs, leading to heart failure. The timing of surgery is critical. The risks increase after six months because the lungs can suffer irreversible damage from the extra blood flow. Early repair gives babies the best chance to grow and thrive,” he adds.

With no options open to them in KwaZulu-Natal and private care out of reach, Kendreya’s future looked bleak – until the Young Hearts Africa Foundation stepped in. Dr Lichtenberg made it his mission to secure the surgery she needed in Cape Town.

“When the Young Hearts Africa Foundation reached out about Baby Kendreya’s urgent case, the Netcare Foundation and Netcare Christiaan Barnard Memorial Hospital immediately prioritised her AVSD repair. There’s a huge need for specialised paediatric heart surgeries — they are complex, resource-heavy, and absolutely essential for giving these children a fighting chance,” comments Mande Toubkin, Netcare’s general manager of trauma, transplant, and corporate social investment.

Dr Lichtenberg says having the operation before Kendreya’s condition worsened made all the difference. “Thanks to the support of the Netcare Foundation, the selfless dedication and cooperation of renowned heart surgeon Dr Susan Vosloo, anaesthetist Dr Marie Bosman, Pathcare Pathologists, Morton & Partners Radiologists, Medtronic, and Cossni Medical, Baby Kendreya finally has a real chance at a healthier future. This surgery has changed the course of her life and given her the opportunity to thrive,” he says.

When Young Hearts Africa reached out to them, the South African charity, Wings and Wishes graciously joined the effort by providing the necessary airline flights for Baby Kendreya and her parents. Their work is dedicated to removing transport barriers, enabling disadvantaged children nationwide to reach the medical facilities for the treatment they urgently need.

Now back home in Durban, Kendreya’s family is filled with gratitude for the care and support that saved their daughter’s life. Paroosha and Kevin recall their darkest days of fear and uncertainty – and the hope that blossomed when they connected with Dr Lichtenberg and the dedicated team at Netcare Christiaan Barnard Memorial Hospital.

“Dr Lichtenberg and Dr Vosloo are our heroes, our angels — our only option, and we can’t express our appreciation to the Netcare Foundation, the Young Hearts Africa Foundation and everyone involved,” the grateful parents say, reflecting on the tireless efforts that made the surgery possible and eased their journey.

The family says the operation itself was a rollercoaster of emotions — the waiting, the reassurance from the medical team, and finally, seeing Kendreya recover with strength and spirit. “She has healed so quickly and been so active since the operation. Kendreya is fascinated by the world around her,” Paroosha shares.

The family describes the ICU nurses’ gentle care, clear communication, and the doctors' skill and kindness as vital to their healing process. Watching their baby smile, clap, and slowly regain her energy brought overwhelming joy and relief.

“As parents, you experience every emotion imaginable, but holding her for the first time after surgery, feeding her, and seeing her fight back made it all worthwhile,” concludes Paroosha.

Heart and Stroke Foundation South Africa commemorates Employee Wellness Week

Wed, 02 Jul 2025 13:04:41 GMT

Focus on the Workforce this Winter

The Heart and Stroke Foundation South Africa (HSFSA) is proud to commemorate Employee Wellness Week (EWW) from 1st to 6th July 2025. This annual initiative recognizes the vital role employees play in driving business success, and acknowledges the hard work and dedication they bring to their organizations every day. EWW encourages employers in the private and public sectors to prioritize the physical, mental, spiritual and emotional well-being of their employees. Adopting a holistic approach to wellness has a direct and indirect impact on workplace productivity, in reducing absenteeism, and creating a positive workplace environment. Partnering with, or requesting the services of the Foundation can help workplaces demonstrate their commitment to employee health and well-being.

Throughout the first week of July, our campaign focuses on creating awareness in both the private and public sectors about the positive impact of maintaining good health and wellbeing in the workplace, of which heart and brain health, as well as the associated risk factors, are our main focus areas. Our employee wellness program yields good health and productivity in the workplace as it offers relevant tools and information towards disease prevention and maintenance of good health. The HSFSA’s employee wellness program is multifaceted and covers all aspects of self care and wellbeing through health talks, health risk assessments, individual counselling, mental state assessments and referral for medical attention where indicated, with a bias in favour of cardiovascular disease.

The health promotion and health risk assessment program team, Nutrition Science team and other professional staff conduct health talks, to disseminate evidence-based health information, and advocate for healthy behavioural choices to reduce the risk of Non -Communicable Diseases (NCDs). These behavioural choices include healthy food choices, sustained regular activity, maintaining good mental and physical health, stopping excessive alcohol use and tobacco smoking and vaping, and treatment adherence for existing health conditions. Conducting health risk assessments for employees allows each individual to know their current health state, such as blood pressure and glucose levels, so that they can take the necessary steps if they are found to be at risk.

The HSFSA urges all employers to join hands in the fight against cardiovascular disease (CVD) by utilizing our Employee Wellness Program, which will afford employees the opportunity to know their important health numbers (such as their blood pressure measure) and try to maintain good health. Our health risk assessment includes blood pressure, blood glucose, cholesterol, body mass index testing and health information leaflets that will assist all individuals to navigate through their healthy living journey. Prof. Pamela Naidoo, CEO, of the Heart and Stroke Foundation South Africa highlights the significance of workplace wellness initiatives, stating that incorporating designated wellness days is a crucial step towards prioritizing employee health. Prof Naidoo states that older persons are more vulnerable to ill health during the winter season and it is therefore very important to engage in disease prevention. Our CEO urges workplaces to contact the Foundation if they would like our staff to conduct an EWP, and in particular conduct health risk assessments by our Health Promotions and Health Risk Assessment Teams.

Seasonal variations significantly impact cardiovascular disease (CVD) morbidity and mortality, with higher incidence rates in winter and lower rates in summer. This pattern affects individuals across age groups, with the elderly being particularly vulnerable due to decreased physiological resilience, comorbidities, and potential social isolation. Factors contributing to seasonal variations in CVD include temperature fluctuations, reduced physical activity, vitamin D deficiency, increased blood pressure, and respiratory infections like influenza. Specifically, conditions such as hypertension, heart failure, and atrial fibrillation exhibit seasonal patterns, with hospitalization rates for heart failure notably peaking in winter. Environmental factors, including cold temperatures and air pollution, further exacerbate these risks. To mitigate these risks, targeted awareness campaigns and prevention strategies should focus on promoting healthy habits, ensuring proper heating and insulation, and facilitating access to healthcare services, particularly for high-risk populations like the elderly, during the winter months.

Our employee wellness program promotes healthy eating habits through initiatives like the HSFSA's Heart Mark programme. This trusted food endorsement initiative empowers consumers to make informed choices by identifying products that meet rigorous nutritional standards. Heart Mark-approved products are lower in salt, sugar, saturated and total fats, and higher in fiber. With approval from the National Department of Health and recognition by 8 out of 10 adults, the Heart Mark is a credible symbol of healthy eating. Our nutrition science team, including our Registered Dietitians Ms. Shonisani Nephalama and Ms. Cari Erasmus, endorses Heart Mark as a valuable guide for making informed food choices, helping employees and their families adopt healthier eating habits. By supporting Heart Mark-approved products, we encourage employers and employees to make healthier choices and reduce their risk of heart disease and strokes.

Interviews will be conducted with our Health Promotions Programme Team, Dietitians and CEO, Professor Pamela Naidoo. To co-ordinate and confirm interview dates you are welcome to contact Themba Mzondi, our PR and Communications Officer on 021 422 1586 / 0781135216 or email themba.mzondi@heartfoundation.co.za

Men’s health warning: Prostate cancer usually has no early symptoms

Thu, 26 Jun 2025 04:05:37 GMT

More precise treatment options with robotic technology

Prostate cancer is a major risk to men’s health, with South African men facing a one in eight chance of developing this most common of male cancers.

Urologists Dr Hannes Brummer and Dr Johan Coetzee, who practise at Netcare Greenacres Hospital, are encouraging men to prioritise prostate cancer screening this Men’s Health Month.

“Usually, men do not feel any symptoms until prostate cancer has progressed significantly, which is why they need to be proactive about booking their routine prostate cancer screenings,” explains Dr Coetzee.

“With the advanced prostate specific antigen [PSA] screening blood test available from GPs these days, there is so much more opportunity for prostate cancer to be detected earlier when it is still at a highly treatable stage.”

“For men who are diagnosed with prostate cancer following a needle biopsy, the treatment options available have improved to such an extent that there is more hope than ever before. Even where surgery is needed, prostate cancer does not necessarily pose a significant disruption to your life,” Dr Brummer adds.

“A prostate cancer diagnosis can be daunting. We have walked this path with so many men, and robotic assisted surgery offers some important advantages for the removal of cancerous tissue in the prostate gland, in particular the precision of this minimally invasive option.”

This Men’s Health Month, urologists Dr Hannes Brummer and Dr Johan Coetzee are urging men to be decisive about booking routine health checks, including prostate cancer screenings.

Over 1 000 robotic assisted procedures have been performed at Netcare Greenacres Hospital since the introduction of this technology in August 2017.

At Netcare Greenacres Hospital, Dr Brummer and Dr Coetzee use the da Vinci X robotic assisted surgical system to operate through tiny punctures in the skin using slender instruments more dexterous than the human hand.

Dr Brummer and Dr Coetzee emphasise that the surgeon remains in control of the robotic system at all times. With magnified 3D imaging capabilities, including a large fixed-focus area at the highest resolution, the nerves, blood vessels and tumour are visible with great clarity for the intricate procedure.

“This robotic system is especially useful for operating on the prostate, as we can more clearly distinguish the nerves controlling erectile function and urinary continence. In most cases, there is less need for blood transfusion and reduced risk of complications,” Dr Brummer explains.

“Another of the advantages of this robotic technology for prostate tumours is that there is much less tissue damage in this sensitive area. Compared with traditional surgery, this means men usually experience much less downtime with less discomfort after the procedure. This translates into shorter hospital stays and faster recovery with robotic assisted prostatectomies overall.”

General manager of Netcare Greenacres Hospital, Reon van Rensburg, joined the urologists in reinforcing the importance of prostate cancer awareness. “Let’s talk to our brothers, fathers, sons and grandsons about health issues, and get to know your family risk for both prostate cancer and breast cancer.”

Van Rensburg thanked Dr Brummer and Dr Coetzee for their continued dedication to making the world-class minimally-invasive robotic assisted surgical option available for patients local to Gqeberha and from as far afield as Knysna, George and East London, inland regions of the Eastern Cape, and parts of the southern Free State, the Northern Cape and the north-eastern region of the Western Cape.

“This Men’s Health Month, let’s pledge to be decisive about booking those routine health checks. Making the time now and every year could help to save your life in future,” Dr Brummer and Dr Coetzee concluded.

Youth Month: HIV does not have to define your future

Fri, 20 Jun 2025 09:45:23 GMT

Courier pharmacy champions prevention and treatment

The foundations of a long and healthy life are laid in youth. This Youth Month, a pharmacist from South Africa’s original national courier pharmacy highlights HIV prevention and effective management as key health concerns the youth should be aware of.

“Young people often feel invincible, but the steady rise in new HIV infections that continue to affect the youth today shows just how important awareness is. This generation must be empowered so that HIV does not define their future. That means each person should be aware of their HIV status – and if positive, learning how to manage the condition in the best possible way,” says pharmacist Themba Muhlarhi of Medipost Pharmacy.

Prevention and testing

“Our actions in our youth can have consequences for our long-term health. Being faithful, that is having just one sexual partner, or abstaining, is the best policy for prevention, and ‘condomising’ should be the norm, unless testing for HIV and screening for other sexually transmitted infections has been done to eliminate the risk.”

Medipost Pharmacy ensures continuous, hassle-free, and reliable delivery of long-term and chronic medicines, including those for the prevention and management of HIV, among many others, to any address in South Africa, making it easy to adhere to treatment as prescribed.

For people who are at higher risk of HIV exposure, pre-exposure prophylaxis (PrEP) is available as an additional means to help prevent infection, for example, where one partner is HIV positive and the other is negative, speak to your doctor for the prescription medication used in PrEP. While rapid HIV tests are also available without a prescription for home delivery from shop.medipost.co.za, they are best done at a facility where pre-testing and post-test counselling are available if needed.

“It is important to understand that even if a rapid test comes back indicating positive, a confirmatory HIV test still needs to be done at a clinic or health facility. Condoms remain the best barrier method of prevention when used correctly every time,” he says.

“Young people who are diagnosed with HIV today have a better chance for a long and healthy life than previous generations. It is important to test for HIV regularly and start ARV treatment as soon as possible if a positive diagnosis is confirmed. Your doctor will prescribe the right medication for you, and your pharmacy team can help explain exactly how to take the treatment.”

Pharmacist’s top tips for a healthy lifestyle

“Take care of your body, and it will take care of you,” says Themba Mhularhi, a pharmacist with Medipost Pharmacy.

Seven tips for better health and wellness

Exercise regularly – Make time for a walk, stretch, jog, or any physical activity you enjoy.
Watch what you eat – Think of more healthy foods like salads, and less processed foods and oily fast foods
Drink more water – Minimise alcohol, sugary soft drinks, and highly caffeinated energy drinks
Take care of your mental health, and reach for professional support if needed
Have regular checkups and never take your health for granted
Protect yourself and others from HIV and STIs – Use condoms and be faithful
Young women, ask your doctor or clinic about the HPV vaccine to help protect against cervical cancer

Don’t skip ARVs

Muhlarhi explains that antiretrovirals, more commonly known as ARVs, are medications that fight HIV in the body, preventing the virus from growing and progressing so that the person can remain healthy for decades.

“There are many ARVs available in the market; most are formulated in a three-drug combination tablet, and others may be in a two-drug combination, with liquid formulations available as well.”

He emphasises that starting HIV treatment early is essential to prevent the spread and multiplication of the virus in the body, giving the immune system a fighting chance against opportunistic infections, such as tuberculosis (TB) or pneumonia, which can be especially serious for people with HIV.

“It is important for people on ARVs to adhere to their treatment and remain consistent with taking their medication. Sometimes a person might experience side effects when starting new medication, and it is advisable to talk to your treating doctor and a pharmacist who can provide reassurance and, where needed, guidance to find a solution.”

What’s the danger?

Muhlarhi stresses that you should never stop taking prescribed chronic medication for conditions such as HIV, diabetes, bipolar disorder or depression, among others, without first seeking the advice of your treating doctor.

“Not taking treatment consistently can result in what we call drug resistance. For HIV, this is a situation where the virus adapts itself to the drug in such a way that the medication no longer works. When this happens, the ARV becomes ineffective, and the virus can rapidly multiply and destroy your body’s immune system cells, which can have lasting effects on your health and future HIV management,” he explains.

“The danger of poor adherence is that once this resistance develops, it often means the person will need to take more medication to control the virus than before. Instead of taking just one pill at night, you may end up having to take two or three tablets twice a day plus the one at night.

“This extra pill burden can make adherence more difficult for some people to keep track of, so please do NOT skip your doses and try to take your medication at the same time every day so that your treatment can be optimally effective and serve you well for years to come.”

In addition to free delivery on chronic medication, Medipost Pharmacy also offers pharmacy advice telephonically in all official South African languages to provide confidential clinical support for registered patients.

“Through greater awareness of HIV and the importance of adhering to chronic medicine and making responsible use of all the prevention measures available, this generation can turn the tide on newly acquired HIV infections and ensure that young people living with HIV have easy, reliable access to the medicines they need to remain healthy and well for decades to come,” Muhlarhi says.

To register with Medipost Pharmacy, email info@medipost.co.za , call 012 426 4000, send a WhatsApp to 012 426 4655 or download the Medipost app. Visit www.medipost.co.za for more information.

Doctors, your mental health matters too

Fri, 13 Jun 2025 14:10:33 GMT

Healthcare professionals urged to recognise the risk of burnout and depression

It has been estimated that 80% to 90% of doctors experience some form of burnout at some point in their careers. This can affect their ability to practise optimally and to connect with their patients with empathy and care. The consequences are serious, as burnout and depression are major risks for doctors, threatening both their wellbeing and the quality of care they provide.

On the first Friday in June each year, everyone is encouraged to wear colourful, mismatched or otherwise attention-grabbing socks to mark Crazy Socks 4 Docs, an international awareness movement aimed at increasing the visibility and support for mental health for medical professionals, who are at especially high risk for depression, burnout and suicide.

It is deeply concerning that at least 50% to 60% of healthcare professionals will experience depression at some point during their working lives. Junior doctors are particularly vulnerable, and their risk for depression and burnout seems to be increasing.

One of the factors that contributes to burnout is work overload, as doctors are expected to do more and more within the same amount of time. Beyond patient consultations, they face a growing mountain of paperwork – from medical aid forms and insurance requirements to documentation and providing clinical feedback on patients with complex medical needs.

Dr Bavi Vythilingum – psychiatrist practising at Netcare Akeso Kenilworth

Often, there aren’t enough doctors to keep pace with healthcare needs, and not enough hours in the day. People may ask why doctors do not take on fewer patients – the need is simply too great and the resources too few. Even in the private sector, if you, as a doctor, decide to see fewer patients, this simply means longer and longer waiting times for people who need treatment from the few specialists in the field available in their city or province. Very often, patients just cannot wait months for an appointment. As caring healthcare professionals, we often tend to squeeze more urgent patients into our days, often at the expense of a much needed break.

Doctors often find themselves in a situation where they are constantly putting their patients’ needs before their own basic needs. In the short term, a person may be able to handle this intense pressure, but in the long term, we know it’s not sustainable and will impact their physical and mental health sooner or later.

Some 20% to 40% of doctors’ time is spent on tasks they are not remunerated for, such as writing scripts, completing documents, making phone calls, following up and speaking with patients’ families. While we do this, and do it with caring, in the ‘always on’ culture of social media and digital technology, healthcare professionals are expected to be available and responsive almost around the clock. Not only are these additional tasks very time consuming, but they are often expected outside of normal consulting hours. This can add to feelings of losing control, a major factor in burnout.

While doctors are looked up to as healers, they themselves may experience ‘moral injury’, which is one of the greatest contributors to burnout among healthcare professionals. This refers to a situation where you are forced into doing something that you may not entirely agree with, often made necessary because doctors are working within the parameters of funding constraints, managed care and patients’ medical scheme benefits.

These limitations mean that we as doctors may not always be able to prescribe the ideal treatment that we feel would be most beneficial for our patients – simply because many of the drugs are grossly unaffordable. This places healthcare professionals who have their patients’ best interests at heart in the very difficult position of sometimes having to make compromises on the treatment they can prescribe. This is often experienced as a moral injury that can weigh down doctors, taking a toll on their mental health as a risk factor for burnout and depression.

Doctors are sometimes mistakenly perceived to be omnipotent, and we are expected to never get ill ourselves, including both our physical and mental health. There is still a huge stigma associated with mental health among doctors. We are expected to keep going, no matter what. This means many doctors don’t seek mental healthcare when they need it, often because they are afraid this reflects negatively on their competence or ability to practice.

Tragically, doctors therefore often wait until they really can’t cope before seeking mental healthcare, and by then it becomes more difficult for us to help, where earlier intervention could have prevented such a serious decline that it may affect all areas of their lives.

Another contributor to doctors’ burnout and depression is the worrying rise in anti-medicine culture globally, such as the anti-vaccine movement and anti-pharma beliefs. As doctors, we bear the brunt of this as individuals who take these beliefs to heart may need our help, but express such distrust, often founded on baseless online conspiracy theories that are counterproductive to their wellbeing. Healthcare professionals are placed in the invidious position where patients come to us and want us to help them, but they do not want the help that we are able to give.

Very often, doctors and their receptionists are unfortunately also on the receiving end of verbal abuse. Even threats and physical violence against doctors are not uncommon, particularly in the public sector.

Doctors, wanting to do their best for their patients, work in a highly stressful environment that has become even more pressured, litigious, and demanding than ever. As doctors, we need to acknowledge that we are only human and be aware of the additional risks our profession places on our mental health so that we can take better care of ourselves. This is the only way to continue doing our best for our patients with the means and time available.

Recognising the immense pressures doctors work under, shifting the narrative from silent endurance to proactive self-care is essential. Just like their patients, doctors must feel empowered to seek help early, whether through confidential counselling, peer support groups, or mental health resources tailored to healthcare professionals. Understanding that needing support is not a sign of weakness, but a vital part of sustaining their ability to care for others, can break down the stigma that so often holds doctors back.

Public and private healthcare facilities and professional bodies also have a responsibility to create environments that encourage openness about mental health, provide accessible support systems, and actively reduce unnecessary administrative burdens. By fostering a culture where doctors can acknowledge their own needs without fear, we protect not only their health but the quality of care patients receive.

Ultimately, caring for ourselves is not a luxury – it is essential. When doctors prioritise their mental wellness, they can continue to serve with the empathy, skill, and dedication their patients deserve.

Dreams back on track for young cataract patient

Wed, 04 Jun 2025 11:28:49 GMT

Restored vision gives student renewed hope for the future

Everything is in HD now.” These are the words of a young woman after receiving specialist eye surgery – an experience she says has given her a second chance at life.

Upbeat 25-year-old student Atang Climantine Makhubedu jokingly calls herself a cataract survivor. Just weeks before, however, she was battling the harsh reality of unexpected vision loss, which Dr Sachin Bawa, an ophthalmic surgeon practising at Netcare Linkwood Hospital, describes as having significantly impacted Atang’s daily life.

Dr Bawa explains that cataracts involve the loss of clarity in the human lens. “The clear lens is found behind the eye’s pupil, and when it becomes cloudy, it can cause visual impairment. In Atang’s case, both eyes had become affected to the point where she needed ongoing help with daily activities from family members and was struggling with her studies

“Most people will develop age-related cataracts, but it can occur in young people with certain risk factors, such as diabetes, chronic use of medications like steroids, trauma to the eye and genetic issues,” he says.

As a person with type 1 diabetes, Atang is fastidious about seeking medical care when unusual symptoms appear, so when she started to experience blurred vision last year, she went straight to her local clinic for assessment.

25-year-old Atang Makhubedu’s dreams are back on track after receiving life-changing surgery to address the cataracts that were significantly impairing her vision. This energetic young student credits the Netcare Foundation and Dr Sachin Bawa, an ophthalmic surgeon practising at Netcare Linkwood Hospital, with giving her a renewed sense of hope for the future.

Atang describes the following months as being tough and depressing. “My vision became so bad that I had lost my smile – I did not like the person I was becoming. The out-of-pocket costs for private surgery were beyond reach, and I was demoralised knowing that the longer I had to wait for the procedure, the more I would have to rely on others,” she says.

Atang’s dreams for the future seemed to be slipping away, but she finally saw some light when the Netcare Foundation responded to an email her sister sent on her behalf. “From that moment on, everything moved so quickly,” she says.

According to Sharlene Swart, Netcare’s corporate social investment projects and funding manager, while cataract surgery is generally considered a straightforward, routine solution, it is sadly not readily available for many, as was the case for Atang.

“It is always heartbreaking to witness the devastating effects of vision loss that could so easily be addressed, particularly in the case of a promising young person with their whole life ahead of them. So, when Atang’s case came to our attention, the Netcare Foundation was only too glad to step up and provide assistance, along with Dr Bawa, who selflessly answered the call,” Swart says.

After consulting with Atang, Dr Bawa wasted no time in scheduling her much-needed surgery for the very next day. “I felt an urgency to help her as soon as we could. The surgery is a painless 20-minute procedure in which the cataract is removed through a micro incision of 2.5 mm, and a new artificial lens called an intraocular lens is implanted.

“Atang had both eyes done at the same time, and her procedure took no more than 40 minutes. Generally, recovery is patient dependent and can take up to a week to improve, but Atang had perfect vision the very next day and returned home with eye drops to use during the recovery period. From there, eyeglasses are generally prescribed after four weeks to further improve vision,” he explains.

Atang highlights the remarkable difference this seemingly routine procedure has made in her life. “I no longer have to ask for help reading the labels on products at the grocery shop, and I don’t have to zoom in on every word just to be able to read a simple text message.

“As a diabetic, physical activity is crucial for my health. I can go for walks without worrying about falling, and I can manage my insulin injections by myself again. At last, I can complete my degree in public relations and move forward with my life. I am a curious being who loves hiking, reading, writing and learning, and I am truly grateful for the independence that has been returned to me.

“Dr Bawa and the team at the hospital really made me feel at home, and the surgery was quick, easy and painless. I am so thankful to them and the Netcare Foundation. I aim to pay it forward and give back to those in need one day, but for now I would like other people living with diabetes to know they are not alone in their journey,” she says.

Dr Bawa highlights that the only available treatment for visually significant cataract is surgery, which, if delayed for long periods, can present challenges for the surgeon and may include a higher risk of complications. “Symptoms of cataract include glare, poor night vision, faded colours and blurred vision. Good general health and nutrition can help delay the onset of cataract, but treatment should be sought as soon as symptoms appear,” he says.

Swart thanks Dr Bawa and the many other dedicated healthcare professionals in South Africa for giving their time and expertise freely to uplift people like Atang.

“We at the Netcare Foundation firmly believe that a spirit of collaboration can continue to move our nation forward in meeting the very real healthcare needs of so many South Africans, and we are honoured to play a role in making that a reality,” she concludes.

Ten hours into the future: Predicting ICU deterioration for earlier intervention

Fri, 30 May 2025 10:41:27 GMT

First for SA: Electronically enabled algorithm supports better clinical decisions

A South African first of its kind tool is transforming patient care locally by leveraging Netcare’s advanced electronic medical records system and abundant clinical data. This will help clinicians identify risk of deterioration from common causes earlier among intensive care patients so that treatment can start sooner.

Doctors in Netcare ICUs now have the support of a scientifically developed algorithm that predicts a person’s risk of deteriorating from causes including heart failure, respiratory instability or compromise, infection, sepsis or acute cardiac arrhythmia.

“The prediction algorithm uses automatically recorded real-time heart rate, blood pressure, oxygen saturation and respiratory rate data to detect a person’s chance of deteriorating. This provides vital information that doctors can use to commence therapy much earlier, when such interventions tend to be most effective,” explains Professor Reitze Rodseth, head of clinical data innovation and research at Netcare.

Underpinned by complex mathematics, the artificial neural network applies a machine learning algorithm to analyse electronic information on patients’ vital signs and anticipate the risk of a patient deteriorating eight to ten hours before it is otherwise clinically identifiable.

International collaboration

The sophisticated algorithm was developed over years by researchers from institutions including Netcare, Charité – Universitätsmedizin Berlin, one of the largest academic hospitals in Europe, Telehealth Competence Centre (TCC) in Germany, the University of KwaZulu-Natal, University of Minnesota School of Medicine and Emory University School of Medicine in Atlanta, United States, and DigitalOn Tech (Pty) Ltd from South Africa.

The algorithm, which goes live in all Netcare ICUs from 28 May 2025, provides an early indication to the treating doctors who are able to assess and adjust medication to prevent their patients’ condition from deteriorating. In the case of sepsis, which is the body’s reaction to an overwhelming infection, this is critical as treatment is especially time sensitive for securing the best outcomes for the patient.

“Crucially, this means that we are supporting doctors to identify this risk hours in advance, and commence potentially lifesaving treatment much earlier – providing an opportunity to address this leading cause of clinical deterioration before it progresses,” says co-author of the article published in The Journal of Clinical Medicine and chief executive officer of the Netcare Group, Dr Richard Friedland.

Turning back the clock

“This insight is of considerable human and clinical value, as once sepsis has reached the stage where the person is showing symptoms, the risk of mortality is tragically as high as 20%. Turning back the clock for the initiation of sepsis treatment with this advanced machine learning algorithm provides clinicians the opportunity to address this leading risk for intensive care patients earlier,” Dr Friedland says.

Digital integration of medical equipment and devices in ICUs and theatres is already well established in all Netcare hospitals through the international award-winning CareOn electronic medical records system, another South African healthcare first that Netcare initiated. With approval from the South African Health Products Regulatory Authority (SAPHRA), this prediction algorithm has been embedded into the CareOn system.

“Strategically, our Group-wide digitisation focus laid a foundation that now enables us to use this technology meaningfully in the clinical setting. The data derived from digitising our operating platforms informs the development and implementation of innovative analytics and algorithms that informs doctors’ decisions at the bedside, improving quality and safety of care, as well as cost-effectiveness,” adds Dr Anchen Laubscher, Group medical director of Netcare.

“The World Health Organization notes that treatment of sepsis is most effective when initiated early, and this evidence based tool seeks to provide an early warning system for doctors, adding an extra layer of protection that is especially significant for persons at higher risk of infection and sepsis, including the elderly, long-term ICU patients and people with certain co-morbidities,” she explains.

During the pilot phase, limited to certain Netcare ICUs, it was observed that even among patients whose vital signs were not yet abnormal enough to typically warrant concern, the machine learning algorithm was able to identify an increased risk in the quick sequential organ failure assessment (qSOFA) score, prompting doctors to evaluate this new information as part of their management of intensive care patients for timeous treatment.

Now, the system has been implemented in all Netcare ICUs as part of an ethics approved clinical study to measure the impact of this technology. The system always protects the privacy of patients, and no personal data ever leaves Netcare’s strictly safeguarded information technology environment.

“We believe early warning systems such as this risk prediction tool represents the future of proactive healthcare. Through strategically harnessing evidence-based medicine that is data driven and digitally enabled, we see this groundbreaking application of the algorithm in our ICUs as another important step in our mission to provide the best and safest care, centred on the needs of the individual,” Dr Friedland concludes.

What is sepsis?

Sepsis is defined as a life-threatening extreme reaction of the body’s own defences against any form of infection, bacterial, viral, fungal or even parasitic.

“When the immune system overreacts to infection in this way, it can cause tissue damage and organ failure. Without prompt treatment, sepsis may progress to septic shock and can be fatal,” explains Dr Anchen Laubscher, Netcare’s Group medical director.

Sepsis accounted for 19.7% of all deaths worldwide, according to research by Rudd et al. published in The Lancet in January 2020, cited by the World Health Organization.

While anyone can develop sepsis, some groups are more at risk:

Pregnant women
Babies
Older persons
People with compromised immune systems, such as those with cancer and HIV+ individuals
Patients with chronic health conditions, such as kidney disease or diabetes
People in ICUs or long-term hospital care

‘Research supports earlier intervention as crucial in treating sepsis, which is why Netcare is pioneering the use of this machine learning algorithm technology in its electronic medical records system to help doctors identify this leading risk early among patients in intensive care units,” Dr Laubscher says.

Technology supporting clinical decision-making explained

“When we set out on the research, our aim was to provide a clinical decision support algorithm able to flag patients at risk of deterioration from any cause, most common being respiratory compromise, infection and suspected sepsis, or heart failure, who may benefit from early intervention,” explains Professor Reitze Rodseth.

Through international collaboration with academic institutions and Telehealth Competence Centre (TCC) in Germany, and DigitalOn Tech in South Africa, an artificial intelligence (AI)-driven model was developed to predict patient deterioration.

This sophisticated machine learning algorithm known as an artificial neural network learns from patterns of data, including an ICU patient’s heart rate, blood pressure, oxygen saturation and breathing rate, to indicate a patient’s risk of deteriorating in the next eight to ten hours.

Doctors in Netcare ICUs now have the benefit of this real-time indicator as another tool to help support better informed clinical decisions for patients who are at high risk of deterioration. In this way, technology is enhancing medical professionals’ ability to make time sensitive decisions earlier, delivering better and safer care to our patients.

DK is thriving with mom’s kidney

Mon, 12 May 2025 10:19:45 GMT

Ditshegofatso Kgobisa, known as ‘DK’ for short, suffered kidney failure at 15. After 11 months reliant on lifesaving dialysis with National Renal Care, DK gained a new lease on life after his mother, Rosemary, was able to donate one of her kidneys to him.

Family thanks dialysis and transplant teams

The family of a young man who spent hundreds of hours in dialysis is sharing their joy and gratitude to the healthcare teams for having his health restored after the teenager received a kidney donation from his mother.

Ditshegofatso Kgobisa, whose name means ‘Many blessings’, was just 15 years old when he suddenly became very unwell and did not respond to initial treatment. “DK couldn’t keep down any meals and our family doctor, Dr Lilian Sanyane, ordered urgent tests. She called us just before midnight on 8 December 2021, telling us to take him to the emergency department urgently,” says his mother, Rosemary Kgobisa.

Ditshegofatso, known as ‘DK’ for short, was soon admitted to Netcare Montana Hospital, diagnosed with stage five kidney failure. On top of his pre-existing epilepsy, kidney failure caused DK to have uncontrollable high blood pressure, which later led to a haemorrhagic stroke requiring emergency surgery.

“As a mother, it was not easy to hear at first, and there was a lot to take in. We didn’t know much about dialysis at that stage, and I hadn’t heard of anyone with kidney failure having a good outcome,” Rosemary recalls.

As doctors provided lifesaving care to DK, National Renal Care (NRC) Montana’s acute dialysis team came to perform his first dialysis sessions in the hospital. “Nephrologists Dr Moses Mahlangu and Dr Rudzani Mathonsi, explained to us that there was a plan for DK, and this therapy was needed to replace the function of his kidneys,” Rosemary recalls.

“They explained it as a solution to help him, and we were determined to remain positive. In this difficult time, God was our anchor. Prayer, the word of God and our constant faith have been essential in our journey, and we found strength daily in Psalm 91,” she says.

Business manager of NRC’s North East region, Mary Mosetlha, was the unit manager of NRC Montana haemodialysis unit at the time, where DK would have his dialysis three times a week, four hours per session, for the next 11 months.

“A supportive family is so important, especially for young patients on dialysis. I must commend the Kgobisas for surrounding DK with love and ensuring his treatment compliance. DK’s parents and brother, as well as his aunts and cousins, would spend time with us in the unit during his dialysis sessions,” Mosetlha recalls.

Sithembile Mthetwa, operations manager for NRC’s North East region, points out that dialysis practitioners spend a lot of time with their patients during their dialysis sessions, over years and decades in many cases.

“Each NRC unit is like a family, and healthcare practitioners who work in renal care are both passionate and compassionate when it comes to caring for patients. It is an intimate environment and in chronic therapy like dialysis, practitioners get to know patients and their families so well that we become personally invested in their long-term wellbeing,” Mthetwa says.

“As a healthcare practitioner, you want to see your patient reach their personal goals, watch their kids grow up, and attend their grandchildren’s weddings.”

“Early on in his dialysis, we discussed the options for DK’s future, and his parents immediately wanted to test for compatibility as kidney donors for their son,” Mosetlha recalls.

Rosemary says she, her husband, and their eldest son were all potential donors in terms of tissue typing, and all three wanted to be the one to give DK their kidney. “My kidney function test results were slightly higher than my husband’s. With amazing support from our transplant coordinator, Sr Nthabiseng Sono, we prepared for the transplant surgery at Netcare Jakaranda Hospital in November 2022.”

The kidney Rosemary donated to DK began to function immediately in her son’s body and, within days he began to feel more energetic and was soon “running around the hospital”, eager to be discharged.

“I told him, it feels like I gave birth to you twice, but I wouldn’t have it any other way. I appreciate my scar a lot, as it reminds me of the gift I gave and the love I have for my son. We are both back to our normal lives, my health is not negatively impacted by donating one kidney, and I don’t even have to take any medication,” Rosemary says.

DK was able to return to school after receiving the kidney from his mom. Now aged 18, he enjoys creative arts, including a love for music, singing and acting, and dreams of becoming a music producer someday.

“I want to thank my family for all their love and everything they’ve done to support me over the years, and especially to my Mom for giving me the kidney that saved my life,” DK says.

“I would not be where I am today without the doctors and nurses who cared for me at NRC Montana, Netcare Montana and Netcare Jakaranda hospitals, and we thank God for them. I would especially like to wish a happy International Nurses Day to all the healthcare professionals who are a lifeline every day for people living with kidney failure, as I was before my transplant,” he says.

“For us as a family, it’s important to share our experience to show that good outcomes are possible for people with kidney failure,” Rosemary adds.

“Our journey highlights that organ transplants save lives, and what it really means to our family to have our prayers for DK answered. I would like to encourage everyone to consider registering as an organ donor, as it’s the greatest gift to give another person a chance at life.”

Managing migraines: Understanding types and triggers

Sat, 03 May 2025 10:20:51 GMT

More than ‘just a headache’, neurologist explains

Migraines can severely affect the quality of life for people who suffer from them, making work, social interactions, and even simple tasks unimaginably difficult. With an estimated 15%* of the global population affected, the impact of migraines on daily life and productivity is significant and cannot be underestimated.

“Migraines are more than just headaches — they are complex neurological events that can significantly impact daily life, often leading to missed days of work or school because of the intense pain and other associated symptoms,” says neurologist Dr Michael Huth, President of the South African Headache Society and Executive Board member of the Neurological Association of South Africa, who practises at Netcare Linksfield Hospital.

“The debilitating and wide-ranging symptoms people experience with migraines can reduce productivity. In addition to brain fog and fatigue, some have sensitivity to environmental factors, such as bright lights, strong smells, or loud noises, which can worsen symptoms.

“Furthermore, the emotional distress of dealing with chronic pain from recurring migraines can contribute to anxiety and depression for some individuals who endure them, underlining the importance of proper diagnosis and appropriate management of migraines,” he says.

“While many people think of migraines as intense head pain, there are different types of migraines, each with characteristic symptoms, duration, and triggers. Determining what type of migraine a person is experiencing is key to establishing what can be done to help manage the episodes effectively and, where possible, prevent them.”

Types of migraines generally fall into two broad categories, depending on whether there is a visual or sensory disturbance known as an ‘aura’ before or during the headache phase. “An aura can be described as flashing lights, blind spots, tingling sensations, or difficulty speaking, and a classic migraine includes aura symptoms for 20 minutes to an hour,” Dr Huth explains.

“A migraine without an aura is known as a common migraine. Symptoms include throbbing or pulsating pain often felt on one side of the head, nausea, vomiting, and sensitivity to light and sound.

“These migraines typically last between four and 72 hours without treatment, and frequency varies with some people experiencing occasional attacks, known as episodic migraine, while others may experience repeated migraines many times in a month.

“Chronic migraine is defined as symptoms occurring for 15 days or more per month for at least three months. These migraines are persistent and can be near-daily in severe cases,” he says.

“Hemiplegic migraine, which is often caused by genetic factors, is experienced as temporary weakness or paralysis on one side of the body, lasting anywhere from a few hours to several days at a time. This type of migraine is accompanied by aura symptoms such as confusion, speech difficulties, or dizziness. While the attacks are usually infrequent, some individuals experience hemiplegic migraine multiple times a year.”

In addition to these more widely recognised migraines, Dr Huth warns that some lesser-known types can be just as disruptive.

“Vestibular migraine, also known as migraine-associated vertigo, involves symptoms of dizziness, balance issues, nausea, and sensitivity to movement – sometimes without a headache ¬– lasting from minutes to hours. Lifestyle changes can be helpful in conjunction with vestibular rehabilitation therapy to improve balance and stability and prescribed treatment such as beta-blockers or anti-seizure medication.

“Abdominal migraines, on the other hand, are recurrent episodes of severe stomach pain, nausea, and vomiting, usually seen in children. Often, adjusting lifestyle factors and drinking enough water for good hydration can help to prevent or minimise abdominal migraines, supported with medication where needed,” Dr Huth says.

“Ophthalmic or retinal migraine symptoms include temporary loss of vision or visual disturbances in one eye, followed by or accompanied by a headache. It is important that people experiencing this type of migraine have an eye examination with their ophthalmologist to rule out the possibility of other eye-related conditions that could be contributing to the condition. Identifying and avoiding triggers can be helpful, as well as migraine-specific medications guided by your treating doctor.”

Tips to reduce migraine frequency and severity

“While medication can help manage migraines, the following lifestyle changes can play a crucial role in reducing their frequency and intensity,” he advises.

1. Maintain a consistent ro utine

Stick to regular sleeping patterns, aiming for seven to nine hours of rest.
Eat balanced meals at the same times each day to prevent blood sugar levels from dropping.
Stay hydrated, as dehydration is a common migraine trigger.

2. Manage stress

Practise relaxation techniques like meditation, deep breathing, or yoga.
Take breaks from screens and limit exposure to bright or flickering lights.

3. Exercise in moderation

Low-impact activities like walking, swimming, or stretching can help.
Avoid overexertion, as intense workouts can sometimes trigger migraines.

4. Watch your diet

Keep a migraine diary to help identify and avoid triggers.
Common food triggers include caffeine, alcohol, aged cheeses, processed meats, and artificial sweeteners.
An elimination diet can help pinpoint specific food triggers.

5. Medication and alternative therapies

Preventive medications may be prescribed for frequent migraines.
Acupuncture and magnesium supplements can provide relief for some sufferers.

“Migraines are complex and vary widely from person to person. Understanding the different types, recognising their symptoms, and implementing lifestyle strategies can make a significant difference in managing them.

“If you or someone you know experiences frequent migraines, there is help available and consulting a doctor for an individualised treatment plan is recommended. Through awareness and prioritising self-care, quality of life can be greatly improved for those suffering from migraines,” Dr Huth concludes.

Be prepared as flu season starts

Mon, 21 Apr 2025 09:30:34 GMT

Ward off serious illness with this year’s influenza vaccine

South Africa’s influenza season has started. While most people recover fully from flu after a week or two without the need for any special treatment, this viral condition can cause serious illness, particularly for those at risk, including the elderly, pregnant women, and small children.

“The influenza or flu virus is particularly fast, clever and savvy at adapting, causing it to constantly evolve new strains to evade our immunity, which means we can become sick every flu season,” explains Dr Michael de Villiers, a general practitioner (GP) practising at Netcare Medicross The Berg.

“Every year, a new vaccination is typically developed for new and particularly bad flu strains. There are many cold and flu viruses to target, and scientists work hard to protect against the most threatening variations. However, it is not yet possible to include protection for all strains in the annual flu vaccine.

“Influenza is caused by a group of viruses, which are tiny invisible 'bugs', that have adapted to be highly efficient in spreading from person to person by remaining in the air or on surfaces after contamination. Symptoms commonly include body aches, fever, nasal congestion, tiredness and coughing, which can interfere with your ability to work or perform your usual daily activities,” he says.

The World Health Organization (WHO) and the Department of Health’s National Institute for Communicable Diseases (NICD) recognise vaccination as the most effective way to prevent flu.

“Explained in simple terms, vaccines act as ‘coaches’ that help to prepare the immune system to quickly defend itself from future invasions of a particular virus before it grows in the body and becomes overwhelming. It takes around two weeks to train the immune system to build up the firepower needed to fight off a full attack of the flu quickly,” Dr De Villiers says.

“The influenza vaccine is generally recommended every year – especially for those at risk of severe flu with complications, which includes individuals who have challenges with their health, including those with chronic illness, children older than six months, those who are pregnant or planning pregnancy and people over the age of 60,” Dr De Villiers says.

“The second group of people who should consider having the flu vaccine are those with high exposure for potential flu infection, such as healthcare workers, care workers or caregivers, and those who work with children, or live with people who are at higher risk, such as those with compromised immune systems.

“It is important to remember that even if you do not get sick with the flu yourself, you can still carry it and pass the infection on to others, leading to wider transmission within communities. Therefore, we all have a role in preventing the spread of infection, including through non-pharmaceutical measures like practising good hand hygiene and staying home when you are ill,” he recommends.

“Vaccines are one of the tools in our arsenal to help reduce the severity of the worst flu infections in a season. If you are vaccinated, you can still get colds or flu; however, the illness is likely to be far less severe with a quicker recovery, compared to an untrained immune army dealing with a particularly nasty strain for the very first time.”

“If you do fall ill, contrary to common belief, antibiotics are ineffective against colds and flu caused by a variety of viruses, which are a specific type of organism. Antibiotics are designed to kill harmful bacteria – a completely different and unrelated set of micro-organisms. There’s no point taking an antibiotic unless there is evidence that the problem is bacterial. For flu viruses, this would be comparable to using a fly swatter to kill a lion, and therefore not an effective or useful strategy in this situation,” he explains.

Using medicine, like antibiotics, when you don’t need it can lead to unnecessary side effects, some of which can be really serious. This adds to the global challenge of antimicrobial resistance, which happens when bacteria become resistant to antibiotics faster than we can create new medicines to treat serious infections.

“If you become sick this influenza season, the most effective treatment for most healthy people includes rest, good nourishment, hydration and patience. Simple and proven over-the-counter medicines and natural remedies, such as paracetamol, ibuprofen, and honey, are good starting points to get through the bad days of uncomfortable symptoms, provided there isn't a reason you can't take these in safe quantities. The flu can last up to 10 days, but most people feel better in about a week,” Dr De Villiers advises.

“It's not a good idea to exercise when you are sick with a cold or flu, especially when it's 'below the throat' with symptoms affecting your chest, as this could put you at risk of serious heart muscle complications, amongst others. It's best to rest and allow your body to devote its resources to your immune army, as exercise can make the illness worse or prolong your illness,” he says.

“If flu is accompanied by any worrying or persisting symptoms, for example, chest pains, shortness of breath, fast breathing or drowsiness – particularly in children, blue discolouration, severe headaches and muscle pains, and if it is not responding to medicine, it’s important to consult a doctor immediately.

“If you or your loved one has underlying health problems, medication problems, or any concern over the body's ability to fight off infection, please book an appointment to see your local GP for a check-up — we are always happy to help,” Dr De Villiers concludes.

Find your nearest Netcare Medicross and make an appointment with a GP on the Netcare app or online at https://onlinebookings.medicross.co.za/.

Early detection of colorectal cancer saves lives

Fri, 11 Apr 2025 06:53:30 GMT

Screening and awareness: The key to a 90% survival rate

Colorectal cancer, one of the most prevalent yet preventable cancers, can develop in the colon or rectum, often starting as small polyps that can quietly become malignant if left unchecked.

Dr Mpho Ramabulana, a colorectal surgeon and gastroenterologist at Netcare Akasia Hospital, underscores the life-saving power of vigilance and the importance of early detection, noting, "We've observed a 90% survival rate in people who are diagnosed at an early stage, highlighting the immense potential of regular screenings to turn the tide in this battle.”

Understanding the disease

Rising incidence in younger populations: Traditionally affecting older adults, colorectal cancer is now increasingly diagnosed in younger individuals. "This shift necessitates heightened awareness and vigilance in monitoring symptoms," says Dr Ramabulana.
Diverse risk factors: Sporadic cancers, linked to lifestyle choices, form 60% of cases, while familial and genetic predispositions account for the rest. "Modifiable risk factors like obesity and type 2 diabetes play a significant role," he adds.

Dr Mpho Ramabulana, colorectal surgeon and gastroenterologist.

Warning signs that you could be at risk

Changes in bowel habits (constipation or diarrhoea)
Unexplained weight loss
Persistent abdominal pain
Anaemia with unknown cause

Chronic inflammatory conditions

“Unfortunately, patients with chronic inflammation of the gut and conditions like ulcerative colitis and Crohn’s disease face increased risks for colorectal cancer. Regular screenings are, therefore, essential for those with a long history of such conditions,” Dr Ramabulana reiterates.

I need a colonoscopy – what now?

A colonoscopy is a vital tool for early detection. "This minor day procedure is performed while the person is under sedation, and the benefits far outweigh the minimal risks," assures Dr Ramabulana, adding that limited access to alternative tests in South Africa, such as the faecal immunochemical (FIT) test, makes colonoscopy a critical screening method.

How a colonoscopy is performed:

Dr Ramabulana highlights the importance of understanding the colonoscopy process, stating, "A colonoscopy is a crucial tool for early detection of colorectal cancer. It is therefore essential for patients to know what to expect and how to prepare for this procedure to ensure the best outcomes."

Sedation: Before the procedure, you'll receive sedation to help you relax and minimise any discomfort. This means you will be drowsy and may not remember much of the procedure.
Insertion of the colonoscope: The doctor will gently insert a colonoscope into your rectum. A colonoscope is a thin, flexible tube with a tiny camera at the end.
Examination: As the doctor slowly guides the colonoscope through your colon, they can view the inside of your colon on a monitor. This allows them to look for abnormalities like polyps or growths.
Polyp removal: If the doctor finds any polyps, they can remove them during the procedure using special small instruments through the colonoscope.
Completion: Once the examination is complete, the colonoscope is carefully withdrawn. The whole process usually takes about 30 minutes to an hour.

Preparing for a colonoscopy

Dietary restrictions: A few days before the procedure, you will need to follow a special diet. This usually involves avoiding solid foods and consuming only clear liquids, like water, broth and clear juices, the day before the procedure.
Bowel preparation: The day before the colonoscopy, you will be given a laxative solution to drink. This helps clear your bowels so the doctor can see clearly during the procedure.
Adjusting medications: Your doctor may ask you to stop or change certain medications before the procedure, especially if they affect blood clotting or your digestive system.
Arranging transportation: Since you will be sedated, you will need someone to drive you home afterwards, as it would be unsafe to drive yourself.

Following these preparation steps carefully is crucial for a successful colonoscopy, as it ensures the doctor has a clear view of your colon.

Innovative screening techniques:

Advancements such as virtual colonoscopy offer a less invasive option. "Though promising, any abnormalities found still require confirmation through a traditional colonoscopy," says Dr Ramabulana.

Prevention through lifestyle:

Avoid red meat and low-fibre diets
Embrace a high-fibre diet that is rich in fruits and vegetables
Avoid alcohol and smoking
Stay physically active to prevent obesity

“By raising awareness and focusing on early detection, individuals can take proactive steps to prevent and combat colorectal cancer effectively. Informed choices and timely medical intervention can dramatically improve outcomes. Armed with knowledge and awareness, you hold the power to not only reduce the risks but also change the course of this preventable disease,” concludes Dr Ramabulana.

How healthy is your heart?

Tue, 01 Apr 2025 05:46:56 GMT

Cardiologist’s top tips for cardiovascular health

With heart disease on the rise in our country, taking care of your heart health and being aware of cardiovascular risk factors can potentially add years to your life.

“Every day there are simple things we can incorporate into our lifestyle that add up to help protect the heart against preventable causes of cardiovascular disease,” says Dr Robert Routier, a cardiologist practising at Netcare Olivedale Hospital.

“While diet and exercise play an important role in heart health, there are other factors that can increase our risk of developing heart disease.”

Check your heart risk factors

Do you have a family history of heart disease?
Do you have diabetes?
Do you have high cholesterol?
Are you overweight?
Do you have high blood pressure (hypertension)?
Are you a smoker?
Do you have a sedentary lifestyle?

Dr Robert Routier, a cardiologist practising at Netcare Olivedale Hospital, is pictured with cardiothoracic intensive care unit manager Sr Nondumiso Fakude. Dr Routier urges the public to check their personal risk factors regularly to help prevent or manage cardiovascular disease.

“Once you are aware of any specific risks you may face, or if you are diagnosed with cardiovascular disease, it is possible to better manage your risk, and if necessary, your cardiologist may prescribe treatment to help slow the progression of the condition,” he says.

“Never ignore symptoms of chest discomfort because, if it is heart-related, seeking medical attention could save your life,” says Dr Routier.

“Too often people mistakenly dismiss cardiac symptoms as “heartburn”, so it is important to establish the cause. An electrocardiogram [ECG] performed by your General Practitioner or at the emergency department with a blood test, can clarify heart-related concerns that require further management.

“If you experience chest pains while exercising, it could be a sign of angina, meaning your heart muscles are not getting enough oxygen, which can be linked to advanced coronary disease, and you should have a medical assessment as soon as possible,” he advises.

Top tips to care for your heart

Aim for at least 40 minutes of defined exercise a day.
Stress control, including a healthy work-life balance and mindfulness, can help to reduce cortisol and adrenergic drive that may be harmful over time.
Maintain a healthy weight.
Have regular heart-related health screenings, including cholesterol, blood pressure and glucose testing.
Carefully manage preexisting chronic conditions and monitor your treatment progress with your doctor.
Incorporate more physical activity into your daily routine (walking, stretching, taking the stairs instead of the lift, etc.).
Take a moment to think about or chart your dietary intake and exercise habits.
Aim for a balanced and varied diet, with more fresh foods, lower fat, and fewer processed foods
Limit alcohol and refined carbohydrate consumption.
Aim for seven to nine hours of sleep each night. Check with your partner if you snore or have trouble breathing in your sleep, and if so, talk to your doctor about the possibility of sleep apnoea.

Get moving for a healthy, more comfortable pregnancy

Wed, 26 Mar 2025 06:54:13 GMT

Relieve stiffness and prepare your body for childbirth

The physical strain pregnancy puts on an expectant mother’s body should not be underestimated. An obstetrician gynaecologist offers her insights for alleviating discomfort and promoting wellbeing with exercise and stretching throughout pregnancy.

“Incorporating a simple stretching routine into your daily schedule can help relieve muscular tension, support maternal and baby health, and prepare the body for childbirth, making the experience a bit smoother.

“The Royal College Guidelines recommend that expectant mothers should aim for at least 150 minutes of moderate intensity exercise per week during pregnancy, as this has multiple benefits for mother and baby,” says Dr Natalie Odell, an obstetrician and gynaecologist practising at Netcare Park Lane Hospital.

“Regular exercise and stretching are associated with a reduced risk of developing hypertension and diabetes in pregnancy, as well as assisting with controlling weight gain in pregnancy.

“Physical activity also helps improve sleep, which is vital for pregnant women and their unborn babies’ development. As your pregnancy progresses closer to full term, it can be difficult to find a comfortable resting position, and you may find using pregnancy pillows or carefully arranging pillows to support you while ensuring no pressure on your bump can be helpful,” she suggests.

Obstetrician and gynaecologist Dr Natalie Odell

“Pregnancy can be an emotional rollercoaster, with the mother experiencing rapid hormonal changes coupled with the excitement and nerves of preparing for parenthood. Studies have demonstrated that exercise significantly improves mood both during and after pregnancy and reduces the risk of postnatal depression in new mothers – a risk that should never be overlooked or taken lightly,” Dr Odell notes.

“Stretching is so important for preventing injury, as it warms the muscles before exercise and post-exercise stretching also helps to avoid stiffness in the muscles both during and after pregnancy.”

Five stretches for Moms-to-be

Lower back stretches can relieve the tension you may feel in your lower back. Position yourself on all fours. Arch your back and hold the position for a few seconds, then straighten your back to be as flat as possible and hold this ‘table’ position.
From this position on all fours, sit back, resting on your shins. Stretch your arms forward and put your head down.
Hip openers can help release stiffness in the hips. Sit on the floor with your knees open as wide as you can manage while you bring your feet towards your pelvis.
While sitting in a chair, extend your neck, stretching to each side with the shoulders relaxed.
In a standing position, tilt your pelvis forward and hold for a few seconds before tilting it back.

Safety first

“If any specific exercise or stretch is uncomfortable, it is best to seek guidance from your treating obstetrician who may refer you for specific therapy, such as with a physiotherapist or chiropractor, to help relieve pain or discomfort,” Dr Odell says.

Avoid any exercises where you lie directly on your stomach
Ensure there is no pressure or trauma to your baby bump
Listen to your body – make adjustments if a position or movement is uncomfortable
From about 24 weeks of pregnancy, avoid lying flat on your back
Seek guidance from your obstetrician before using heat packs on sore joints

As a specialised maternity facility, Netcare Park Lane Hospital includes one of the country’s most respected neonatal intensive care units alongside caring and experienced obstetric teams.

“As soon as you are contemplating pregnancy or discover that you are expecting, it is vital to make your first appointment with an obstetrician gynaecologist to help you prepare for all aspects of pregnancy for the best chance at a safe and healthy confinement,” Dr Odell concludes.

Urgent call to improve children’s kidney health in South Africa

Wed, 19 Mar 2025 05:37:34 GMT

Highlighting the critical resource shortage and the need for greater awareness

Dr Patience Sigwadi, a leading paediatric nephrologist practising at Netcare Unitas Hospital in Centurion, has issued an urgent call for increased focus on skills development to address the escalating kidney disease crisis among children in South Africa.

“Despite the rising burden of chronic kidney disease in developing countries like South Africa, our current strategies to address this critical issue fall short,” she warns.

Chronic kidney disease (CKD) impacts between 11% and 13% of the global population, and in South Africa, the challenges in paediatric kidney care are particularly daunting. The healthcare system is stretched thin, with fewer than 30 paediatric nephrologists nationwide. This is especially concerning given that nearly 34% of South Africa's 64.7 million residents are children under 18.

"The shortage of paediatric nephrology professionals, including dedicated nurses who understand the nuances of this field of medicine, highlights a critical gap in our healthcare system. This situation demands immediate action to protect the health of our youngest citizens," says Dr Sigwadi.

Causes and challenges

Dr Sigwadi and her team run one of few private paediatric nephrology centres in South Africa. They provide dialysis for children from birth to age 13, using a multidisciplinary approach to treat various kidney conditions including congenital abnormalities, acute and chronic diseases, infections, and hypertension.

She notes that in South Africa, kidney disease in children is often linked to congenital kidney anomalies and genetic and acquired factors such as streptococcal throat infections and recurrent bladder infections. “Acute kidney injury, often resulting from untreated diarrhoea, vomiting, and dehydration, is common among children, and early detection and management can reduce the progression to chronic kidney disease. Other systemic diseases like lupus and diabetes can lead to chronic kidney disease. Additionally, the prolonged use of high doses of medications, such as diuretics and NSAIDs, e.g. ibuprofen, can also contribute to kidney injury, explains Dr Sigwadi.

A silent disease

According to Dr Sigwadi, regular check-ups are crucial for children with risk factors for kidney disease to prevent complications like hypertension and proteinuria, which is an excess of protein in the urine, so potential issues can be identified and managed early.

“CKD often lacks symptoms, making early detection vital. It's typically silent until advanced stages, with poor growth, swelling of the body, decreased frequency of urination, and hypertension being common indicators in children. Early detection allows doctors to treat and protect the kidneys by addressing treatable factors. The three main manageable conditions are high blood pressure, urinary tract infections and proteinuria. Kidney disease often presents vague symptoms, complicating early diagnosis.

“Acquired CKD is also a silent disease that may only become symptomatic in its more advanced stages. Symptoms are often nonspecific; for example, infants usually present with feeding-related complaints, rickets, body swelling, blood in urine and poor growth.

“In infants with congenital anomalies of the kidney and urinary tract, the disease may be discovered through routine antenatal ultrasound scanning during pregnancy. In older children, the diagnosis may come as a surprise when a pathological condition is discovered incidentally. Regular blood pressure checks for children over the age of two should be standard practice, and screening pregnant women can help identify potential issues early on," advises Dr Sigwadi.

The essential role of nurses

Dr Sigwadi emphasises the critical need for more trained healthcare professionals, especially nurses, to improve the understanding and treatment of paediatric kidney disease and deliver quality ongoing care. "Training nurses who can offer care beyond the ordinary is key to tackling this crisis.”

She underscores the importance of nursing professionals who are skilled and deeply empathetic, viewing their work as a calling rather than just a job. "These nurses must connect with young patients and their families, offering comfort and understanding during difficult times. Empathy and dedication are as vital as medical expertise. We need nurses who can look beyond charts, understand the fears, challenges and hopes of children and parents, and are committed to making a real difference," asserts Dr Sigwadi.

Barriers to treatment

“Families face significant challenges in accessing treatment, with some children travelling long distances for dialysis, often without parental support due to economic constraints. Though renal transplantation is available in major centres, cultural customs and a lack of public education on organ donation limit the availability of organs, which makes it essential to create awareness to encourage donor registration.

“Since 2017, only 19 paediatric kidney transplants have been performed in Pretoria, a number hindered by the COVID-19 pandemic. Public education on organ donation could significantly enhance outcomes for children with severe kidney conditions,” notes Dr Sigwadi.

A call for change

Dr Sigwadi's call to action highlights the need for comprehensive care and collaboration among medical professionals, with a particular emphasis on nurses' nurturing role. "By enhancing early detection, resource allocation, and public awareness, we aim to improve the quality of life and health outcomes for affected children across South Africa.

As South Africa grapples with these challenges, Dr Sigwadi's message is clear: “The time for action is now to ensure a healthier future for the nation's children. Cultivating a new generation of nurses committed to empathetic care can pave the way for a brighter tomorrow," she concludes.

Acclaimed paediatric kidney specialist receives prestigious global recognition

Tue, 11 Mar 2025 08:00:03 GMT

Shining a spotlight on local excellence in paediatric nephrology

A passion for ensuring patients receive the best possible care while also advancing the science of nephrology has culminated in a highly respected paediatric nephrologist and advisor on the Transplant Ethics and Advisory Committee for Netcare, Professor Rajendra Bhimma, receiving a Fellowship to the International Society of Nephrology (ISN).

Based at Netcare St Augustine’s Hospital, Professor Bhimma was recently awarded the Fellowship to acknowledge his extensive work in research, community-based outreach and teaching of paediatric nephrology, among others.

Among his other portfolios, he also heads up the Paediatric Kidney Clinical Unit at Inkosi Albert Luthuli Central Hospital, which is affiliated with the University of KwaZulu-Natal (UKZN) and is the Chairperson of the KZN Renal Transplant Panel.

Professor Bhimma, however, has no time to bask in the reflected glory of his many accomplishments. He is working hard to find answers to the many questions he has about several worrying kidney-related illnesses being experienced by South Africans. He explains one of these, saying that the average age of patients beginning dialysis in KwaZulu-Natal is just around 43 years. By comparison, the average age of patients going into dialysis in the USA and Canada is between 62,5 years and up. “There, they have a geriatric population going onto dialysis. Here, we have young people at the most productive stage of their lives with stage five chronic kidney disease. We don’t fully understand it, but studies are underway to determine why this is the case. We’re seeing a lot of children and teenagers going onto dialysis. We have to find out why.”

KZN's champion for children's kidney health: Professor Rajendra Bhimma, who practices at Netcare St Augustine’s Hospital, has received global recognition with a Fellowship from the International Society of Nephrology for his pioneering work in paediatric kidney disease.

What does the achievement of the ISN Fellowship mean?

The status of Fellow of the International Society of Nephrology (FISN) indicates professional excellence to both the recipient’s peers and patients, as well as medical professionals worldwide. While thrilled at the news that he’d got the Fellowship, Professor Bhimma said he didn’t initially believe it.

“To be considered, you have to do groundbreaking, innovative research, not descriptive studies. They look at your training and teaching of paediatric nephrology to the larger community, and I’ve trained quite a few paediatric nephrologists. Then, they look at your community outreach and how you simplify everything and bring it to the community. For instance, I’ve done radio talk shows and talks at schools, religious gatherings as well as interest groups.”

Reka Dulandas, Netcare’s KwaZulu-Natal regional transplant manager, paid tribute to Professor Bhimma, saying his expertise and contributions to kidney medicine are widely recognised. “His dedication to advancing medical knowledge and improving patient outcomes is evident not only in his clinical work, but also in his significant roles in academia. As a committed educator and researcher, he has been instrumental in developing best practices in paediatric nephrology.”

She said Professor Bhimma has shown unwavering dedication to the field of transplant medicine. “A valued advisor on the Transplant Ethics and Advisory Committee for Netcare, his deep understanding of ethical considerations and patient care helps maintain the highest standards in transplant procedures. Furthermore, his role as Chairperson of the KZN Renal Transplant Panel highlights his leadership in driving improvements in renal care in the region, particularly in the area of kidney transplants.”

A change in plan

Professor Bhimma began his career in internal medicine in adults, but this was not where he would end up making his mark on the medical world. “Originally, I wasn’t going to become a paediatrician. The shift in my career happened surprisingly. In my final exam, I cheeked my examiner because I knew I was right and he was wrong. But he didn’t like that, so he failed me, and I had to repeat six months of my training. During the time I did a repeat stint in paediatrics, my friend’s dad, Dr Ronnie Pillay, told me he thought I should do paediatrics. ‘You’ll never go wrong,’ he said.”

Professor Bhimma went to Canada to complete his super-specialist training in kidney disease in children, and when he returned, he began performing kidney transplants for children at King Edward Hospital. “Previously, we used to transplant adult patients only, and children in KwaZulu-Natal were referred to Johannesburg or Cape Town. Many patients were from poorer communities and couldn’t afford to go all the way there for the transplants they needed.

“My research in children with hepatitis B showed that a large percentage of affected children have a genetic mutation that predisposes them to kidney disease. We found that many of these children also had silent liver disease, which was quite severe. We were able to treat them, and the majority of them recovered. We don’t only work on the pathogenesis of a disease. We also treated the disease. The biggest advance was the introduction of the hepatitis B vaccine in April 1994. Now that the vaccine is available, this disease will almost disappear. “

In 2003, Professor Bhimma started doing kidney transplants for children at Netcare St Augustine’s Hospital. “Fortunately, if we are able to treat them early, in many instances, we can defer a transplant until they are adults.”

Sharing his knowledge with new medical practitioners is very important to Professor Bhimma. “Research dictates clinical practice. Science is constantly being evaluated and changing. From the existing research, we see that what’s applicable in high-income countries may not be applicable to us. We’re doing much innovative work and looking at genetic studies in chronic kidney disease. We’re asking questions all the time. We must find the answers that are relevant to us here, and not to a different country, far away. We want to help our people at home. We owe that to our patients.”

Worrying rise in kidney disease

Professor Bhimma says kidney disease is on an exponential rise. “According to World Health Organization data on non-communicable diseases, in 2005, kidney disease did not make the top 20. By 2013, it was at number 16 or 17. In 2021, it was at number nine, and by 2040, we expect it to be at around number five on the list. The ISN plans to request that the WHO consider a resolution on kidney disease at the World Health Assembly in May 2025, aiming to elevate its status as a priority NCD. In KZN, we have a very high incidence of chronic kidney disease. People need to be aware that lifestyle choices can influence a lot of this. Choosing not to exercise, being obese, and not treating infections, hypertension, and diabetes are killing a large number of patients. For instance, the danger of heart disease gets a lot of attention, but people must remember that our kidney health is very important too.” Alarmingly, the WHO’s data indicates that the number of deaths from kidney disease increased by 95% between 2000 and 2021.

Children with high blood pressure

Professor Bhimma highlights a community-based study he was involved in, which revealed disconcerting results. “I’ve had an interest in childhood hypertension. Many people don’t realise that children do get hypertension. Our study in low-income groups looked at grade 12s who are otherwise perfectly normal. We measured their blood pressure, blood sugar, weight and height, checked their urine for protein, and came up with an astonishing finding. Our study showed that 14% of black children, around the age of 17 years, already have hypertension. It’s an important finding because the figures we’d previously had for primary hypertension was for children in Western countries. We can see that these figures from high-income countries are very different from our local population.”

The study was published in the International Journal of Hypertension. “Now I belong to a consortium in hypertension research in children [Childhood Hypertension Consortium of South Africa (CHCSA)], and we’re looking at setting normative values for blood pressure in black children.”

Groundbreaking studies at genetic level

Professor Bhimma began his paediatrics career at King Edward Hospital and realised he had a flair for nephrology. His PhD thesis was on nephropathy associated with the hepatitis B virus.

“Professor Miriam Adhikari, one of my supervisors, had made an interesting observation. While Indian children, white children and those of mixed race responded to steroid treatment for nephrotic syndrome very well, many black children did not.” Later, Professor Bhimma was involved in innovative studies which showed that one of the reasons black children do not respond to steroids is because they have a mutation in a particular gene. “We found out why the steroids weren’t working. We had to look at different ways of treating them.”

Tragic end for a special patient

The story of the first child Professor Bhimma performed a transplant on will stay with him for life. “The child had gone into kidney failure from nephrotic syndrome. His bone disease from the kidney problem was so bad that he couldn’t walk. He was in so much pain that his mother used to put him in a stroller to get about. After the transplant, he recovered so well. He was walking on his own and flourished into adulthood. When he was 20, he wanted to learn how to ride a motorcycle. That’s how well he had recovered. Tragically, at the age of 22, he died in a motorcycle accident.”

Early diagnosis of paediatric kidney disease is critical

Kidneys are complex and intricate organs with different structures that do a range of things, including filtering blood, maintaining fluid balance, and regulating mineral levels in the body.

“Kidneys are complicated. We need them to function well for good health. When something goes wrong, it can lead to serious illness and even death. In children or tiny babies, the importance of a correct diagnosis, made early and accompanied by the appropriate treatment, is critical,” says Professor Bhimma.

Additional sources

https://ukzn.ac.za/news/paediatric-nephrologist-receives-prestigious-international-fellowship-award/

https://www.theisn.org/in-action/community/fellow-of-the-isn/#fisn-2025

https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

African expertise for European Society for Vascular Surgery committee

Fri, 07 Mar 2025 07:26:39 GMT

Netcare congratulates Prof Bhekifa Dube

The European Society for Vascular Surgery (ESVS), one of the world’s leading scientific organisations in vascular care, has invited Professor Bhekifa Dube to join its clinical practice guidelines committee.

“We heartily congratulate Professor Dube on his achievement of being the only specialist from the continent selected to join this significant medical committee on the global stage,” says Alan Abrahams of Netcare’s Cape region.

Professor Dube, who completed his sub-specialist training at Groote Schuur Hospital through the University of Cape Town, is Head of the Clinical Unit at Livingstone Tertiary Hospital in Gqeberha and has been practising at Netcare Greenacres Hospital since February 2016.

Professor Bhekifa Dube

As the sole ESVS Guidelines Committee representative from Africa, Professor Dube joins an elite group of international vascular surgeons – mainly based in Europe – to develop guidelines that will shape high standards in the future of vascular conditions treatment globally.

The ESVS Vascular Surgery Guidelines Committee aims to provide the most comprehensive, up-to-date, and unbiased advice to clinicians to guide best practice in vascular care.

“In our increasingly connected global society, we are very fortunate to have the opportunity to collaborate across continents and share collective learnings to strengthen the standard of care for patients the world over in line with the latest advances in our discipline,” says Professor Dube.

“I look forward to contributing to the ESVS Clinical Practice Guidelines through participating in the Vascular Surgery Guidelines Committee and demonstrating South Africa’s growing expertise in this field.”

Professor Dube, who has extensive experience in both the public and private sectors, has a special interest in endovascular techniques and has contributed to academic articles published in the Journal of Endovascular Therapy and Cardiovascular Journal of South Africa , as well as participating in conferences including this year’s Surgical Update Conference 2025 in Cape Town.

Reon van Rensburg, general manager of Netcare Greenacres Hospital, commended Professor Dube for his generosity in embracing the opportunity to share his insights as part of the ESVS Guidelines Committee while remaining committed to his patients here in South Africa.

“With specialists of Professor Dube’s internationally sought-after calibre, Netcare Greenacres Hospital is honoured to provide world-class care for our patients right here in Gqeberha. We congratulate Professor Dube on this opportunity to showcase his knowledge and contribute to better outcomes for thousands of people worldwide,” Van Rensburg concludes.

Rare Disease Day on 28 February spotlights the lives of over 4.2 million South Africans with rare and difficult to treat diseases

Fri, 28 Feb 2025 08:06:55 GMT

The lives of millions of South Africans with a litany of rare diseases can be vastly improved, and even saved, by addressing challenges in identifying, studying and treating their conditions.

With Rare Disease Day on the 28th of February 2025, the Rare Diseases Access Initiative (RDAI) is driving an evolution of the country’s healthcare, through innovative strategies to better care for over 4.2million people living with an estimated 7000 rare diseases.

“As our healthcare system faces significant changes in the years ahead, it is vital that we also advocate for people living with rare diseases in South Africa, especially those with limited healthcare access,” said Kelly du Plessis, CEO of Rare Diseases South Africa (RDSA), a member of RDAI. “As part of our ongoing research and awareness efforts, RDAI has conducted an initial analysis of the incidence and prevalence of rare diseases within the country.”

This research will assist in improving access to healthcare, policy development, and patient advocacy, while giving critical insight into the challenges faced by patients.

“According to research, some rare diseases affect fewer than 1 in a million people, while others, such as Down syndrome, cystic fibrosis, and haemophilia, have a more recognisable prevalence,” says Dr. Helen Malherbe, RDAI lead researcher on rare disease prevalence data. “Many conditions are undetected, underdiagnosed or misdiagnosed, with too many having no information available about them at all.”

The RDAI was formed in 2019 to promote a more favourable environment for those impacted by rare diseases in South Africa. Participants include Ampath, the Board of Healthcare Funders (BHF), Discovery Health, Genetic Counsellors South Africa (SASHG), the Government Employees Medical Scheme (GEMS), Health Funders Association (HFA), Medihelp, Medscheme, North-West University (NWU), Rare Diseases South Africa (RDSA), the South African Medical Association (SAMA) and The South African Medical Technology Industry Association (SAMED). The Council for Medical Schemes (CMS) participates as an observer.

In the same year, Rare Disease International signed a memorandum of understanding with the World Health Organisation leading to an international rare disease policy framework. In 2021, the United Nations General Assembly moved to adopt a resolution recognising 300 million people living with rare diseases worldwide.

“A general lack of awareness and delayed diagnosis remain major hurdles for those affected by rare diseases. Policymakers and healthcare stakeholders need to prioritise access to treatment, diagnosis, and support for rare disease patients,” says Bada Pharasi, CEO of IPASA, “Through this initiative, working collaboratively with stakeholders at every level of the healthcare supply chain, we can bring real and meaningful change to those affected, including family members and care givers, through smart and efficient strategies.”

The globally agreed definition of a rare disease is any medical condition with a specific pattern of clinical signs, symptoms, and findings that affects fewer than or equal to 1 in 2000 persons in a population.

“Most are genetic, and some are inherited and passed down in families,” Malherbe says. “Some affect only the patient’s genetic recipe, while others may be acquired during life due to infection, trauma, or environmental effects. For many, the cause is still unknown.

“These conditions mainly affect children, as they are largely incurable and many are life-threatening. Some require specialised and co-ordinated care, some have limited and expensive treatment options, while others have no information or effective treatments at all,” she adds.

The RDAI is calling for a patient-centred care model built on equitable access, transparency and efficiency. Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government.

“The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.”

The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring.

Thoneshan Naidoo, Chief Executive Officer of the Health Funders Association noted that, “We appreciate the unique opportunity provided by RDAI which enables stakeholders across the industry to work together and identify strategies that improve equitable access to the appropriate diagnosis, treatment and healthcare services for rare disease patients, in an affordable and sustainable manner, taking account of the other pressing needs across the healthcare system.”

“True innovation in healthcare is only possible through partnerships and joint advocacy efforts that raise awareness and improve access to treatment. Our long-term goal is the development of a rare diseases policy framework and guidelines for coordinated care,” says Pharasi. “Our members are united in the commitment to unlocking improved patient outcomes and improving access to services and robust health needs assessment facilities.” he concludes.

About RDAI

The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change.

About RDSA

Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life.

Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa.

About IPASA

The Innovative Pharmaceutical Association South Africa (IPASA) is a voluntary trade association representing 24 leading pharmaceutical companies committed to research, development, and innovation. Our mission is to drive healthcare advancement by advocating for policies that improve patient access to safe, high-quality, and affordable medicines.

Understanding the toll acid reflux can take on your health

Wed, 26 Feb 2025 06:08:02 GMT

How lifestyle choices can help manage GORD

What happens when the hydrochloric acid produced in the stomach escapes upwards into a person’s oesophagus? A bitter taste in the mouth, heartburn, sore throat, hoarse voice or unexplained chronic cough can be tell-tale signs of the acidic burn of reflux or the longer-term condition gastroesophageal reflux disease (GORD).

“The troublesome symptoms people with GORD experience can have significant social, workplace, and economic impacts, especially when the condition is persistent and chronic. It’s also one of the most common conditions primary healthcare physicians and gastroenterologists are consulted for,” says Dr Barbara Makumbi, a gastroenterologist practising at Netcare Sunward Park Hospital.

“Typically, when we eat, food passes down the oesophagus and enters the stomach through the lower sphincter, which functions as a one-way valve to seal the stomach and prevent digestive contents from flowing back into the oesophagus. However, in some cases – especially after eating certain foods, or when lying down soon after a meal – the pressure in the stomach can increase, causing the acidic liquid to escape from the stomach upwards, irritating the more sensitive lining of the oesophagus and leading to discomfort,” she explains.

Gastroenterologist, Dr Barbara Makumbi

Dr Makumbi points out that the symptoms of reflux can be sporadic and mild for some people, but may develop into a progressively worse chronic condition, known as GORD, if not addressed. “Over time, this unconscious regurgitation causes inflammation that can make eating or its after-effects quite painful, disrupt the person’s sleep, and potentially lead to other troubling complications,” she cautions.

Recognising GORD

Dr Makumbi says there are various possible symptoms associated with reflux and gastroesophageal reflux disease (GORD).

Typical symptoms

Heartburn is a burning sensation usually felt in the centre of the chest that often occurs after meals and worsens when lying down.
Regurgitation – When the digestive fluid comes up the oesophagus, this can result in a bitter taste in the mouth.
Belching (burping)
Nausea or vomiting
Experiencing a sensation of fullness sooner when eating.

Dr Makumbi says that in more severe cases, complications involving damage to the oesophagus and nearby anatomy can result in atypical symptoms, including the following:

Inflammation of the lining of the oesophagus leading to difficulty swallowing or painful swallowing and bleeding.
Laryngitis or pharyngitis : Throat inflammation resulting in a sore throat or hoarse voice.
Small amounts of the acidic gastric fluid can enter the airways of the lung, resulting in chronic cough, new or worsening asthma and scarring of the lung tissue called fibrosis.
Dental complications can occur when the teeth are exposed to regurgitated stomach acid, including erosion of tooth enamel, tooth decay and bad breath.

Dr Makumbi encourages anyone experiencing persistent symptoms of reflux or GORD to consult a healthcare practitioner for a diagnosis and appropriate treatment.

GORD risk factors may include:

Structural changes to the sphincter muscle, such as a hiatus hernia, where the stomach bulges into the chest above the diaphragm
Abdominal fat, weight gain, or being overweight or obese
Pregnancy
Diet and habits that can weaken the oesophageal sphincter, including fatty foods, caffeine, smoking, alcohol, and carbonated drinks
Certain medications’ side effects
Having large meals or eating too close to bedtime

“If GORD is not identified and managed, either through lifestyle modification alone or in combination with medication, the person may be at risk of developing oesophageal strictures. This is where, over time, the lining of the oesophagus is repeatedly irritated and inflamed and develops scar tissue, which can narrow the passage that conveys food from our mouths to our stomachs, making it difficult to swallow.

“Another important reason to get reflux addressed is Barrett’s Oesophagus, which is a precancerous lesion of the lower part of the oesophagus that is associated with repeated acid exposure. As the disease progresses, Barrett’s can develop into oesophageal cancer.

“Be sure to inform your doctor if you have a family history of oesophageal or stomach cancer, as this can also suggest a need for heightened vigilance,” she advises.

Some patients may require further investigation with a gastroscopy, where a gastroenterologist or surgeon uses a long thin tube with a camera to check the mouth, oesophagus, stomach and duodenum. Other times, a barium swallow in a radiology department may be requested, where the patient drinks a contrast fluid to reveal the swallowing mechanism and the anatomy of the oesophagus and stomach.

“In severe cases, reflux monitoring and pH studies can be done, whereby a catheter is inserted via the nostrils into the oesophagus to monitor the amount of reflux and the acidity of the digestive contents to confirm and classify diagnosis of GORD,” Dr Makumbi explains.

“Lifestyle modification is important for management of GORD, and a few simple steps can often help bring significant relief for mild to moderate cases,” she says.

Tips for coping with GORD

Elevate your head and upper body with a few extra pillows when you sleep. This allows gravity to assist in reducing reflux.
Shedding excess kilos can help reduce upward abdominal and gastric pressure that contributes to reflux.
Try sleeping on your left side.
Eat dinner three hours before bedtime.
Avoid lying down after meals.
Avoid alcohol and smoking.
Reduce the size of meals.
Consult a dietician and avoid fat, citrus, spicy food, tomato-based products, chocolate, peppermint, and caffeinated or fizzy drinks.
Keep a food diary to help identify your individual triggers.

“Most cases of GORD can be effectively managed with these principles, and over-the-counter short-term relief or prescription medications as needed. Surgical options may be considered for certain patients whose conditions are severe. However, these procedures are not undertaken lightly. Nowadays, such procedures are usually performed laparoscopically, or with a ‘pinhole’ surgery approach,” Dr Makumbi concludes.

Time-critical specialist emergency medicine and trauma expertise saves lives

Wed, 19 Feb 2025 10:27:14 GMT

Pictured (left to right) Netcare St Anne’s Hospital general manager Sharon Singh, emergency medicine specialist Dr Steve Feris, Director of the Trauma Programme at the hospital Professor Damian Clarke, emergency department unit manager Sr Nobuhle Mhlongo and nursing services manager Sr Precious Shelembe.

ED and Level 1 trauma centre always ready for any urgent care

From treating trauma injuries caused by wildlife, road accidents and sports, to heart attacks, stroke, or the sudden onset of other concerning medical symptoms – the emergency department at Netcare St Anne’s Hospital never sleeps.

The recent introduction of emergency medicine specialist services – alongside the well-established and accredited Level 1 trauma service further strengthens the emergency department at Netcare St Anne’s Hospital.

“This has been tremendously beneficial, as both trauma specialist and emergency medicine specialist services are needed to deal with emergencies whenever they happen,” explains Professor Damian Clarke, Director of the Trauma Programme at Netcare St Anne’s Hospital and academic head of the trauma system in Pietermaritzburg and Western KwaZulu-Natal.

“When patients access treatment earlier, there is more we can do in trauma care and medical emergencies. Having dedicated specialists available to see acutely unwell patients, 24 hours a day, makes a great difference, as they can recognise and take the initial time-critical treatment steps that can save your life.”

“If someone suddenly starts experiencing chest pains, or a child develops a dangerously high fever in the middle of the night, it’s not an option to wait for an appointment – specialist emergency assessment, treatment, and sometimes intensive care are needed immediately,” says Dr Steve Feris, an emergency medicine specialist with over a decade of clinical experience, and special interest in toxicology and stroke.

When entering an emergency department, patients are first triaged according to the urgency of their condition, and those who have the most severe or time-sensitive injuries or medical symptoms are attended to first.

“When it comes to urgent medical conditions, including heart failure, severe pneumonia symptoms and acute stroke, the emergency department provides care to ICU standards with multidisciplinary specialist care at the front door – there is no need to wait.”

For emergencies large and small, Dr Feris, Maharaj, and Partners, comprising married couple Dr Feris and general practitioner and telehealth expert Dr Jotika Maharaj, as well as emergency medicine specialists Dr Reza Laas and Dr Daniel Fiandeiro, are on hand to shorten the time to treatment at Netcare St Anne’s Hospital emergency department.

“As a family practice, we understand that when your child is sick, or you are unwell or in pain, immediate assurance from a trained medical professional is essential. We have therefore introduced telehealth consultations, making routine care not requiring a visit to the emergency department more accessible by providing primary healthcare guidance remotely,” adds Dr Maharaj, who provides urgent care and care coordination utilising virtual healthcare to streamline treatment.

Since the introduction of emergency medicine specialist services, a greater percentage of people treated for medical conditions in the emergency department were well enough to return home without the need for hospitalisation.

As one of only four private Level 1 trauma centres accredited by the Trauma Society of South Africa (TSSA), Netcare St Anne’s Hospital’s emergency department has seen a growing number of referrals for Priority One patients, that is people with the most critical injuries who require urgent lifesaving intervention, from all over KwaZulu-Natal, often via helicopter transfer, over the past year.

“Being a Level 1 trauma centre means that the facility is equipped to specific standards, with appropriately qualified and trained trauma doctors and nursing staff to treat any injury, including Priority One complex or multiple injuries, at any time of day or night, in line with best practice in trauma medicine,” Prof Clarke explains.

“In trauma medicine, we work according to an evidence-based trauma system that is proven to improve outcomes. The system aims to shorten the time between injury and appropriate specialist intervention to maximise the person’s chance of survival and minimise the harm. The system and the team are crucial to get the most benefit out of what we call the Golden Hour.”

Prof Clarke points out that other disciplines, including neurology and cardiology, are leveraging the approach the trauma system pioneered, the benefits of which are now felt in acute care services. “From the cath lab where amazing minimally invasive life-saving procedures are performed, to the intensive care facilities and every facet of multidisciplinary care – the whole hospital is uplifted,” he says.

“We are grateful for the expertise of our eminent trauma team and the incoming specialist emergency medicine practice, which together ensure that the communities of Msunduzi, the Midlands and further afield in KwaZulu-Natal can rely on the emergency department of Netcare St Anne’s Hospital for any urgent healthcare needs,” hospital general manager Sharon Singh concludes.

Recognising self-harm in teenagers

Mon, 10 Feb 2025 14:35:21 GMT

Parents and caregivers: Talk to help teens heal

As many as one in ten teenagers may self-harm, often in secret, concealing the scars or evidence of their injuries. As Teen Suicide Prevention Week approaches, Netcare Akeso is highlighting the often-hidden struggle of self-harm among young people.

“Self-harm is any non-suicidal behaviour where someone directly and intentionally inflicts harm or injury on their body, often as a way of dealing with emotional distress and pain without the conscious intention of suicide,” says Megan Gonsalves, Netcare Akeso’s Crisis Line manager.

Self-harm can take many forms, including cutting, scratching, picking at scabs so they don’t heal, intentionally causing bruising, burning oneself with cigarettes, matches, candles, or lighters, poking objects through the body, self-medicating, using poison or harmful chemicals, and pulling out hair.

“If left unaddressed, self-harm can increase the risk of suicidal thoughts and behaviours, so parents and caregivers should be aware of the subtle signs that could suggest self-harming, particularly among teenagers who are in this high-risk age group,” she says.

It can be difficult to identify if your child is self-harming, as the behaviour is often hidden, although there may be some warning signs.

Is your teenager:

Avoiding activities where their legs, arms, or torso can be seen
Wearing clothes that cover their legs and arms, even in hot weather
Flinching or showing pain when their arms, legs, or torso are touched
Hiding objects like razor blades or lighters, or
Unable to properly explain cuts, burns or injuries.

“Other signs of mental health distress that should also be of concern include changes in the young person’s eating or sleeping patterns, loss of interest in things that were once enjoyable, increased risk-taking behaviours, drug or alcohol use, isolation, aggressive behaviour, mood changes, and feelings of guilt or worthlessness,” Gonsalves says.

Megan Gonsalves, Netcare Akeso’s Crisis Line manager.

Three myths about self-harm

Self-harm is attention-seeking behaviour: NOT TRUE. Teens who are self-harming often do not tell or show others about their behaviours. While some may do this as a way to communicate their distress, there are many possible reasons for self-harm. Ultimately, it is a sign that there is incredible emotional distress.
Only girls self-harm: NOT TRUE. While girls are almost three times more likely to self-harm than boys, anyone can engage in self-harming behaviour.
People keep self-harming because they enjoy it: NOT TRUE. Self-harming is often physically very painful for the individual, and, in many cases, the person craves the sense of temporary relief or distraction this provides from emotional pain. There is no evidence that people who self-harm experience pain differently from others.

Making sense of self-harm

It can be hard to understand why a young person would harm themselves intentionally. Self-harm serves many different functions for the people who feel the need to engage in these behaviours, and the reasons for self-harm differ.

“Self-harm can serve as an attempt to regulate difficult emotions, especially when a person does not feel able to express this verbally, or to handle situations beyond their control and cope with trauma, abuse or memories of trauma. For some, it can be an outlet for stress and tension, provide a sense of safety and protection, or even serve as a form of self-punishment,” Gonsalves says.

“Cutting and other forms of hurting oneself intentionally can offer a distraction from emotional pain through physical pain. Whatever the underlying cause of distress, not talking about it increases the pressure until it becomes unbearable for the young person. When overwhelmed by emotions, a young person might direct these feelings inward, using their own body to express what they cannot put into words. In moments of panic, this act might seem like the only option, offering a fleeting sense of relief.

“As long as the underlying reasons for the distress remain, along with the burden of their self-harming secret that often leads to feelings of guilt or shame, this exacerbates emotional suffering, leading to further self-harm. And this is how the cycle continues, eventually becoming a habitual outlet when the person feels overwhelmed,” she explains.

She points out that studies indicate that some 50% of teens who self-harm do so repeatedly, increasing their risk of greater physical harm over time. “Usually, self-harming wounds are initially not severe enough to require stitches or medical attention. Therefore, the impulse continues unnoticed and unchecked. Sometimes self-harming behaviours can escalate, with wounds eventually requiring clinical intervention – frequently, this is what makes others aware of it for the first time.”

Talking about self-harm is one of the surest methods of prevention, and teaching healthy coping skills for managing difficult emotions can go a long way to protecting your child, she advises.

“If your child is self-harming, professional mental health support can help with addressing the underlying issues or emotions that may be contributing to the behaviour,” Gonsalves says.

“During adolescence, the brain is still developing, and the rational part—the prefrontal cortex—is not fully mature until around age 25. This means teens don’t process situations as adults do and often react based on feelings rather than careful thought, experiencing emotions more intensely and sometimes making impulsive choices.

“Understanding this can help parents approach conversations with more patience and empathy, fostering better communication during these critical years of development. By creating a supportive environment, encouraging open conversations, and modelling healthy decision-making, parents can help their teens develop the skills needed to cope with the full spectrum of emotions in their transition to adulthood.”

If you or someone you care about is dealing with self-harm or any other mental health issue, Netcare Akeso is ready to support you. Contact the 24-hour Crisis Line on 0861 435 787 for confidential counselling and advice on available assistance options.

Living life with no regrets – why you want to test for cancer

Tue, 04 Feb 2025 08:30:10 GMT

The untold story of nuanced optimism in cancer care

We all want to live a life without regrets, and one of the main regrets people express when they are diagnosed with cancer is that they did not test for the condition earlier.

With one in four South Africans affected by cancer, either directly or through a loved one’s diagnosis, the importance of regular screenings cannot be overstated. These screenings should hold at least as much priority in our lives as the routine renewal of our car licences. Yet, all too often, life gets busy, and we put off what needs to be done, postponing these critical appointments. We tell ourselves that we couldn’t possibly deal with a cancer diagnosis on top of the pressures and obligations we already face, inadvertently compromising our health.

Prioritising our health means confronting our fears with proactive action, ensuring that we do everything possible to identify potential issues before they escalate. By screening regularly, we are not just taking care of ourselves but are also providing peace of mind to those who care about us.

Here’s a home truth from someone who has worked in cancer care and on the frontlines of medicine for close to three decades: Trust me, you do want to find out if you have cancer as soon as possible. Cancer is largely invisible, and the easiest way to set your mind at ease and live without regrets is to make a point of discussing your family history of cancer and personal risk factors with your doctor, and finding out which tests are covered in your medical scheme benefits and how often.

With the range of treatment options that exist today, there should be a more nuanced optimism in society’s understanding of cancer. We hardly ever hear about the many stories of recovery, where people are diagnosed early, receive treatment and go into remission to live for many more fulfilling years.

Dr Prinitha Pillay is a radiation and clinical oncologist practising at Netcare Alberton Hospital. Photo credit Elzaan Pienaar.

About the author Dr Prinitha Pillay

BSc Hons (Wits), MBBCh (Wits), MSc (LSHTM), MMed (Wits), FC Rad Onc (SA)

Dr Prinitha Pillay is a radiation and clinical oncologist practising at Netcare Alberton Hospital. Before specialising in Oncology and undertaking a fellowship in Radiation Oncology, she spent a decade in Doctors Without Borders and served as its president for South Africa. Dr Pillay served as a technical specialist on HIV and TB with the University of Witwatersrand and holds a Master’s degree in Infectious Diseases and Global Policy from the London School of Hygiene and Tropical Medicine.

They don’t make movies about the stories of survival we see and the quiet strength of those whose cancer can be medically managed over years and decades – often while the person continues working and participating in family life.

Wherever possible, it’s imperative to take steps to detect cancer before it reaches a stage where it starts impacting your quality of life – please get yourself checked from top-to-toe regularly. Book your Pap smear, or preferably talk to your doctor about HPV-subtype testing that indicates a risk of cervical cancer, your prostate exam and blood tests, mammogram, ENT appointments and dermatologist checks.

I would especially like to urge people living with pre-existing conditions like HIV or diabetes and their healthcare practitioners to remain vigilant of the ever-present risk of cancer.

If your screening reveals something of concern, remember you are not alone, and there is a vast network of support. A basic truth about cancer is that usually, when we can pick it up earlier, the outcomes and options tend to be better. It’s crucial to shift our perspective and recognise that early detection can be a lifeline that can make all the difference, offering a wider array of treatment possibilities and a better chance at remission. Whatever the stage or type of cancer a person has, there is always something we can do to help.

No one walks this road alone. The journey through cancer is as much about the support that surrounds the patient as it is about the medical treatments they undergo. Friends and family become pillars of strength, offering emotional support and practical assistance, whether accompanying someone to appointments or simply providing a listening ear.

As healthcare professionals, we understand that our role extends far beyond providing medical expertise. We are here to offer compassion and understanding, striving to be a beacon of hope for those navigating the challenging journey of cancer. We recognise the power of human connection and make it our mission to ensure that no one feels alone during this time.

Support groups and communities are more than just gatherings; they are lifelines where shared experiences create bonds that foster belonging and resilience. Every person involved, from family members to fellow patients, contributes to a collective strength that helps lighten the burden. In moments of adversity, it's the empathy and solidarity of those around us that remind us of our shared humanity.

We walk this path together, reinforcing the idea that even in the toughest times, we are never truly alone.

Melanoma: Even occasional sunburn can be harmful

Mon, 27 Jan 2025 11:18:50 GMT

Oncologists urge skin cancer screening and prevention

This SunSmart Skin Cancer Awareness Month, two clinical oncologists practising at Netcare Alberton Hospital highlight the importance of sun protection and regular screening in South Africa’s sunny climate, focusing on melanoma awareness.

Skin cancer is the most common type of cancer in South Africa. The main types of skin cancer are squamous cell carcinoma, basal cell carcinoma and melanoma.

“It’s been estimated that South Africa receives 2 500 hours of sunshine on average a year, and being an outdoors-loving nation this unfortunately comes with heightened risk of skin cancer,” says Dr Sylvia Rodrigues.

“Although not all skin cancers are attributable to sun exposure, even occasional sunburn can increase a person’s risk for developing these types of cancer.”

The skin is the body's largest organ. It protects against heat, sunlight, injury and infection. The skin has several layers, but the two main layers are the epidermis (the top or outer layer) and the dermis (the lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells: squamous cells, basal cells and melanocytes.

Clinical oncologist Dr Karen Motilall with Netcare Alberton Hospital radiation therapy unit manager Busi Mzelem.

“Cancers that originate in the cells of the skin are known as skin cancers, although some types can spread to other parts of the body and have potentially severe effects if they remain undiagnosed and untreated,” says Dr Karen Motilall.

“Melanoma, which originates in the melanocytes or pigment-producing skin cells, is often regarded as the most dreaded form of skin cancer because of how quickly it can spread, or metastasise. Although exposure to the sun’s ultraviolet rays has a role in skin cancer, melanoma in particular is associated with a strong genetic or family risk – although this may not always be present,” she explains.

Melanoma often looks like a mole or a new growth on the skin with an uneven form. It might be dark or light, presenting in various colours from skin tone, pink, red, black, purple, blue, or white. The mole or lesion may also be multicoloured and could have an asymmetrical shape. Other signs to watch for include a mole that scales, oozes, bleeds, itches or other changes in sensation or appearance.

Dr Rodrigues points out that while people with fairer skin are generally more prone to melanoma, those with darker skin are at higher risk of acral lentiginous melanoma (ALM), an especially aggressive form of melanoma that usually appears as a mark on the palms of the hands or soles of the feet, or under a nail.

“The key is not to wait if you notice a new mark on your skin or a change in one of your moles – rather book an appointment with your GP or dermatologist as soon as possible before it can spread. Better yet, make regular mole mapping part of your annual health routine for peace of mind,” Dr Rodrigues advises.

“Although there is more we can do to treat and manage various kinds of skin cancer, prevention must always be the main priority. Protect yourself and your children from sun exposure, and discuss your individual risk for skin cancer, which may include family history and conditions such as albinism, with your healthcare practitioner, who can advise and monitor you more closely if needed.”

The integrated cancer care centre within Netcare Alberton Hospital offers a comprehensive diagnosis and treatment service, including surgery, chemotherapy and radiation therapy. An experienced multidisciplinary team provides professional, holistic care for each person’s individual needs.

“Depending on the type and stage of skin cancer diagnosed, we may recommend surgery, chemotherapy or radiotherapy, or a combination of these options to remove and reduce the cancerous cells both at the primary site and elsewhere if it has started to affect lymph nodes or other organs,” Dr Karen Motilall says.

“Given melanoma’s tendency to metastasise, radiation therapy is showing more promise for treating the spread of skin cancer cells within the body, described as stage four cancer. Using the Varian TrueBeam™ 4.0 linear accelerator, we are able to target the metastases with great accuracy, wherever they may be in the body, sparing nearby nerves, healthy tissue and critical structures from the effects of radiation,” she says.

“As oncologists, we really would like to encourage everyone to take steps to prevent skin cancer as far as possible, and protect themselves and their families against the harmful effects of sun exposure. As one of the most common types of cancer in our country, we need the power of public awareness to help improve outcomes and survival rates.”

How much vitamin D do you need? It’s complicated…

Fri, 17 Jan 2025 08:30:43 GMT

The sunshine vitamin’s surprising role in overall health

Vitamin D, commonly known as the sunshine vitamin because sunlight helps our bodies to produce it, is essential for maintaining strong bones and a healthy immune system. However, too much can have adverse effects on your health.

“Vitamin D involves a complex interplay between environmental and individual factors. Either deficiency or overdose of vitamin D can affect overall health, yet understanding individual vitamin D requirements can be complicated,” explains Dr Jay (Jayalakshmi) Narainsamy, a specialist physician and endocrinologist practising at Netcare Park Lane Hospital.

“Individual factors such as having darker skin, cultural aspects, pre-existing illnesses, higher Body Mass Index [BMI] and our modern lives’ tendency toward more indoor activities, may also contribute to vitamin D deficiency even where there is bountiful availability in sunny climates, such as ours.”

Dr Jay Narainsamy

“Most studies on vitamin D deficiency have been conducted in other countries, where the climate, demographic and socioeconomic factors differ from our local context. Data on South African populations is scarce and a lot more complicated to interpret given the different sun exposures across provinces, different ethnic groups and general lack of recent information,” she explains.

A meta-analysis looking at data from studies between 1978 and 2015 reported that vitamin D was sufficient in most healthy South Africans. However, among those lacking vitamin D, black South Africans were most affected at 62,9%, while 35,7% of coloured South Africans, 14,7% of Indian South Africans and 8,9% of white South Africans experienced deficiency of this key nutrient.

Why do our bodies need vitamin D?

“Vitamin D is responsible for regulating the calcium levels in our cells, therefore a deficiency of vitamin D also leads to low levels of calcium and phosphate, and an increased parathyroid hormone in response. This is detrimental to bone health and causes bone loss that may increase the risk of fractures,” Dr Narainsamy warns.

Apart from the risks to skeletal health, the effects of vitamin D deficiency are being studied in more detail for wider ranging consequences. “One meta-analysis suggested that vitamin D supplementation reduced cancer mortality. While cardiovascular risk reduction has not been conclusively proven, there have been studies which showed benefit in reducing blood pressure, reduction of irregular heart rhythm risk in older patients and lower incidence of heart attacks,” Dr Narainsamy notes.

“Vitamin D is known to influence the immune system, especially the innate immunity which is the body’s first response to fighting off harmful pathogens, and may therefore assist in protecting against respiratory illness. Conversely, vitamin D deficiency might be related to an increase in autoimmune diseases.

“People with diabetes and prediabetes can also benefit from identifying vitamin D deficiency, as it has a role in insulin regulation too,” she says.

Such is the importance of vitamin D to overall health that some international societies have suggested screening for deficiency in susceptible groups, including people who are malnourished, have a sedentary lifestyle, limited sun exposure, obesity, dark skin, are over the age of 65, as well as individuals with conditions causing gastrointestinal malabsorption, liver disease or failure, renal insufficiency, fibrosis and those taking medications that alter vitamin D metabolism.

Potential symptoms

“Most people with vitamin D deficiency do not experience symptoms and are probably unaware of the issue. Those who have a severe and prolonged deficiency may present with bone discomfort or pain in the lower back, pelvis, or lower extremities, and could experience falls and impaired physical function, muscle aches, proximal muscle weakness and symmetric lower back pain, that is, pain on both sides,” Dr Narainsamy says.

“If a person suspects they are vitamin D deficient, I recommend discussing testing with a healthcare practitioner such as your general practitioner, an endocrinologist or nephrologist. A medical referral is required for the test, as the result needs to be interpreted with the patient’s history and managed holistically. A thorough evaluation should be done before medication or supplementation is prescribed.”

In addition, some people may also need more detailed evaluation including calcium, magnesium, phosphate, 1.25 hydroxy vitamin D and parathyroid levels tests.

“Dietary sources of vitamin D include sardines, cod liver oil, salmon, tuna, egg yolks, beef liver and fortified cereals or plant-based dairy alternatives, although diet alone may not be sufficient and lifestyle changes may be advised along with either short- or long-term supplements prescribed.”

Dr Narainsamy points out that vitamin D is a fat-soluble vitamin that can be stored and may build up in the body. If vitamin D levels become too high, this can cause hypercalcaemia, a condition in which blood calcium levels become too high. This may present as nausea, dehydration, constipation, or symptoms of hypercalciuria, such as needing to urinate more frequently or in greater volumes, and kidney stones.

“It is therefore important to have levels checked regularly, especially if you are taking supplements, as vitamin D overdose can be harmful,” she concludes.

Health and safety tips for a stress free holiday season

Sun, 22 Dec 2024 07:11:24 GMT

A safe holiday starts with awareness, says emergency doctor

As the holiday season kicks off, it’s all too easy to get caught up in the festive spirit and overlook potential medical emergencies. Dr Neville Vlok, a specialist emergency medicine physician practising in the emergency department at Netcare Unitas Hospital, highlights four health issues that could disrupt even the most carefully planned holiday celebrations.

1. Allergic reactions and insect stings

Outdoor activities such as picnics and hikes can increase exposure to allergens and insect stings. While most bites and stings cause only minor irritation, Dr Vlok warns that severe allergic reactions, known as anaphylaxis, can be life-threatening.

“Over-the-counter antihistamines can help with mild reactions, but immediate medical attention is needed for symptoms like swelling of the lips and tongue, a skin rash or difficulty breathing,” he advises.

Bee sting first aid: Use a card or fingernail to gently scrape out the sting, avoiding squeezing it. If you're allergic, carry an adrenaline injection and always wear a medical bracelet. Allergies can develop at any time, so remain vigilant for symptoms like difficulty breathing, abdominal pain, or severe headaches.

Dr Neville Vlok, a specialist emergency medicine physician

2. Prioritise water safety

With families flocking to beaches and spending time around swimming pools, drowning is a significant concern at this time of year. Dr Vlok emphasises vigilance around water and recommends learning cardiopulmonary resuscitation (CPR) to be prepared in case of emergencies. "Saving local emergency numbers on your phone can be a lifesaver," he suggests.

Water safety tips: Never swim alone or at night. Avoid swimming under the influence of alcohol, and always supervise children around water. Ensure pools are secured with a net or fence, and only swim in designated beach areas with lifeguards. Always check water depth before diving.

Even if you have never done CPR before, Netcare 911’s national emergency operations centre [EOC] is putting life-saving skills into the hands of the public with an innovative telehealth video call technology application. When a caller reports an emergency requiring CPR to Netcare 911’s EOC on 082 911, the coordinator immediately initiates the video calling process by sending the caller a link via SMS to a live, secure video platform. The caller clicks on the link to connect with the Netcare 911 emergency care providers, enabling them to see and hear each other to better guide the caller in performing CPR until help arrives.

3. Guard against heat exhaustion and dehydration

High temperatures can lead to heat exhaustion and dehydration, especially when spending long hours outdoors. Symptoms like dizziness and fatigue should not be ignored. “Stay hydrated, wear light clothing, and use sunscreen to prevent sunburn. Avoid excessive alcohol, as it can worsen dehydration,” advises Dr Vlok.

Beat the heat: Avoid strenuous activities in hot conditions and seek shade during peak sun hours. Drink fluids regularly but avoid over-hydration. Wear sunglasses and a wide brimmed hat, and protect your skin with a broad-spectrum sunscreen, which protects against both UVA and UVB rays. Use sunscreen with at least SPF 15; a higher SPF, like 30 or 50, is recommended for extended outdoor activity.

4. Prevent food poisoning

Holiday feasts are a highlight of the season, but improper food handling can lead to food poisoning. Dr Vlok stresses the importance of food hygiene. “Keep perishables refrigerated and cook meat thoroughly. Keep hydrated if you experience symptoms like nausea or diarrhoea.”

Food safety guidelines: Be cautious with high-risk foods like shellfish and undercooked meats. Only eat fruits you can peel yourself, and ensure dishes are served hot. Pay extra attention to food handling while travelling.

Be prepared for emergencies

Dr Vlok emphasises the importance of being ready to handle minor injuries or medical issues before professional help arrives. A well-stocked first-aid kit should include bandages, antiseptic wipes, pain relievers and a thermometer. Familiarise yourself with nearby medical facilities and have a family emergency alert system in place.

Dr Vlok recommends including these essential items in your first-aid kit for home and travel.

Emergency thermal blanket: Essential for preventing hypothermia in case of exposure or shock after an accident.
Bandages and sterile dressings: For covering wounds and controlling bleeding.
Antiseptic wipes or solutions: To clean cuts and reduce the risk of infection.
Adhesive tape and scissors: For securing dressings and handling minor repairs.
Pain relievers: Over-the-counter medications like ibuprofen or paracetamol.
Burn gel and ice packs: For treating burns, sprains, or swelling.
Tweezers and gloves: For hygienic removal of splinters or debris.
Oral rehydration salts: To combat dehydration from heat or illness.
Thermometer: To monitor fevers and temperature during illness.

“Emergencies are unpredictable, but preparation can save lives. Stay calm, assess the situation, and act swiftly. The emergency department at Netcare Unitas Hospital wishes everyone a safe and enjoyable holiday season, and we will be open throughout for our community’s peace of mind,” Dr Vlok concludes.

Technologically advanced radiotherapy creates hope for cancer patients

Wed, 11 Dec 2024 07:13:09 GMT

Accurately targeting tumours and metastases

The prospects for treating a wide range of cancers have been greatly improved for communities of Johannesburg’s southern suburbs and further afield since the introduction of a sophisticated radiation therapy imaging and delivery system at Netcare Alberton Hospital’s radiation unit.

Clinical oncologists Dr Sylvia Rodrigues and Dr Karen Motilall have been prescribing radiation treatments for their cancer patients requiring this treatment modality, with the Varian TrueBeam™ 4.0 linear accelerator (linac), for the past year and have seen the equipment’s versatility and advantages for patients.

“We are seeing renewed hope with advanced technology like this, which has broad applications for treating tumours all over the body, even in especially hard-to-reach areas or close to other vital structures,” says Dr Rodrigues.

“Among the various types of treatment, the system is equipped to deliver, highly precise doses in stereotactic body radiation therapy [SBRT] offering a non-invasive treatment option, which is especially beneficial for people who are unable to have surgery for their tumours.

“We treat breast cancer, colorectal and gynaecological cancers, head and neck tumours among others. For people with metastatic disease, which is the spread of cancer cells from the place where they first formed to other parts of the body, we can target the metastases with great accuracy, wherever they may be in the body, sparing nearby nerves, healthy tissue and critical structures from radiation.”

“The system has excellent imaging capacity, allowing us to visualise the tumour and its surroundings while treatment occurs and ensuring that the tiniest movement is adjusted for, including the person’s breathing during treatment,” she says.

Demare Wahl, Netcare Cancer Care’s regional medical physics manager for Gauteng adds: “The respiratory gating technology, which is an added technology available on the TrueBeam, allows radiation delivery to synchronise with the patient's breathing cycle, ensuring precise targeting of tumours, even as they move with breathing.

“This is especially important when treating breast cancer, as the breast is very susceptible to movement due to its location close to the lungs. In using the gating technology, we can significantly reduce the radiation dose to the heart and thus improve patient outcomes,” she says.

The Varian TrueBeam system is designed to deliver very precise radiation therapy for cancer treatment. It can adjust the radiation dose to be high and accurately shaped to match the tumour’s exact size and shape. This precision is achieved using features such as Multi-Leaf Collimators (MLCs), which are like a set of movable "fingers" that shape the radiation beam to fit the tumour’s outline, avoiding as much of the healthy surrounding tissue as possible.

The treatment table can tilt and move in various directions, allowing for precise patient positioning, and ensuring the radiation is aimed exactly where it needs to be. Together, these features make it possible to target tumours with sub-millimetre accuracy, improving effectiveness while minimizing damage to nearby healthy tissue.

“Since the new system was installed at Netcare Alberton Hospital’s radiation unit, it has extended the potential for performing complex radiation treatments, improving quality of life, and prolonging life, if not curing cancer, either alone or in combination with chemotherapy or surgery,” Dr Rodrigues says.

“The detailed perspective that the new radiation therapy system provides in visualising tumours enables targeted external radiotherapy treatment for a wide spectrum of cancers, including gynaecological, liver, lung, bone and pancreatic cancers, among others,” adds Dr Motilall.

“At least half of my patients require treatment for cervical cancer, and when prescribing external beam radiation in the pelvic area for this, colon and other cancers, there are many other nerves and organs within narrow confines of the pelvis and the real-time imaging and precision of the new system provides confidence that the radiation dose is focused exactly where it is needed while avoiding healthy tissue,” she says.

Wahl adds that the system has onboard imaging technologies which can create high-quality, real-time images that show the tumour and nearby body structures in 3D, with the added ability to track motion over time, like during breathing. It also uses low-energy X-rays to quickly take images of the patient, making it easy to double-check and adjust their position before treatment. “This enables radiation therapists and oncologists to visualize the target area with unparalleled clarity, allowing them to precisely localise the tumour and tailor treatment plans to suit each patient’s needs,” she says.

“There is more we can do to treat cancer than ever before, so there is more cause for hope than ever.” Radiation therapy unit manager, Busi Mzelem, says that more than 300 people have been treated with the Varian TrueBeam™ since it was installed at the radiation unit at Netcare Alberton Hospital in February 2024.

“Patients find the quicker treatment times more comfortable and more convenient to fit into their daily activities,” she says.

“Our radiation unit is just one component of the person-centred comprehensive cancer treatment services within the integrated Netcare Alberton Hospital, and our experienced and dedicated team is committed to providing professional holistic care for each person,” Mzelem concludes.

SA surgeon demonstrates complex live procedures at Global Digestive System Congress

Thu, 05 Dec 2024 07:54:37 GMT

Registered Nurse Sister Sonya van den Berg and Prof Heine van der Walt are pictured in surgery at Netcare Unitas Hospital. A two-way real-time livestream link enabled thousands of international congress delegates to watch the complex procedures live.

Minimally invasive surgeries livestreamed for thousands of delegates

Internationally renowned South African laparoscopic surgeon Professor Heine van der Walt was recently selected to demonstrate his minimally invasive surgical techniques for two highly complex procedures at the Global Digestive System Congress held in Rome, Italy.

“Prof Van der Walt is well known for his generosity in sharing his knowledge with colleagues both at home and abroad, which extends the benefit of his expertise to countless more patients worldwide, in addition to those he treats directly at our hospital,” says Netcare Unitas Hospital manager Pieter Louw.

Now in its 35th year, the Congress is a leading international platform for medical professionals and one of the largest surgical congresses in the world, with some 3 000 in-person attendees at the Auditorium del Massimo in Rome, Italy, and many thousands more delegates participating remotely from all over the world.

On Thursday, 28 November, Prof Van der Walt demonstrated two laparoscopic revisional anti-reflux surgeries via live stream from a specially equipped theatre at Netcare Unitas Hospital as an educational demonstration for the Congress. Of the five continents represented in 150 live educational procedures, Prof Van der Walt was the only representative from Africa.

Laparoscopic surgeon Professor Heine van der Walt who practises at Netcare Unitas Hospital recently demonstrated his minimally invasive surgical techniques for the Global Digestive System Congress held in Rome.

“It is always an honour to be invited to participate in these conferences that bring together the medical community to exchange knowledge and develop skills relevant to related disciplines. These live transmission cases allow us to demonstrate both novel and standard techniques and keep abreast of any significant updates,” Prof Van der Walt says.

“The two live procedures are for patients who require revisional anti-reflux interventions to correct previous failed surgeries. These can be extremely complicated cases, and the surgeon must be prepared for a range of possible scenarios.

"Every opportunity to share knowledge and skills that can better equip surgeons for such procedures is therefore invaluable, particularly since the oesophagus is one of the most sensitive organs in the body.”

Prof Van der Walt, who is highly sought after for international conference presentations, points out how technology is making it easier than ever before to contribute to global knowledge building forums such as the Congress.

“I used to have to travel to Europe in person for these educational cases; however, with how far technology has come, I can now perform the surgeries from here, and the transmission clarity is excellent.

“Over the years, we went through so many telecommunications techniques, from a mobile satellite dish on the roof of the hospital to eventually having the breakthrough of 5G to transmit the livestream, which, in fact, worked rather well.

“Now we have got even more advanced: using the hospital’s fibre connection, and with the assistance of a technical link up team, we can establish a clear real-time two-way link with the conference venue, and it has become relatively simple to share the experience of live educational procedures with hundreds of thousands of surgeons all over the world.

“It is very rewarding to be a part of these opportunities for global exchange of knowledge aimed at improving outcomes for patients everywhere,” Prof Van der Walt says.

“We thank Prof Van der Walt for his dedication to cultivating surgical skills in this highly specialised field and for continually remaining at the cutting edge of his discipline internationally,” Louw concluded.

Beyond the mo and the blue ribbon: Unveiling the heart of Movember

Mon, 25 Nov 2024 08:53:53 GMT

What every man needs to know about prostate cancer

The Movember movement is changing the face of men's health worldwide, turning quirky moustaches and iconic blue ribbons into powerful symbols of meaningful action and change.

"At its heart Movember is about encouraging conversations, challenging societal norms, and creating a tangible impact on how men approach their health, particularly concerning prostate cancer," says Dr Philip Pretorius, a specialist urologist at Netcare The Bay Hospital in Richards Bay, KwaZulu-Natal.

"It's not just about raising awareness but about taking decisive action. Therefore, I want to encourage men throughout South Africa to commit to their health this November by scheduling a prostate checkup with their general practitioner. Take this essential step for yourself and inspire others to do the same."

Specialist Urologist, Dr Philip Pretorius

Dr Pretorius highlights the urgency, stating, "Prostate cancer is a major concern among men, second only to lung cancer in terms of mortality rates. Globally, prostate cancer accounts for 6.6% of deaths, while in South Africa it accounts for 13% of deaths in males, with over 4 000 South African men diagnosed with prostate cancer annually*. Increasing awareness that inspires men to action both locally and internationally is, therefore, urgently needed."

Understanding prostate cancer

The prostate gland is a small, walnut-sized organ located just below the bladder and in front of the rectum. It encircles the urethra – the tube responsible for carrying urine and semen out of the body – and plays a vital role in the male reproductive system by producing seminal fluid, which nourishes sperm and assists in their transport.

Prostate cancer occurs when cells in the prostate gland begin to grow uncontrollably, forming a tumour. This abnormal growth can disrupt the normal function of the prostate and, if left unchecked, can spread to other parts of the body. Early detection and treatment are key to managing the disease effectively. Regular screenings and awareness of risk factors, such as age (particularly over 50) and family history, are vital.

Diagnosis and screening – what to expect

“To accurately assess prostate health, your doctor will take a thorough medical history and conduct a physical examination including a digital rectal examination [DRE], which provides valuable insights into the condition of the prostate and can detect any abnormal masses,” says Dr Pretorius.

“In addition to the physical exam, a prostate-specific antigen [PSA] test is performed measuring the level of PSA in the blood. If the result is higher than four, it typically prompts a referral to a urologist for more detailed evaluation and testing. The definitive diagnosis of prostate cancer is made through a prostate biopsy, a relatively quick procedure that takes about 30 minutes and is performed on an outpatient basis,” he explains.

Key insights into prostate cancer every man should be aware of

Given that 1 in 8 men will be diagnosed with prostate cancer in their lifetime, prostate cancer remains a significant health concern. "This underscores the importance of understanding and managing this disease effectively," notes Dr Pretorius.

“Regular screenings, starting at age 45 or earlier for those at higher risk, are crucial, as symptoms often do not appear until advanced stages. Treatment options include surgery, radiation therapy, and active surveillance tailored to the cancer's stage and aggressiveness. Thanks to early detection and new technologies, survival rates have improved significantly, with early-stage prostate cancer having a nearly 100% five-year survival rate,” he adds.

What are the symptoms?

It is important to note that patients with prostate cancer often experience no symptoms. However, if symptoms do occur, they may include:

Blood in urine
Trouble urinating
Sudden or urgent need to urinate
Frequent nighttime urination
Difficulty starting or stopping urine flow
Weak or interrupted urine flow
Pain during urination
Difficulty having an erection or painful ejaculations
Frequent pain or stiffness in the lower back
Unexplained weight loss

The Movember movement

Movember goes beyond statistics to build a supportive community, encouraging open discussions about men's health. By growing moustaches, men worldwide unite to promote early detection and proactive health measures.

"Movember is a catalyst for change. It's about transforming conversations into actions and fostering a global commitment to better health outcomes. Together, we can redefine men's health, one conversation, one checkup, and one moustache at a time," concludes Dr Pretorius.

More cardiac capacity good news for heart health in KZN

Mon, 18 Nov 2024 08:35:50 GMT

St Annes Cardiac Ward Opening: Cardiothoracic surgeon Dr James Chen, medical ward unit manager Zamani Cele, enrolled nurse Gugu Mahlaba, PA Vanessa Davids, Netcare St Anne’s Hospital general manager Sharon Singh and Clinical Application Support Specialist Jamie Lee Hein are pictured at an event to mark the opening of the dedicated medical and cardiac wards. (Photo credit Jason Lisher Photography)

Dedicated state-of-the-art cardiac and medical wards

A dedicated cardiac ward equipped with state of the art technology is contributing to the expansion of private specialised cardiac care services in the KwaZulu-Natal Midlands at Netcare St Anne’s Hospital.

“The surge in cardiovascular conditions affecting our society is well documented. Fortunately, advances in cardiac medicine and heart-related treatment technologies are progressing and providing more cause for optimism,” says resident cardiologist Dr Yuvashnee Govender.

“With our multidisciplinary team approach, we can provide each patient with the collective expertise of leading specialists, and the new dedicated cardiac ward offers a centralised, tranquil healing environment tailored to the specific needs of patients undergoing heart procedures, recovering from cardiac arrest or dealing with a wide range of heart-related conditions requiring acute hospitalisation.”

Cardiac ward Netcare St Annes: (Front row from left to right) Enrolled nurse Cindy Moodley, resident cardiologist Dr Yuvashnee Govender, registered nurse Nadira Ittal, cardiac ward unit manager Donna Marillier, and (back) resident cardiothoracic surgeon Dr Jehron Pillay.

Resident cardiothoracic surgeon Dr Jehron Pillay, who has been instrumental in establishing the specialised cardiac care unit, says the team is performing increasingly complex interventions alongside more routine procedures at Netcare St Anne’s Hospital.

Patients admitted for advanced heart failure therapy, advanced catheterisation and other crucial cardiac services have the reassurance of a resident cardiac team, experienced nursing care and a state of the art digitally enabled ward that is fully centred on heart health.

“The specialised cardiac care unit is run by a passionate and diverse team who have the drive to provide world-class cardiac care to our patients, and we see the new ward as the next logical step in expanding this critical discipline,” Dr Pillay says.

Other cardiac services include the facility’s high-tech catheterisation laboratory, which houses sophisticated diagnostic imaging equipment used to visualise the vascular system and the chambers of the heart. This enables cardiologists to diagnose specific cardiovascular conditions accurately, guiding their treatment through minimally invasive interventions.

Netcare St Anne’s Hospital general manager Sharon Singh says the newly built cardiac ward comprises 12 beds, with single, double and four-bedded rooms with adjoining bathroom facilities.

“The design incorporates partitioned cubicles in the shared rooms to ensure each patient’s privacy and comfort is provided for. Our new cardiac ward also includes an isolation cubicle equipped for both negative or positive air pressure control, as well as a spacious private VIP suite with a large ensuite bathroom,” she

says.

“In addition, a newly renovated 23-bedded medical unit is fitted with the latest technology for patients’ comfort and safety. This includes six private rooms with two isolation suites and most rooms have access to the garden, which is both soothing and beneficial for recovery.”

Be proactive about heart health

“Whether or not you have a family history of heart problems, looking after your heart and cardiovascular system should be a priority from a young age,” says Dr Pillay.

The World Health Organization (WHO) cites cardiovascular disease as the leading cause of death globally.

“Regularly check in with your primary healthcare practitioner for health screenings to check for risk factors such as high blood pressure, raised blood glucose, cholesterol levels, and indicators such as obesity,” he says.

“If detected early, these factors can often be managed with lifestyle changes and prescribed medicines to dramatically reduce the risks of heart attack, stroke, heart failure and other potentially life-threatening conditions,” Dr Govender adds.

“We aim to improve public awareness that heart health cannot be taken for granted and continue to build excellence in cardiac care for the people of Pietermaritzburg and surrounding communities in KwaZulu-Natal.”

Critical hours: The race against time in stroke treatment

Wed, 13 Nov 2024 06:19:51 GMT

Advanced imaging supports faster interventions, stronger stroke outcomes

A fleeting window of a few critical hours following a stroke presents the opportunity to minimise the damage and severity of brain injury, provided the individual receives prompt treatment at a facility equipped to provide comprehensive stroke care.

“The big thing with stroke is that treatment can’t be delayed as every minute without treatment results in the death of thousands of brain cells. Yet, unfortunately, there is still not enough public awareness that stroke is a medical emergency. This lack of awareness is a major barrier to securing better stroke outcomes,” says Dr Moaaz Valli Omar, a neurovascular interventional radiologist who practises at Netcare Milpark Hospital.

“Everyone should be aware that there are things we can do to prevent or limit the brain damage resulting from a stroke if treatment begins soon after the stroke occurs. The potential for recovery is highest when patients are promptly treated at the right specialised facilities, equipped with the full range of acute stroke diagnostics and therapies.”

World-class angiography system

The comprehensive multidisciplinary stroke management capabilities of the level 1 accredited trauma centre at Netcare Milpark Hospital have been significantly bolstered with the addition of an Artis icono biplane Digital Subtraction Angiography (DSA) system.

“This advanced system elevates our capacity to treat both haemorrhagic and ischaemic strokes, along with other complex neurovascular conditions, to a new level,” says Dr Omar, one of few specialists in South Africa qualified to perform mechanical thrombectomy for major vessel occlusive strokes.

Dr Moaaz Valli Omar, a neurovascular interventional radiologist practising at Netcare Milpark Hospital, says greater public awareness is needed that stroke is a medical emergency, and that with prompt intervention at a comprehensive stroke facility more hopeful prognoses are possible. Dr Omar is pictured with the Artis icono biplane Digital Subtraction Angiography (DSA) system.

Usually, only conscious sedation is required for this minimally invasive procedure, where a fine catheter wire is inserted through a tiny incision in the groin or wrist and is guided with the assistance of precision imaging through the arteries to the site of the blood clot in the brain. In the case of an ischaemic stroke, the clot is captured and gradually guided out, restoring blood flow to the affected area of the brain.

“When initiated promptly, procedures such as these can dramatically turn around the person’s outcome from potential death or being left permanently bedridden to a much more hopeful prognosis, where a great degree of functionality and quality of life can be restored,” Dr Omar explains.

The biplane DSA system, which was introduced at Netcare Milpark Hospital in June, significantly shortens the time to treatment through its superior imaging capability, in many cases eliminating the need for preparatory scans or repositioning, shortening the time to femoral access by as much as half an hour.

"This is revolutionary when we are working in blood vessels or need to negotiate access to vessels in areas deep within the brain or near bony structures,” he says.

Time is brain

“Time is brain, which means the sooner we can treat acute stroke, the more brain function we can potentially save. We are working with very sensitive structures within the brain, so the more views we have, the safer and more successful these interventions will likely be.

“Being able to see the soft tissues clearly from two angles, or in some cases even three-dimensional visualisation, allows us greater perspective in navigating arteries and mapping, which supports precision and contributes to shorter procedure times,” Dr Omar explains. “Other system advantages include unparalleled clarity with significantly reduced radiation exposure and minimal use of contrast agents, thanks to this technology,” Dr Omar explains.

“Public awareness is key to getting people to an emergency department supported with a fully equipped stroke centre where these interventions can be optimally effective.”

Know the signs of stroke

“Anyone can help save a life by recognising the signs of stroke as a medical emergency and taking action immediately. Advances in stroke treatment can often help to prevent loss of life or limit the extent of brain damage. Still, clinical outcomes tend to be best when appropriate treatment is administered within the first few hours after a person has a stroke,” says Dr Ismail Moola, a neurologist who is part of the multidisciplinary team treating stroke at Netcare Milpark Hospital.

“Time is of the essence with stroke, but too often people do not recognise the symptoms of stroke or do not realise the urgency of commencing treatment after a stroke.

“The signs of stroke are sometimes more subtle than those of a heart attack, but it is no less of a medical emergency. The acronym BE FAST is a helpful reminder of the signs of stroke and what to do,” Dr Moola explains.

B for Balance – Sudden difficulty in maintaining balance.

E for Eyes – The person may experience problems with their vision, including loss of sight in one eye or blurry vision.

F for Face drooping – Facial muscles are weak, often causing facial asymmetry as one side of the face starts to droop.

A for Arm or leg weakness – The person may feel weak in one or both of their arms or legs and may feel numb on one side of their body. They may also have poor coordination and difficulty walking or standing up. Usually, this occurs on one side of the body.

S for Speech difficulty – The person may slur words, use words incorrectly or not be able to speak.

T for Time – Take note of the time the stroke began or was first noticed. This is also the time to call emergency medical services, such as Netcare 911 on 082 911.

“Nowadays, we have remarkable capabilities to mitigate stroke damage, but the key is securing emergency medical assistance without delay. Every minute counts and even a few can drastically impact a patient’s survival and recovery outcomes,” Dr Moola concludes.

Rheumatologist recognised for lifetime contribution to global research

Wed, 06 Nov 2024 04:57:27 GMT

Netcare congratulates Prof Dessein on ScholarGPS Top Scholar status

Esteemed rheumatologist and respected academic Professor Patrick Dessein has been recognised by the international online scholarly analytics platform ScholarGPS.

Prof Dessein, who practises at Netcare Rosebank Hospital, was recently recognised as one of the top 0.5% of ScholarGPS researchers worldwide based on his strong publication record, the impact of his work, and the notable quality of his scholarly contributions.

“We heartily congratulate Prof Dessein on this latest acknowledgement of his academic prowess and the immense body of work that is continually being referenced and built on by other academics internationally,” says Sibusiso Vilakazi, general manager of Netcare Rosebank Hospital.

Prof Dessein holds dual Honorary Professorship at the Internal Medicine and Physiology Departments of the University of the Witwatersrand. He moved to South Africa from Belgium in August 1983 and started working at Kalafong Hospital, Pretoria.

Professor Patrick Dessein

In January 1988, he became a registrar in the Department of Internal Medicine at the Johannesburg Hospital (now Charlotte Maxeke Johannesburg Academic Hospital) and Hillbrow Hospital, where he was later a consultant physician internist for the Department of Rheumatology.

“Since 1986, my main interest has been in rheumatology research, particularly pathogenetic mechanisms, including sympathetic overactivity and instability and overlapping risk factors and pathogenetic mechanisms between rheumatic diseases and cardiovascular disease, with their implications for improved therapies of disease manifestations and disease outcomes as well as neuroendocrine deficiencies,” Prof Dessein explains.

He also practised at Netcare Milpark Hospital from 1995 to 2016. From 2016 to 2018, he served as Head of Rheumatology at the University Hospital and Free University in Brussels, Belgium, before returning to South Africa and Netcare Rosebank Hospital.

Over the past 12 years, Prof Dessein’s academic work has focused mostly on cardiovascular risk and atherogenesis, including molecular mechanisms such as altered endothelial activation and altered adipokine production and cardiac function and structure in patients with rheumatoid arthritis and chronic kidney disease.

“More recently, a new interest has been the identification of predictors of poor outcome and optimising interventions in socio-demographically disadvantaged patients seen in public care in South Africa,” Prof Dessein explains.

Prof Dessein has maintained strong international relationships, including as a member of the TransAltantic Cardiovascular Risk Calculator for Rheumatoid Arthritis Consortium, which consists of 15 research groups in 10 countries dealing with combined data from 5 685 patients with rheumatoid arthritis. He has also served as an editorial board member of the Journal of Rheumatology and the Journal of Cardiology and Therapy.

In addition to consulting patients, Prof Dessein remains a leading hands-on figure in empowering local medical professionals by generously sharing his specialised knowledge. He also supervises numerous PhD students.

“On behalf of the Netcare family, we warmly applaud Prof Dessein for the extraordinary reach of his academic contributions and thank him for his dedication over decades to improving outcomes for patients, both those under his direct care at home in South Africa and the patients of the many healthcare practitioners internationally who have benefitted from his invaluable, wide-ranging research contributions,” Dr Erich Bock, managing director of Netcare’s hospital division, concludes.

Dynamite comes in small packages: Tiny Tshiamo celebrates her first birthday

Wed, 30 Oct 2024 10:35:55 GMT

Tshiamo Risimati was born prematurely weighing only 585 grams. She recently celebrated her first birthday, and her parents are looking forward to their first family Christmas at home.

Proud parents of premature baby recall Christmas 2023 in NICU

When a young mom-to-be’s blood pressure dangerously increased during pregnancy and medication failed to bring it down, the best hope for mother and baby was an emergency c-section. A year later, the resilient mother reflects on the emotional rollercoaster of the past year and looks forward to her extremely premature daughter’s first Christmas at home.

“My blood pressure escalated out of control around 26 weeks into my pregnancy. At 28 weeks, on 13 October 2023 my obstetrician, who has since retired, admitted me for observation at Netcare Krugersdorp Hospital,” says Tshiamo’s mother, Ntsako Risimati.

Tests revealed the risk to Ntsako and her unborn baby was becoming critical, and the next day, on 14 October 2023, the anxious expectant mother and father, Benny, were advised to prepare for the imminent delivery of their highly premature daughter.

“I was not prepared for this; I was going to the theatre in 30 minutes to have the baby, which was only expected on 15 January 2024. I was extremely scared. I had to be put under anaesthetic to better control my blood pressure, and when I woke up, they explained my daughter was already in the neonatal intensive care unit [NICU],” says Ntsako.

A “very tiny” Tshiamo made her entrance into the world weighing a mere 585 grams, little more than a block of butter, and unable to breathe for herself. “As well as being premature, she was so tiny because hypertension limits the growth of the foetus, so my baby’s growth was behind by two weeks of her gestation age, too.

“I also had to be moved to intensive care as my blood pressure refused to go down, and I couldn’t go and see her. My partner and the NICU nurses were really amazing, showing me photos and videos of Tshiamo so I could feel closer to her. One of the nurses even made a footprint of her tiny foot, which I treasure even now, and that inspired me to fight for my life.”

Paediatrician Dr Leonie De Jager remembers Tshiamo as “a fighter from the very start”. “Being born so small is very risky, and the chance of survival is not very good, not even talking about survival without complications,” she says.

“Tshiamo’s lungs were not quite mature enough for her to be able to breathe without a ventilator, which she required for the first five weeks. She also needed strong medication to keep her blood pressure stable, as Tshiamo’s blood pressure was low, and she had some heart problems that made her struggle to keep up with her body’s demands. Feeding was also challenging. Despite all these things, Tshiamo pulled through.”

Paediatrician Dr Aurelie Gerin took over Tshiamo’s care in December 2023 when Dr De Jager emigrated to Australia. “By this time, Tshiamo had reached 1 400 grams and her growth corrected to 39/40 weeks’ gestation, which is the stage of development most babies reach at birth. Tshiamo was still oxygen dependent, and she was being treated for her congenital heart defect, a hole in her heart.

The multidisciplinary team caring for Tshiamo included the dedicated and caring nurses of the NICU, a speech therapist who assisted with developing her feeding ability, a neurophysiotherapist, and the paediatricians.

“Due to her complex illnesses and extreme prematurity, Tshiamo wasn’t gaining weight as she should. She had periods of feeding intolerance, where she was reliant on intravenous fluids. Her liver enzymes were mildly elevated, this was managed supportively and fortunately resolved over time.”

As soon as Tshiamo was strong enough, the nurses helped her parents begin skin-to-skin contact. “At first, we were scared to even look at Tshiamo she was so tiny, and I was terrified that I might drop her. The nurses reassured us and showed us how to lie with her falling asleep on our chests and it was the most amazing feeling,” Ntsako recalls.

Netcare’s neonatal intensive care facilities promote kangaroo care, or skin-to-skin contact, as it has numerous proven benefits for parents and babies. These include improving the baby’s temperature regulation, which enhances growth, helping the baby’s skin mature and develop a healthy microbiome, helping to develop the immune system, stabilising the baby’s heart rate, oxygen level, breathing and blood pressure, and promoting bonding, among others.

“We are so grateful to all the doctors, nurses and therapists who were involved in caring for Tshiamo and our family during this time. The staff at Netcare Krugersdorp Hospital, especially the NICU team, were really wonderful throughout this emotionally and physically taxing time. I asked a million questions, and just when I got home from visiting her, I would immediately phone them for an update, and they were so kind.”

As Christmas approached, Tshiamo’s parents were determined to make the day memorable for their daughter. They brought festive cheer to the NICU, including decorating their daughter’s cot and dressing her in an adorable miniature Christmas outfit.

“All we wanted was to bring her home, but she was still struggling with the effects of the hole in her heart, and she was still on nasal flow oxygen. All doctors and nurses love our babies, and they take good care of them. They also encouraged us to take care of ourselves, and I was truly grateful to have this dedicated team looking after our daughter.”

Dr Gerin says that Tshiamo’s health has gradually improved. “The hole in her heart eventually closed spontaneously, fortunately without the need for surgery. Tshiamo was successfully weaned off oxygen, to the relief of her parents, and discharged home on Valentine’s Day, 14 February, at 45/40 weeks corrected age in mid-January 2024, weighing just less than 3kg.

“Tshiamo is, of course, a very small baby, and she will most likely remain small throughout her life, however, she has been doing beautifully at home. Dynamite comes in small packages, and Tshiamo has shown us that although she is small, she is very strong. She is a testament that through love, expertise, care, and committed hard work, micro-premature babies like Tshiamo can have excellent outcomes,” Dr Gerin says.

“Tshiamo crept into my heart from the first day she said hello to the world. Now she is developing well, and who would ever know that she spent the first few months of her life fighting for the basic things we often take for granted,” Dr De Jager says.

Ntsako says that celebrating Tshiamo’s first birthday at home and looking forward to the family’s first Christmas together is like a dream come true.

“Tshiamo is a happy, feisty little girl and she is growing up and getting stronger. We are continuing with physiotherapy to help her reach her milestones and she is doing so well. She can sit independently and is learning to crawl. She is eating solids, and her favourite is broccoli with butter. We are so thankful for the progress Tshiamo has made, and we will never forget the NICU team at Netcare Krugersdorp Hospital for the care they showed us,” Tshiamo’s parents concluded.

Hole in the heart healed for a hope-filled future

Tue, 22 Oct 2024 07:49:57 GMT

New lease on life for teen

Dr Samkelo Jiyana, who practises at the Netcare Greenacres Hospital, says World Heart Day is not only about educating the public about adult heart disease. “Many are unaware that approximately one in a hundred children are affected by heart conditions or heart disease. Raising awareness of paediatric heart conditions can lead to earlier diagnoses and more effective treatments using modern medical techniques. With timely intervention, children diagnosed with heart conditions often have the potential to live long, healthy lives."

His patient, Kheera Mcetywa, is a bubbly 13-year-old with a quick sense of humour who enjoys drawing and writing her own songs. Although spirited and lively now, Dr Jiyana recalls that when he first met her, Kheera was a frail child. "Kheera presented with recurrent chest infections and had been unwell since infancy. She was eventually diagnosed with a congenital ventricular septal defect (VSD), a condition characterised by a hole in the wall separating the two lower chambers of the heart. While there is always hope that a VSD will close on its own, Kheera's did not, leading to recurrent chest infections. Additionally, her growth was stunted, and she was smaller than her peers. She had needed the procedure for quite some time," he adds.

Dr Jiyana explains that a VSD is typically present at birth and results from improper heart development during foetal growth.

Dr Samkelo Jiyana – Why I became a paediatric cardiologist

After training to become a medical practitioner, Dr Jiyana said he’d done a stint in charge of a paediatric ward at Mount Frere Hospital during his community service. “I found it to be very rewarding. I saw how the children were getting better and decided to further my training and become a paediatrician. I spent time at the Red Cross Hospital in Cape Town, and when I returned to East London, cardiology came about because there were only two paediatricians who could do heart scans and take care of children with heart conditions. I wanted to be one of the people who could do this. I wanted to do this so I could help heal children with congenital and acquired heart disease.” He also provides a range of holistic paediatric cardiology services.

Kheera Mcetywa (13) is full of confidence for a bright future ahead of her after a successful procedure to repair a heart defect by paediatric cardiologist Dr Samkelo Jiyana at Netcare Greenacres Hospital in Gqeberha. Kheera has decided she wants to be a paediatric heart surgeon, so she can help children like herself one day.

Mrs Micaela Mcetwya and her daughter Kheera (13 years old) say they are grateful for the caring treatment Kheera received to treat a heart condition at the Netcare Greenacres Hospital.

Benefits of non-invasive techniques

Kheera’s family was initially shocked and afraid when they were told she needed treatment to close the hole in her heart. “But when I explained that we would repair the defect using a minimally invasive procedure through a small hole in her groin, they were more comfortable. It’s so much safer than open heart surgery. The patient can generally go home the next day, whereas with open heart surgery, patients remain in hospital for two weeks.”

Dr Jiyana cautions that the procedure is not without risks. “There’s still anxiety because complications can occur. There’s also the sense that you’re working on a child, and this can present its own challenges. Each child has their own anatomy, and the procedure is not something you do every day.”

Dr Jiyana explains that when a VSD is closed percutaneously (through the skin) in a cath lab, the heart is accessed through the skin, typically via a small incision in the groin area where a catheter (a thin, flexible tube) is inserted into a blood vessel. “We insert a device to close the hole, with the pressure inside the heart keeping the device in place. In time, a membrane will develop over the device, which helps keep the hole closed. It wasn’t the simplest procedure, and it took about four hours. But, there’s no need for a large chest incision or stopping the heart, leading to a shorter recovery time and less pain. Kheera was able to go home the very next day. There’s also a lower risk of complications than with open-heart surgery.”

Postoperatively, checks are done to ensure there’s no fluid around the heart, the device hasn’t dislodged, and there are no leaks around the device. “We also check that the valves we went through are not torn. Fortunately for Kheera, we didn’t have any of that. Once I was happy, I let her go home on aspirin to promote healing. She’ll still have regular check-ups, decreasing in regularity as she progresses.

“Now that she’s better, I’m seeing the real Kheera,” he smiles. “Initially, she was very reserved and shy, but now she is lively. She’s thriving.”

Worrying time for mom

Micaela Mcetywa, Kheera’s mother, describes her daughter as a brave, intelligent child. “She’s not scared to take chances. She constantly seeks to improve herself and improve her knowledge.”

She says initially, they didn’t know there was a problem with Kheera’s heart, but they’d noticed she’d been a sickly child from birth. “She had no appetite and was always getting a cold. At two years old, she contracted TB. When she was four, she was sick with tonsillitis. The doctor we took her to then detected that her heart was making an unusual sound, so he referred her for tests, which revealed she had a VSD. I was overwhelmed by the news and thought it meant I was going to lose my child. We all know that a heart condition is a very serious thing. All I could think about was that my child was going to die.”

After a long journey through different hospitals and doctors and bouts of serious illness, including bacterial meningitis, which impacted Kheera’s heart, another disaster struck – COVID-19. Mrs Mcetywa says that because of her heart condition, Kheera had to be completely isolated and was not allowed to go outside at all. “We were so cautious. We were always anxious that she’d become ill.”

Last year, Dr Jiyana suggested that Kheera undergo treatment for the hole in her heart. “But, we felt she was doing fine. We didn’t want any complications. However, they explained that Kheera could suffer from pulmonary hypertension when she grows up if the VSD was left untreated. That’s when we decided to go ahead. They also explained that the procedure didn’t involve open heart surgery. We realised that if we didn’t allow her to have the procedure, it could cut her life expectancy in the long run. That’s when we decided to step up our faith and get through this.”

Mrs Mcetywa says Kheera remained “very cool and calm” throughout her experience in the hospital. “We didn’t give her a chance to panic. There was a time when she was withdrawn from us. Her grandmother said this may be due to her upcoming surgery, so I talked to her, and she told me she realised there was no other option; she knew it had to be done, and she was optimistic.”

When Kheera went for the procedure, her mother had just begun a new job, working out of town. “My sister was with her. I was at work but worrying all the time. It was very hard. I video-called her and told her, ‘Make sure you pray before you go in for the procedure and make sure you believe in your prayers’. I also kept my faith.

“I really want to thank the staff at Netcare Greenacres Hospital. They were so friendly, helpful and accommodating. Dr Jiyana is so professional and approachable. He individualises his clients.”

Kheera has a good support system at home. Her loving grandmother, Mary-Ann Mcetywa, who is part of her extended family, cares for her and guides her to health and healing.

Healing and hope for the future

For Kheera, while recovering from the procedure is frustrating, it also holds the promise of a more active lifestyle when she’s fully healed. “I feel suffocated because I can’t do the normal things I used to do. I have to sit at school and watch my friends running around. Dr Jiyana says I need to take it easy for the next six months until I am well. That will be next year in February. In the meantime, I write my own songs and sing.” Asked if she aspires to be on stage one day, she’s quick to say, “No way. You’ll see me in the hospital. I’m going to become a paediatric cardiologist. I’m studying hard, and I’m totally up for it.”

She describes Dr Jiyana as “very nice and patient”. “I like his colourful clothes, just like him – very bright. And I love his smile.”

Reflecting on their difficult journey, Mrs Mcetywa says Kheera’s granny has been a pillar of strength throughout. “We were always afraid in our hearts, but our prayers have been answered. Kheera is very brave. Now she wants to help children with the same condition as her.”

Kheera sums up her thoughts about getting better. “I’m a confident girl, and I’m confident in the future,” she says with a grin.

Child heart health

Dr Jiyana explains that some babies can be born with a blue skin tone due to specific health issues. These issues could be related to the heart, lungs, or blood circulation. Identifying the cause is crucial so doctors can provide the proper treatment to help the baby recover and stay healthy. “People tend not to pick up on this, and sometimes it’s difficult for us to intervene. There is much work to be done to raise awareness so people don’t despair. Putting your head in the sand is often more comfortable than seeking help. Sometimes, when the diagnosis is made, the parents don’t come back because the child needs an operation. If they hear the words ‘heart operation’, they think their child is going to die. But children can survive and have a much better quality of life. Kheera’s story is a testament to this. She got the help she needed and is now thriving compared to the child who was often sick before.”

About VSD

VSD is often diagnosed through a physical examination, where a doctor might hear a heart murmur and is confirmed with imaging tests such as an echocardiogram, chest X-ray, or cardiac MRI. Dr Jiyana says when a child has a VSD, the hole in the wall of the heart allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle. “This can lead to increased blood flow to the lungs and overworking of the heart.”

Symptoms can vary depending on the size of the defect. “Small VSDs may close on their own and require no treatment. Larger defects may need medication to manage symptoms or surgical intervention to close the hole.

The prognosis for individuals with VSDs varies. Many people with small VSDs live healthy lives without complications, and surgical repair of larger VSDs has a high success rate,” adds Dr Jiyana.

‘Time is brain’ - Golden window critical for treatment of strokes

Wed, 16 Oct 2024 08:59:22 GMT

Netcare The Bay Hospital was recently recognised for excellence in stroke care by the World Stroke Organization and Angels Initiative. From left to right are Kasturi Yagambaram (deputy nursing manager), Marna Basson (pharmacy manager), Luleka Mhlauli (nursing manager), Dr Naazim Siddi Ganie (neurologist), Sr Nomvula Mthembu (unit manager of the emergency department), Maxeen Murugan (KZN Angels initiative consultant), Phiwokuhle Sapula (acting technical manager), Slindile Hlongwane (HR manager), Susana Redelinghuys (financial manager) and Nkosingiphile Biyela (deputy nursing manager).

Hospital’s excellence in stroke care recognised by World Stroke Organization and Angels Initiative

Within minutes of a stroke occurring, brain cells begin to die. This critical neurological damage means that time is of the utmost essence for the patient.

Specialist neurologist at Netcare The Bay Hospital, Dr Naazim Siddi Ganie, elaborates on the gravity of the situation: “When the blood supply to the affected part of the brain is interrupted or reduced, brain tissue can no longer get the oxygen and nutrients it needs. This makes a stroke a medical emergency that requires prompt treatment. The mantra ‘Time is brain’ underscores a crucial reality: within minutes of a stroke occurring, brain cells begin to die, making rapid medical intervention paramount.”

This urgency is a defining factor in the treatment protocols at Netcare The Bay Hospital in Richards Bay, which recently received the prestigious Gold Award from the World Stroke Organization (WSO) and the Angels Initiative for its excellence in stroke care.

Dr Ganie explains that having a stroke remains one of the leading causes of disability and death worldwide: “In South Africa, the challenge is even more pressing, especially in underserved areas like Richards Bay and other areas of Northern KwaZulu-Natal.”

According to the World Stroke Organization (WSO) Angels Initiative, worldwide, every 30 minutes, a person who suffers a stroke and could have been saved either passes away or suffers a lifechanging brain injury because they weren’t treated in a hospital that follows the internationally recognised criteria in stroke management. “This underscores the importance of access to such facilities and adds to the team's pride at Netcare The Bay Hospital for our recent Gold Award by the Angels Group,” says Dr Ganie.

The award recognises the hospital's outstanding achievements in optimising stroke care and achieving exceptional patient outcomes. “By implementing a highly coordinated and optimised stroke care pathway, the hospital has improved early stroke recognition, ensuring that patients receive the care they need within the critical time frame.”

Specialist neurologist at Netcare The Bay Hospital, Dr Naazim Siddi Ganie and Sr Nomvula Mthembu, unit manager of the emergency department at Netcare The Bay Hospital with the prestigious Gold Award from the World Stroke Organization (WSO) and the Angels Initiative, which was recently awarded to the hospital for excellence in stroke care.

Can strokes be prevented?

Dr Ganie explains that following a healthy lifestyle may prevent most strokes. He recommends maintaining a healthy weight, exercising regularly, reducing stress levels, limiting alcohol intake and quitting cigarettes if you’re a smoker. “It is also imperative to manage conditions like high blood pressure, atrial fibrillation (a type of abnormal heart rhythm), diabetes, and high cholesterol”, he adds.

However, some strokes are caused by unavoidable factors. “Ageing contributes to an increased risk of stroke. Women, unfortunately, have an increased risk of stroke after menopause. In addition, family history also plays a role. Genetic conditions like familial high blood pressure and cholesterol or clotting disorders, for example, also increase the risk of a stroke.”

What are the different types of strokes?

Dr Ganie explains that around 85% of all strokes are ischaemic strokes caused by a blood clot. They occur when a major blood vessel in the brain is blocked, either by a blood clot or by a build-up of fatty deposits and cholesterol known as plaque.

“A haemorrhagic stroke occurs when a blood vessel in the brain bursts, flooding nearby tissue with blood. This causes pressure and irritation to the delicate brain tissue.”

Dr Ganie stresses that a transient ischemic attack (TIA) – which is when blood flow to part of the brain is reduced by a clot or fatty deposit – can result in symptoms similar to a stroke but that the damage is not permanent.

There is cause for optimism for stroke patients

According to Dr Ganie, Netcare The Bay Hospital offers cutting edge treatments for stroke patients, including thrombolytic therapy, which dissolves blood clots and restores blood flow to the brain. They also facilitate mechanical thrombectomies, a minimally invasive procedure to remove clots from large arteries. “Both treatments have been shown to significantly reduce disability and improve survival rates when administered promptly.”

The optimisation of stroke care at Netcare The Bay Hospital doesn't stop at acute treatment, with Dr Ganie and his team ensuring patients receive a comprehensive rehabilitation programme designed to help them regain as much function as possible to reintegrate into their communities.

“This holistic approach acknowledges that while acute intervention is critical, long-term recovery is just as important. After discharge, stroke survivors are connected with physiotherapists, speech therapists, and occupational therapists to help them recover lost abilities and improve their quality of life. The hospital also provides ongoing support through regular follow-up appointments, ensuring patients receive continuous care throughout their recovery journey.”

The hospital's stroke team works closely with local paramedics, equipping them with the knowledge and tools needed to quickly recognise and act on suspected stroke cases. Dr Ganie says this pre-hospital coordination means the team is prepared even before the patient arrives, ensuring that precious minutes are saved. “Once the patient is in the emergency department, the team jumps into action with a clearly defined protocol that minimises delays in diagnostic imaging and treatment decisions.”

Education is key

“An easy way to remember the signs of a stroke is to use the acronym FAST. This stands for Face drooping, Arm weakness, Speech difficulty and Time to call emergency services.”

Dr Ganie says this is important because many patients get to healthcare facilities too late. “If they’d arrived earlier, they could benefit from treatments such as thrombolysis or mechanical thrombectomy, both of which can dramatically improve outcomes if administered within the golden window.”

About the award

Netcare The Bay Hospital general manager Deon Smith says the hospital has made considerable strides in stroke management under the leadership of Dr Ganie. “Having the prestigious Gold Award from the Angels Group among our accolades means we’ve become the only hospital in Northern KwaZulu-Natal to achieve such recognition. This accomplishment reflects the programme's profound impact on improving acute stroke care.”

The Angels Initiative is dedicated to improving stroke patients’ chances of survival and a disability-free life. In eight years, around 7,5 million patients have been treated at over 6 000 Angels hospitals worldwide.

“This award is a testament to the success of the hospital's stroke management initiative and reflects its commitment to providing world-class care in an area where such services are desperately needed,” adds Smith.

Zasskia Wiese, Netcare’s national stroke programme manager, explains that to qualify for the award, all hospitals recognised by the WSO Angels Initiative must register with and submit data to the Registry of Stroke Care Quality (RES-Q), an initiative of the European Stroke Organisation’s Enhancing and Accelerating Stroke Treatment (EAST) protocols.

This registry allows for international benchmarking and continuous improvement and monitoring to ensure consistency of quality stroke care. “We are committed to the highest standards of care for our stroke patients, which shows our efforts are recognised globally. We’re honoured by this prestigious award, which cements our dedication to continuous improvement in stroke care and assures our patients that we’re a beacon of hope in Northern KwaZulu-Natal,” she says.

A doctor’s perspective on how to stay healthy well into your retirement

Tue, 08 Oct 2024 07:26:22 GMT

Ten golden rules for a golden retirement

“You've spent most of your adult life working hard, often putting in long hours and sacrificing holidays and precious time with loved ones. Now, as you step into retirement, it's time to relish the rewards of your dedication while maintaining your good health,” says Dr Christo Bester, a general practitioner at Netcare Medicross Parow in the Western Cape.

"Retirement should be your golden ticket to savouring life's joys and enjoying the company of family and friends," says Dr Bester. "It's your time to shine, with the help of some valuable insights to keep you feeling vibrant and well."

Dr Bester's comprehensive advice emphasises proactive health management, offering ten golden rules to help you make the most of this exciting new chapter in your life.

1. Prioritising health screenings and check-ups

As you approach retirement, it's crucial to prioritise various health screenings and check-ups. These typically include:

Cardiovascular health: Monitor your blood pressure, cholesterol, glucose, thyroid, and uric acid levels, as well as your weight and abdominal girth.
Cancer screenings: Plan for a colonoscopy, gastroscopy, chest X-ray, Pap smears, mammograms (if applicable), and prostate checks.
Musculoskeletal health: Post-menopausal women, in particular, should keep a close eye on their bone density.

Pedalling to wellness: Dr Christo Bester, a general practitioner at Netcare Medicross Parow in the Western Cape pedalling his way to health and fitness! Practising what he preaches, this doctor knows the golden ticket to life's joys is staying active.

2. Managing chronic conditions

Effectively managing or preventing chronic conditions such as hypertension, diabetes, and arthritis involves regular check-ups. Annual check-ups will suffice if you're healthy without comorbidities, otherwise, consider twice-yearly visits. Maintain a healthy weight, exercise regularly, eat a balanced diet, and quit smoking. Do not cancel your medical aid.

3. Dietary and nutritional adjustments

Good nutrition is imperative for sustaining your health and energy levels during retirement. Focus on reducing salt, fat, and sugar intake and aiming to maintain a healthy weight.

4. Beneficial physical activities

Regular physical activity is essential for maintaining mobility and overall health as you age. Consider regular walks—at least three times a week—joining a Run-Walk For Life club, participating in Park Runs every Saturday, cycling, swimming, and practising yoga.

5. Medication management

Manage your medications safely by opting for combination medications to reduce the number of pills you take. Your doctor can help with this. Switch to generic equivalents to save costs, and again, do not cancel your medical aid.

6. Preventive care

Specific vaccines and preventative measures become increasingly important as you age. Stay up to date with the tetanus vaccine every five years, pneumococcal vaccines (both types), and the annual flu vaccine before winter.

7. The importance of social engagement

Social engagement is vital for your health. Stay active in your community, church, and family to maintain social connections and mental wellbeing.

8. Improving sleep quality

To improve sleep quality, avoid having a television set in your bedroom, limit caffeine after 17:00, reduce your alcohol intake, avoid large meals late at night, and exercise regularly.

9. Emergency preparedness

Ensure you are prepared for healthcare emergencies by updating your mobile phone's health app with your medical aid details, medications, allergies, medical conditions, and the contact information for your spouse, children, GP, cardiologist, and two nearby friends or family members who can assist you. Keep sufficient funds in a savings account for medical emergencies, and never travel without travel insurance.

10. Embrace new hobbies and learning

Retirement is the perfect time to pick up new hobbies and continue learning. Engage in activities that stimulate your mind and bring joy. Whether gardening, painting, learning a new language, or travelling, staying mentally active is just as important as physical activity.

"Retirement is a time to enjoy the fruits of your labour and cherish moments with loved ones," concludes Dr Bester. "Focusing on your health and wellbeing can ensure that these years are vibrant and fulfilling. Remember, your health is your wealth. Take proactive steps to maintain it, and you'll be able to enjoy your golden years fully. Stay active, stay engaged, and most importantly, stay happy.”

When all else fails: A psychiatric treatment option for suicidal patients

Thu, 03 Oct 2024 11:54:06 GMT

Caution and hope in therapeutic ketamine

Initially identified in the early 1960s for its anaesthetic properties in veterinary use, ketamine is now listed among the World Health Organization's List of Essential Medicines. It has also been abused for its properties over decades. With a balanced view and cautious approach, ketamine can have potentially lifesaving applications in psychiatric medicine.

Psychiatrist Dr Bavi Vythilingum practises at Netcare Akeso Kenilworth and Ukukhanye Wellness, a psychiatrist-led ketamine clinic that focuses on evidence-based ethical ketamine treatment.

She emphasises its usefulness for certain patients but also warns healthcare practitioners and the general public about misinformation and inappropriate use of the drug. “Ketamine is a pharmacologically novel treatment with proven efficacy in major depressive disorder. It is one of the first non-monoaminergic treatments, which means not involving the balance of hormones such as serotonin or norepinephrine.

“There are major safety concerns when it is used irresponsibly or illegally, even in controlled, licensed psychiatric settings. It is essential that it is only ever administered in line with the clinical guidelines to appropriate patients where all else has failed to bring relief to treatment resistant depression or bipolar depression, suicidality, or post-traumatic stress disorder.”

Dr Bavi Vythilingum

Dr Vythilingum points out that fewer than 15% of people with treatment-resistant depression achieve remission with mainstream antidepressant therapies. “When there is suicidal intention, particularly, the threat that it poses to life may, for some individuals, require novel therapies such as ketamine to be considered.

“However, it cannot be overemphasised that there are dangers and potential for adverse risks and, like any medication, in the wrong hands it can be potentially life-threatening. Ketamine stimulates the heart to beat faster and can increase blood pressure which may, for example, trigger heart attacks in predisposed individuals.”

Over time, ketamine use is also associated with adverse symptoms affecting the lower urinary tract and genitourinary toxicity, such as potential kidney damage. It is also not safe for use during pregnancy or breastfeeding.

“When ketamine is clinically indicated for a specific patient, and administered by a suitably qualified medical professional, it is important to monitor the person’s cardiovascular status and ensure advanced cardiac life support is on hand in case of an emergency.”

The patient should also be professionally supported by a suitably trained and experienced psychiatrist as there is a low risk of psychosis. At higher doses, sometimes used for anaesthesia in emergency settings, dissociation may occur.

“It is interesting to note, however, that dissociation is not necessary to achieve the antidepressant effects of ketamine. This is supported by a growing body of international psychiatry research,” Dr Vythilingum says.

Although it is short-acting, the person’s cognitive functions may be impaired, and they should not drive until the following day – hence transport must be arranged for after the treatment.

“There are various routes of administering ketamine. For treatment resistant depression there is unequivocal, rapid significant efficacy with intravenous infusion in the short to medium term. Independent of ketamine’s effect on depressive symptoms, patients also experience rapid reduction of suicidal thoughts and behaviour, and this therapeutic effect may persist up to six weeks with repeat dosing.”

Ketamine’s recreational use for its psychedelic effects raises pertinent concerns about its risk for abuse, and this is where patient selection is key. “It is important to note that there is no evidence to suggest increased risk for substance use disorders following therapeutic ketamine psychiatric treatment.

“Ongoing mental health support, including psychiatric management and follow-up for patients with mood disorders, must be considered as an essential part of the treatment plan. Ketamine does not appear to offer long-term relief and further options may need to be considered as part of the multifaceted and often life-long journey of people who suffer from treatment resistant depression and other persistent mental health disorders,” Dr Vythilingum concludes.

International collaboration for keyhole spinal surgery

Tue, 24 Sep 2024 07:08:09 GMT

Left to right – Head of neurosurgery at Stellenbosch University, Professor Ian Vlok, is pictured with visiting German neurosurgeon Dr Vincent Hagel, neurosurgeon Dr David Roytowsky, head of neurosciences at Wits University, Professor John Ouma and anaesthetist Dr Nick Meyersfeld.

Building local expertise in advanced endoscopic techniques

A patient is recovering well after a groundbreaking advanced endoscopic spinal procedure at Netcare Christiaan Barnard Memorial Hospital, where German and South African neurosurgeons collaborated to repair a cerebrospinal fluid leak caused by an extremely rare condition.

Carmen Dippenaar, a 52-year-old lawyer living in Gardens, Cape Town, developed a dural tear on her lower thoracic spine caused by a sharp bone spur on a calcified intervertebral disc earlier this year, causing her intense pain that rendered her virtually bedridden for three months.

“After developing severe headaches that didn’t respond to any pain medication, Mrs Dippenaar had previously undergone two blind epidural blood patches and two targeted epidural blood patches, which failed to resolve the dural tear as the bone spur kept piercing the nervous system’s protective membrane known as the dura, causing her cerebrospinal fluid, which acts as a shock absorber for the brain, to lose pressure. This was causing the brain to sag in the skull, pressing on the brainstem resulting in debilitating pain,” says neurosurgeon Dr David Roytowski.

“The cause and location of Mrs Dippenaar’s dural tear made this a very rare pathology. It was situated directly anterior (in front) to the spinal cord. Accessing this area is particularly difficult and traditionally requires much more invasive surgery, involving collapsing one of the lungs, cutting through the diaphragm and opening the T12 vertebra to access the site of the dural tear.

“Yet today there are endoscopic spinal techniques that are becoming established elsewhere in the world that show great promise for such procedures, reducing risks associated with open surgery. There are a few South African centres that offer endoscopic spinal surgery, but this is mainly limited to surgery of the lumbar spine, an area which carries much less risk of neurological injury,” he says.

Dr Vincent Hagel, a leading senior physician at the Spine Centre of the Asklepios Hospital in Lindau, Germany, renowned for his expertise in endoscopic spine surgery in the thoracic spine, travelled to South Africa to perform the procedure with Dr Roytowski.

Dr Roytowski hailed the academic support for advanced endoscopic spinal techniques, with the head of neurosurgery at Stellenbosch University, Professor Ian Vlok, and the head of neurosciences at Wits University, Professor John Ouma, discussing the case with the German expert and observing the pioneering procedure at Netcare Christiaan Barnard Memorial Hospital.

In addition, Royal Ortho, a local medical devices company specialising in training surgeons in endoscopic spine surgery, has played a vital role in expanding access to this minimally invasive technique. They not only provided significant support to the surgical team but also facilitated and funded Dr Vincent Hagel's trip to South Africa.

“The benefit of the endoscopic transforaminal approach is that we can precisely access the point on the side of the spinal column to remove the small, calcified disc herniation that is causing the cerebrospinal fluid leak without having to move the organs and retract the spinal cord,” Dr Hagel says.

“Although this can be a challenging procedure if using the traditional techniques, it is something I regularly do endoscopically in Germany for treating disc herniations. Coupled with my experience in treating thoracic spinal patients, this is very familiar ground to me, although it is such an unusual presentation of the pathology,” he explains.

Endoscopic spinal surgery is an emerging super-speciality in South Africa, which considerably reduces the physical trauma associated with open surgery, enabling shorter hospital stays and quicker return to daily activities. A small puncture of approximately 8mm is made in the skin, and a slender instrument called an endoscope with a light and a tiny camera is inserted to enable neurosurgeons to perform procedures through a ‘keyhole’ approach rather than exposing a large surgical site.

“This means that we can avoid the need for a large incision on the person’s back, and there is no longer a need to fracture the vertebra, which would have to be repaired and supported with metalwork. Instead, endoscopic procedures offer a very targeted approach, allowing for the natural spinal column to remain intact,” Dr Roytowski explains.

Dr Vincent Hagel, a leading senior physician at the Spine Centre of the Asklepios Hospital in Lindau, Germany, travelled to South Africa to perform a groundbreaking advanced endoscopic spinal procedure at Netcare Christiaan Barnard Memorial Hospital, where German and South African neurosurgeons collaborated to repair a cerebrospinal fluid leak caused by an extremely rare condition. Here he is photographed with neurosurgeon Dr David Roytowski.

Back on her feet and back on the mountain! After undergoing a groundbreaking advanced endoscopic spinal procedure at Netcare Christiaan Barnard Memorial Hospital, where German and South African neurosurgeons collaborated to repair a cerebrospinal fluid leak caused by an extremely rare condition, Carmen Dippenaar cherishes every step here while walking Maddie and Noah on Table Mountain.

In a procedure lasting three hours, the doctors exposed the dural defect, shaved off and removed the sharp bone spur that had been piercing the dura and patched the leaking area.

Mrs Dippenaar says she was amazed that she was able to get out of bed the day following her procedure and walk around with little to no pain.

“At its worst, for a period of three months (March, April and May) I couldn’t be upright for longer than 10 minutes at a time without feeling the worst headache I have ever experienced – I can barely describe how debilitating it was, like my brain was in a vice and being squeezed. There were other symptoms too – dizziness, nausea and tinnitus. I could not physically drive into work or sit at a desk, I could not exercise at all, not even go for a short walk and I couldn’t be upright long enough to do ordinary activities like shower, socialise or have a meal seated at a table. There were some very dark moments. I wondered if I would ever be able to resume a normal life again” she recalls.

“I spent one night in high care and one night in a general ward, and then I could return home. Within ten days of the endoscopic spinal intervention, I was able to return to everyday life.

“I have been looking forward to exercising again after living with the leak for six months, three of which were spent lying down in bed. I am so grateful to the doctors for making it possible for me to have this minimally invasive procedure. All the specialists were exceptional and went above and beyond what was expected of them.

From Dr Marc Jordaan, the neuroradiologist at Morton and Partners who located the exact site of my dural leak and performed two targeted epidural blood patches, to Dr Roytowski for explaining the options available to me, for hearing me and persisting in finding this innovative approach and Dr Hagel for coming all the way from Germany, as well as the anaesthetist, Dr Nick Meyersfeld, who performed the initial two blind blood patches and continued to be involved in my care, even though he wasn’t required to, as well as performing the anaesthetic for the endoscopic procedure.”

Shadeeran Govender, general manager of Netcare Christiaan Barnard Hospital, thanked Dr Hagel for sharing his expertise with local neurosurgeons.

“The benefits of hosting an eminent international expert and local medical academic leaders in the field in our facility are that it enables these super specialised skills to be developed and assist more patients more safely in the future with the structured approach to endoscopic surgery. We heartily congratulate Dr Hagel, Dr Roytowski, and the team on successfully completing this landmark procedure,” Govender concluded.

As snakes become more active, know what to do if you’re bitten

Wed, 18 Sep 2024 08:39:37 GMT

Don’t take a ‘wait and see approach’ for symptoms

As the warmer summer months approach, South Africans should expect cold-blooded snakes that have been hibernating over winter to start being active again.

Dr Kevin McEwen, a trauma doctor who practises at Netcare St Augustine’s Hospital’s emergency department, says while the incidence of those coming in for help after snakebites is far more prevalent in summer, the warm climate of KwaZulu-Natal means snakes can be encountered year-round.

“Snakes are far more likely to come into contact with people in the hotter months when they’re livelier and breeding. That’s when we see an increase in the number of people seeking often lifesaving treatment for snakebites.”

Watch out for these snakes in KZN

Dr McEwen, who has extensive experience in dealing with emergency situations, says some of the most venomous snakes in KwaZulu-Natal are the black and green mambas, as they are neurotoxic (nerve toxic) venomous snakes.

“The cobras, including the spitting cobra, which has a mixture of nerve and cell venom, are also very dangerous. While the bite of a puff adder is serious in terms of cell damage, we don’t see them around urban areas so much. They’re more likely to be found in the bush in places like northern KwaZulu-Natal.”

By far, the most common bite they see at the Netcare St Augustine’s emergency department, says Dr McEwen, is from the innocuous-looking stiletto snake or burrowing adder. “People make the mistake of thinking the stiletto snake is harmless and pick it up with their hands. They don’t realise that the stiletto snake has sharp fangs on either side of its mouth, and it can move independently of the other. When people try to pick them up behind the neck, it can easily spike its fangs into your finger. It’s a brilliant defence technique, so it’s the most common snakebite we see.”

Caution advised

Dr McEwen is quick to point out that not all snakes have venom that has a toxic effect. “Our most common snakes are not dangerous, but it’s best to always be cautious of all snakes. The most common snakes we see around eThekwini in homes and gardens are non-venomous, like the red-lipped herald, the house snake, the variegated bush snakes, and mole snakes. Rats are their only real prey in built-up areas. Because mambas and cobras live off rodents and birds, they are more likely to be found where these foods are more easily available.”

How are snakebites treated?

“Once the patient arrives at the emergency department, announce that you are seeking urgent assistance for a snakebite”, Dr McEwen advises.

“We’ll start gathering information straight away. We ask the patient where they’ve been bitten and what the snake looks like. We’ll also ask where they were when it happened and what the environment was like. This helps us pinpoint exactly what type of snake it may have been.

“Then we clean the wound and start collecting observations, looking for signs of envenomation, which is the exposure to snake venom. These can include local swelling, pain, and redness. We also check for systemic symptoms like nausea, headache, vomiting, or difficulty with vision, speaking or swallowing. These observations will give us a good indication of whether we need to administer antivenom for the snakebite or not.”

Advice for preventing snakebites

“Prevention is always better than cure, particularly when it comes to snakebites,” says Dr McEwen.

“Many people are bitten while trying to corner or chase a snake they’ve encountered. A threatened snake will defend itself. While accidental contact with snakes does happen, for instance, when a snake is under a structure and someone walks past, the greatest chance for contact is when people encounter a snake and then try to catch it.

“If you see a snake, don’t try picking it up or approaching it. Rather call trained, experienced snake experts to catch the snake with their special equipment and tongs so they can bag it and take it away.”

What should you do if you are bitten by a snake?

Stay calm. “Keep your wits about you,” says Dr McEwen.
Try to get a good look at the snake so you can identify it. Dr McEwen says your doctor needs to know what snake has bitten you so they can treat you with the appropriate antivenom if necessary.
“Use your cellphone camera, if you can, to take a photo of the snake. We’re in contact with some very experienced herpetologists (snake experts) and often send them photos that patients have taken to help identify snakes accurately.”
Get to the hospital straight away. “The most important step is to call for help and get medical attention as soon as possible.”

Dr McEwen stresses that people must not wait for symptoms to show before they decide they need help. “Don’t take a ‘wait and see’ approach to snakebites. Neurotoxic venom can start working as rapidly as within half an hour. Immediately call for an ambulance or get someone to take you straight to hospital so we can monitor you in a safe environment to see how the symptoms progress.”

Five minutes between now and forever

Tue, 10 Sep 2024 09:13:41 GMT

One call for suicide prevention could save a life

Suicide may be an uncomfortable topic – but talking about it is very necessary as it can help prevent tragic, untimely deaths.

World Suicide Prevention Day, an annual awareness day marked on 10 September 2024, highlights the importance of ongoing awareness and public education to help reduce suicide rates and reach those who need professional support in time.

“Suicide is complex and there is rarely a single deciding factor, however depression, anxiety, and substance abuse, as well as interpersonal conflicts or a crisis, are often underlying risk factors,” says Megan Gonsalves, Netcare Akeso’s crisis line and marketing manager.

“While some suicides are planned carefully months in advance, many appear to be impulsive and may be acted on within hours or minutes of being conceived. A study by the Harvard School of Public Health found that one in four survivors of almost lethal suicide attempts deliberated for less than five minutes before acting on the impulse, and a mere 13% of those interviewed had thought about suicide for more than a day.

“Other studies suggest almost half of people attempt suicide within just 10 minutes of the thought entering their minds, while Australian research indicated 40% acted on suicidal thoughts within the first five minutes,” Gonsalves says.

“It is deeply disturbing that in a mere five minutes, a person can decide to end their life forever. Netcare Akeso is creating awareness with a campaign One call – the difference between now and forever to intervene in these crucial minutes when a person may be contemplating suicide.”

This campaign aims to help suicidal individuals break free from the ‘fog’ they may feel trapped in and move into a clearer and brighter space where hope can be found beyond the immediate crisis they are experiencing.

“One call to check on a friend, colleague or family member who is going through a difficult time, or placing one call to a mental health resource for help can make the difference between life and death for someone who’s suicidal,” Gonsalves says.

Megan Gonsalves, Netcare Akeso’s crisis line and marketing manager

Suicide facts by numbers

Suicide accounts for approximately 700 000 deaths each year worldwide.
For each suicide, there are an estimated 20 suicide attempts.
In 2019, suicide was the fourth leading cause of death among 15–29-year-olds globally.
It is estimated that one in five people has suicidal thoughts in their lifetime.
South Africa is ranked in the top 10 countries by suicide rate with 23,5 suicides per 100 000 people, and this represents approximately 14 000 suicides each year

The World Health Organization's (WHO) goal for suicide is to decrease the rate by one-third globally by 2030. To achieve this, countries with high suicide rates must prioritise interventions, as they are proven to be effective.

Acting to intervene in the space of opportunity before somebody takes their life can be as simple as making a phone call. Don’t hesitate to reach out if you know someone who may be at risk of suicide.

Five steps to help a person at risk

“It can be challenging to know how best to approach someone who may be having suicidal thoughts, however bear in mind that this conversation needs to be direct to ascertain the risks and to determine what can be done to help the person,” Gonsalves says.

Five practical steps when you are concerned someone may be at risk:

Ask: Be direct in asking the person whether they are thinking about suicide or have plans to harm themselves.
Be there: Listening without judgment is key to understanding more about what the person is thinking and feeling. Remember, this is not an easy conversation for them either. You don’t need to give advice; just listen and be there for them.
Help them keep safe: Don’t leave the person alone. Where possible, reduce access to any harmful items or areas where suicide could be attempted. Asking the person if they have a plan can help to identify these factors and help keep them safe if suicidal thoughts occur.
Connect with professional help: There are many resources and suicide helplines that can be contacted, including the Netcare Akeso 24 hour crisis line on 0861 435 787 and the South African Anxiety and Depression Group (SADAG) 24-hour suicide crisis helpline on 0800 567 567. Help guide the person to a safe place for support and, if possible, help them reach out to these resources.
Follow up: Stay in touch with the person after the crisis or after they have contacted a professional. Ongoing support is important to mental health and wellbeing.

Tragically, stigma remains the main barrier to people seeking help when they are at potential risk of developing suicidal ideation. This could be influenced by the taboo many feel when it comes to discussing mental health and a misplaced, though widespread societal belief that suicide shouldn’t be spoken of. This only perpetuates feelings of shame or failure that stand in the way of people reaching out when they need support and treatment.

The more people who speak up to encourage suicide prevention strategies and know how to offer support to someone who could be at risk, the greater our chance of dismantling the stigma and reducing the unquantifiable burden of tragedy the suicide rate represents.

Addressing myths about suicide

Myth 1: Talking about suicide will encourage suicidal attempts

“Talking about suicide can help reduce suicidal ideation. Talking about these difficult topics increases the likelihood of someone seeking help. Having a conversation around suicide can help to provide alternative views for someone struggling to see beyond their specific existing circumstances,” says Megan Gonsalves, Netcare Akeso’s crisis line and marketing manager.

“Asking someone in crisis if they are thinking about suicide can help to open a conversation that they otherwise may not know how to begin.”

Myth 2: Suicides happen without warning

“While people do not always share their thoughts, some studies have found that almost 50% of people do tell someone about their suicidal thoughts or behaviours. This is not always obvious or direct but could be through non-verbal gestures or subtle comments.

“Even if someone doesn’t directly say they may be experiencing suicidal thoughts, there are often warning signs to look out for,” she says.

Talking about suicide, statements such as “I wish I were dead”, “I wish I hadn’t been born”, or preoccupation with death or dying
Having access to weapons or means to take their own life, or engaging in risky or self-destructive behaviour
Withdrawing from social contact and isolating from others
Feeling trapped, hopeless, or helpless about a situation
Increased use of alcohol or drugs
Giving away belongings or getting their affairs ‘in order’ and saying goodbye to people as though they won’t see them again
Personality changes, severe anxiety or agitation
Extreme changes in normal routine, such as sleeping patterns
Previous history of suicide attempts
Experiencing trauma or crisis

Myth 3: Once a person is intent on suicide you cannot stop them

“Suicide can be unpredictable, but in many cases, it can be preventable. A person thinking about suicide is often experiencing hopelessness or extreme emotional pain and helping them to address those feelings and seek support can make a lifesaving difference,” Gonsalves says.

Myth 4: People who threaten suicide are seeking attention

“Any threat or talk of suicidality should be taken seriously. Some people open up to those around them about how they are feeling, which can be a way of asking for help. If someone talks about feeling suicidal, it is important to be kind and sensitive, avoid blame or judgement, and ask direct questions to understand the risks,” Gonsalves says.

“Connecting with professional mental health or medical support should be encouraged and facilitated if necessary.”

The lifelong importance of dental health

Wed, 04 Sep 2024 08:32:28 GMT

You’re never too old or too young to take your dental health seriously

As Oral Health Month and Spring kick off in South Africa, this is a timely reminder that you're never too old or too young to take dental health seriously. Get to know the dental priorities for your age group – your good health may depend on it.

“Neglecting oral care is not just risking cavities and gum disease – poor dental hygiene can potentially open the door to severe healthcare issues like heart disease, diabetes, and respiratory infections,” cautions Dr Rahul Gathiram, dental director of Netcare Medicross medical and dental centres.

Baby steps:

The oral health journey begins in infancy. Cleaning your baby’s gums is essential even before the first tooth erupts to prevent bacterial buildup.

“It is important to celebrate the arrival of your child’s first tooth, which usually happens around six months of age and, in most cases, is a lower central incisor tooth. This is the ideal time to introduce a brushing routine using a soft toothbrush and a tiny bit of infant toothpaste,” encourages Dr Gathiram.

He advises parents to begin familiarising their children with the dentist as early as six months after the first tooth has pushed through, as tooth decay can occur anytime. “Early visits to the dentist, ideally by the child's first birthday, are not only to check for cavities and developmental issues but also to educate parents on proper oral hygiene practices.”

Dr Rahul Gathiram, dental director of Netcare Medicross medical and dental centres

To avoid tooth decay as a result of bottle feeding and teeth misalignment due to sucking, try to wean your baby off of the bottle by one year of age and monitor excessive sucking of pacifiers, fingers and thumbs. Try to avoid giving your child a bottle of milk at naptime or bedtime, and never give them juice or sweetened liquid at that time.

“Bringing your child to the dentist early lays the foundations for a lifetime of good oral care habits and helps them get used to the dentist’s rooms, making for stress-free visits in the future. Ultimately, children with healthy teeth can usually chew food easily, learn to speak clearly, smile confidently and retain their teeth to a ripe old age if they continue to practise good oral and dental care,” says Dr Gathiram.

“It’s important to note that the timing of tooth eruption can vary for everyone, so do not be overly concerned if your little one takes a bit longer to get their first tooth. Remember, baby teeth are placement holders for adult teeth. So, limiting sugary snacks and drinks is important to prevent early tooth decay.”

Growing up:

“From early childhood to adolescence is an exciting time in your child's development and, on the dental front, children start losing their baby teeth at around six years, and by the age of 12, most of their permanent teeth will erupt.

“The first permanent tooth to appear is usually the first molar right at the back of the mouth. This makes it particularly important to ensure your child gets right to the back of their mouth when brushing their teeth,” advises Dr Gathiram.

Generally, the first baby teeth to fall out are the incisors, either at the top or bottom.

“It is vital to encourage children to brush their teeth twice daily and clean each tooth's front, back, and chewing surfaces. It is also advisable for children to start flossing between all teeth at least once a day. Regular dental check-ups every six months are key during this stage of rapid change in the mouth.

“Taking your child to the dentist is the best way to prevent problems such as tooth decay and malocclusion, or crooked teeth, from a young age. Dentists can also identify their fluoride needs. As they get older, fissure sealant – a durable sealing resin agent applied to decay-prone fissures on the chewing surfaces of permanent teeth is often recommended by your dentist when the permanent teeth appear in the mouth.

“The teenage years bring their own dental challenges, such as orthodontic treatments and increased risk of cavities due to dietary choices. Braces or removable appliances are often recommended during this period to correct misalignments and ensure proper bite function,” adds Dr Gathiram.

Primetime:

As individuals transition into adulthood, the good oral hygiene habits developed while growing up must be continued. Brushing twice daily and flossing daily are crucial to prevent gum disease and cavities. Regular dental checkups and cleanings are also needed to keep smiles bright and healthy.

“It is important to be aware of the impact that lifestyle choices, such as smoking and diet, have on oral health. The use of tobacco can lead to gum disease, tooth decay, and oral cancer. Consuming sugary drinks and snacks, on the other hand, can result in enamel erosion and cavities. Dental problems like impacted wisdom teeth and gum disease are common in this age group and should be addressed promptly,” he says.

Golden years:

“Getting older does not mean the end of your oral health journey – no matter your age, good oral hygiene habits are always important. Stay vigilant for dental issues, such as gum disease and tooth loss, that can arise with age. Regular visits to your dentist are essential as they can help you navigate the unique challenges of oral health in your golden years,” says Dr Gathiram.

According to Harvard Health, as people age, they face new challenges in maintaining oral health. Medications can cause dry mouth, increasing the risk of cavities and gum disease. Older individuals are also more susceptible to oral cancer, which requires regular screenings. Maintaining a diet rich in calcium and vitamins can help keep teeth and gums healthy, and it is important to continue visiting the dentist regularly for cleanings and check-ups to address these issues promptly.

Keep it simple and manageable: “Don’t avoid your dentist; schedule regular check-ups if you’re not doing so already. We are fortunate to live in an age where modern dental techniques and instruments, highly effective local anaesthetic and specialised tools and treatments virtually guarantee that dental visits and procedures will not be traumatic. Many patients look forward to their bi-annual visit, coming away with wonderfully clean teeth and knowing their oral health is in check. Every smile has its own unique journey; let’s make it a healthy one,” he concludes.

Contact your local Netcare Medicross medical and dental centre to book your dental checkup, or visit https://www.netcare.co.za/search?path=medicross_medical_dental to make an appointment with a dentist.

A lifeline of hope: Expanded bone marrow transplant unit opens

Wed, 28 Aug 2024 07:21:17 GMT

Haemalife doctors and Joy: (Left to right) Haematologists Dr Simon Brett, Dr Pieter de Witt, Dr Hannes Koornhof and Dr Michael Cass are pictured with Joy Schoor (centre) at the bone marrow transplant unit at Netcare Kuils River Hospital.

You could be someone’s one chance at life

For some people with life-threatening blood cancers, a bone marrow transplant may be their only remaining treatment option. The launch of the upgraded and expanded Haemalife Bone Marrow Transplant (BMT) unit at Netcare Kuils River Hospital signals more hope and an opportunity to create lifesaving awareness of South Africa’s bone marrow donor registry programmes.

“The time sensitive and highly specialised nature of haematology treatments, and the growing need for such services in the Northern suburbs of Cape Town and for patients from further afield, emphasises the importance of the additional capacity that has been created with this larger bone marrow transplant unit,” says Dirk Truter, general manager of Netcare Kuils River Hospital.

“We thank Dr Hannes Koornhof and Dr Pieter de Witt, the founding haematologists of the Haemalife practice, as well as their colleagues Dr Michael Cass, Dr Simon Brett, medical officer Dr Liza Stockland, and all members of this immensely caring team for their dedication to improving the facilities and growing the expertise available to help our patients and their families.”

Dr Koornhof says that the BMT Unit opened eight and a half years ago with eight beds and was very soon at full occupancy. The unit’s first of many successful bone marrow transplants was performed in February 2016.

“While the expansion of capacity is welcome news for patients who urgently need treatment and their referring doctors, there is also an urgent need for more South Africans to consider registering as potential bone marrow donors to contribute more diversity to the international bone marrow donor registry and increase the hope of finding suitable life-saving matches both at home and elsewhere in the world.”

“Specialised single isolation rooms, each with their own en suite bathroom and ventilation system, are required when a person has a bone marrow transplant or intensive chemotherapy,” adds Dr Cass.

“Before a bone marrow transplant, we need to suppress the person’s immune system with chemotherapy and specialised medications to reduce the risk of the patient’s body rejecting the introduced donated stem cells. For this reason, a very controlled environment is needed to protect the patient for three to six weeks,” he explains.

“With the Department of Health’s approval of the application, the BMT unit has now been expanded to 19 beds. The original isolation suites have been upgraded, and an upper level of isolation suites has been added on the floor above with an interlinking staircase, making this one of the largest bone marrow transplant units in the country.

“Bone marrow transplants may be indicated for leukaemia, multiple myeloma or lymphoma, or when a person’s body is unable to produce enough healthy blood cells due to a health condition or from the effects of prolonged treatment,” Dr De Witt says.

The Netcare Kuils River Hospital unit is the only facility in the northern suburbs to provide bone marrow transplants and treat acute leukaemia. Although adult patients are the focus, the unit also treats patients as young as ten years old. Holistic, personalised services are provided for all stages of treatment, including survivorship and palliative services that support the patient and their loved ones throughout.

The newest haematologist to join the multidisciplinary team, Dr Simon Brett, adds that some bone transplant patients may be able to receive a bone marrow stem cell donation from a family member if there is a close enough tissue match between them.

“For those who do not have a familial matching donor, there is only an average of one person out of every 100 000 tested who might be a compatible tissue match. The more people who register as bone marrow donors, the more patients with blood cancers or other blood disorders can be matched for a potentially lifesaving bone marrow transplant.”

Registering as a bone marrow donor is free of charge and non-invasive, and could save a life. For more information, please visit https://sabmr.co.za/become-a-donor/ and https://www.dkms-africa.org/get-involved/become-a-donor .

Contact the HaemaLife Bone Marrow Transplant Unit at Netcare Kuils River Hospital on 021 900 6277; via email reception@haemalife.co.za or visit https://haemalife.co.za/ .

Leukaemia survivor returns as medical student

Bone marrow transplant inspired Joy’s career choice

Joy Schoor was just 14 when she was diagnosed with acute myeloid leukaemia. Now, celebrating eight years in remission, she is paying forward her second chance at life by studying to be a doctor and encouraging the public to join the registry of potential stem cell donors.

“I was returning with my parents from a holiday in the Kruger National Park when suddenly I started feeling sick and developed a fever. At first, doctors thought it could be a common infection and had to rule out malaria. After more tests at various hospitals, I was diagnosed on 10 January 2016 – although I didn’t fully understand what it meant at the time,” Joy, now 23, remembers.

“I have such a supportive family, and with my whole future in question, my parents heard that haematologists Dr Hannes Koornhof and Dr Pieter de Witt of Haemalife were equipped to offer the specialised bone marrow transplant procedure at the nearby Netcare Kuils River Hospital.”

As the first patient to receive a lifesaving bone marrow transplant at the hospital in 2016, it was a poignant moment when Joy was recently invited back as a guest of honour to cut the ribbon officially declaring the expanded comprehensive bone marrow transplant unit open alongside the haematologists who treated her then.

“My journey through three rounds of chemotherapy was not easy, but it is one of the reasons I was inspired to study to become a doctor. The warmth, compassion and kindness my family and I experienced at the unit during this difficult time in my teenage years stayed with me and made me want to help others in their time of need,” Joy says.

“Even though I was so young, the doctors explained everything so carefully to me and my parents and did everything they could to make us feel at home and as comfortable as possible in the circumstances.

“I am grateful that my brother, who was only 12 at the time, was an almost perfect tissue match and he agreed to donate stem cells to me for the bone marrow transplant I needed.

“There is only a 25% chance of a sibling being a match, and some people can have 12 brothers and sisters, and none of them are sufficient matches, so I was exceptionally lucky, and to this day can’t thank my brother enough – although he still teases me about it,” Joy says.

“Tragically, there are people in need of bone marrow transplants for whom matching donors can’t be found. As a survivor, this is why I would like to pay it forward by raising awareness of the need for more people to register as stem cell donors – you could save a life.”

Joy will also be job shadowing at the practice that saved her life as part of her medical studies later this year.

“I am making the most of my second chance at life, living my dream of becoming a healthcare professional and eight years cancer-free thanks to the specialised care I received here. I cannot tell you how significant it is for me to be cutting the ribbon at the same facility that will be a beacon of hope for many other families in the years to come,” Joy concludes.

Pono-Entle’s heartwarming homecoming

Wed, 21 Aug 2024 06:52:15 GMT

Back where he belongs - from left to right are Dr Omolemo Kitchin, paediatric pulmonologist, gynaecologist and obstetrician Dr Michael Thubisi, Pono-Entle Maluleke and Desiree Maluleke.

Netcare Waterfall City Hospital’s first baby revisits his birthplace

Thirteen years after his arrival as Netcare Waterfall City Hospital’s first baby, Pono-Entle Maluleke, affectionately known as ‘Mr Netcare Waterfall’, recently visited the place of his birth.

Born just before 09h00 on 7 July 2011, weighing a healthy 2.84 kilograms, Pono’s birth marked a significant milestone for doctors and staff at Netcare Waterfall City Hospital, which had just opened its doors.

Pono’s return to his birthplace was a memorable moment not only for him and his mother, Desiree Maluleke, but also for hospital management, staff and doctors – many of whom are still at the healthcare facility.

For Desiree, the visit felt like a journey back in time. She vividly recalls holding Pono-Entle, which means 'Beautiful vision from God’, for the first time in the hospital’s brand-new maternity ward. At the time, the hospital was one of few buildings in the area and by far the tallest. Nowadays, the area has developed into a busy metropolis and the hospital has been expanded and enhanced too, becoming a premier healthcare facility and an important part of this fast growing community.

When Desiree recently contacted Netcare to obtain a copy of the media story that was written about Pono-Entle’s birth to mark her son’s 13th birthday celebration, she was met with a delightful surprise.

“Not only did the hospital provide me with a copy of the story and some photographs, but they invited us to join them for a small celebration. The atmosphere at Netcare Waterfall City Hospital was one of pure joy when we arrived as the staff, some of whom had been present at Pono-Entle's birth, gathered to welcome ‘their firstborn’ back home. A special tea party was arranged, and Pono received a gift hamper of healthy snacks, which filled him with excitement,” added Desiree.

She describes the experience as heartwarming. "Pono was speechless. When we came home, he could not stop talking about the experience – in fact, he still talks about it."

Dr Omolemo Kitchin, a renowned paediatric pulmonologist with 25 years of experience, and Dr Michael Thubisi, a distinguished gynaecologist and obstetrician with 32 years in private practice, were pivotal in Pono’s birth and welcoming him back to his birthplace recently. Both specialists have been with Netcare Waterfall City Hospital since its inception and have earned the admiration of their patients for their dedication and compassion.

According to hospital general manager Jaco du Preez, the doctors gave Pono-Entle a hospital tour, pointing out the advancements made over the years. “Dr Kitchin, with his expertise in paediatric pulmonology and allergies, shared insights into his daily routine, while Dr Thubisi, who finds his greatest gratification in delivering healthy babies to joyful parents, walked Pono-Entle through the maternity ward and nursery at the hospital. He even showed Desiree her file, which was the first one he ever opened.

“Pono-Entle's homecoming to his birthplace was not just a personal milestone but also a celebration of the hospital's journey and its impact on countless families. The staff at Netcare Waterfall City Hospital, both old and new, expressed their admiration for Pono-Entle, affectionately dubbing him ‘Mr Netcare Waterfall’. There is a deep connection between the hospital and the community we serve that makes our work so much more fulfilling,” says Du Preez.

As Pono-Entle prepares to transition from Chloorkop Primary School to high school in a few months, the visit to Netcare Waterfall City Hospital serves as a reminder of where he came from. Reflecting on their life in Klipfontein View, a tight-knit community where Pono-Entle has many friends and a busy social life, Desiree says Pono enjoys drumming, a talent he has honed since the age of two and now shares with his church community. Meanwhile, Desiree is actively looking for a new career opportunity, hoping to find a role that will support their aspirations and provide stability for the family.

This visit was particularly poignant for Desiree and Pono, as it coincided with Pono-Entle entering his teenage years. What began as a search for a picture of his birth story for Pono’s birthday, turned into something much more significant, and she and Pono will never forget the day.

"We took many pictures, and it felt like a family reunion. The staff welcomed us with open arms and love, making Pono feel like a star. This event was more than just a celebration – it was a touching reminder of the love and care I felt on the day Pono was born.

“It was a moment of pride and joy, seeing Pono recognised and celebrated by the very place that marked his beginning,” concludes Desiree.

Avoiding the hypertension danger zone

Wed, 14 Aug 2024 11:38:43 GMT

Check your blood pressure to guard against ‘the silent killer’

Do you know your blood pressure reading? If not, it might be time to find out.

Dr Zelda Brits, a general practitioner at Netcare Medicross Roodepoort, says hypertension can go undiagnosed for years, causing significant damage to the body. In some cases, this can eventually trigger a severe health crisis, prompting the patient to seek medical care.

“A worrying factor about this common life-threatening condition is that many people don’t realise they have it, giving it its ominous nickname – the silent killer,” explains Dr Brits. “The prolonged effects of high blood pressure, or hypertension, are just too serious to be taken lightly.”

Symptoms of hypertension

While many people can’t put their finger on exactly what they are feeling when their blood pressure is too high, some do experience symptoms associated with hypertension, says Dr Brits.

“A patient may experience headaches, shortness of breath, nosebleeds, dizziness, chest pain, blurred vision or swollen feet. These symptoms are often dismissed as merely feeling out of sorts or consequences of a hectic lifestyle.

“This can lead to a situation where the first sign that one’s blood pressure is unacceptably high may be something as serious as a stroke, a heart attack or heart failure. For patients with longstanding hypertension, which has already caused organ damage, the devastating result can be kidney failure or vision loss,” says Dr Brits.

“This is why it’s important that your Netcare Medicross medical practitioner, as part of our point of care approach, checks your blood pressure when doing your health checks and assesses whether any interventions are required.”

Simply put, blood pressure is an indicator of how much force the blood circulating in the body exerts on the walls of the arteries, which are the blood vessels that carry oxygenated blood away from the heart. If blood pressure is higher than recommended levels over time, this can cause damage.

How do I know I’m at risk?

Dr Brits says the risk factors for hypertension can be related to either lifestyle, genetic or medical factors, or a combination of these.

“The lifestyle factors can be hard to acknowledge, but these are notable contributors towards hypertension that must be addressed alongside the need for medication as part of the treatment plan.

“A diet high in salt and saturated fats can lead to elevated blood pressure, and people who are mostly sedentary with little physical activity may also be at risk. If their weight is not under control, this can cause higher blood pressure, and in addition, smoking and drinking excessive amounts of alcohol can also increase one’s risk,” she says.

Dr Brits says those with a family history of high blood pressure should discuss this with their medical practitioners. “Their GP should be made aware of their family health background so they can monitor their patient.” Existing medical conditions like diabetes, sleep apnoea, kidney disease and high cholesterol are also associated with hypertension, and as one gets older, the likelihood of increased blood pressure increases. Pregnancy and certain medications can also affect one’s blood pressure.

Netcare Medicross general practitioners and nurses support their hypertensive patients to help them manage their condition. “Your GP will assist with screening for related conditions such as diabetes or excess cholesterol and triglycerides and make valuable suggestions about lifestyle changes. If adhered to, these can be very effective.

“If these measures alone are not sufficient, there are a range of anti-hypertensive medications which can help to reduce blood pressure, taking the patient out of the danger zone for strokes or heart and kidney failure.”

Dr Brits emphasises the importance of further tests to evaluate other potential complications of hypertension, such as damage to the heart and kidneys, and to manage these if they occur. Additionally, monitoring for possible side effects of the prescribed medication and ensuring it is effective is crucial.

Can hypertension be prevented?

Regarding prevention, Dr Brits advises that there are proactive steps people can take to assist with preventing hypertension.

“Start with a balanced diet that is low in salt and saturated fats. Ensure you exercise regularly and do your best to maintain a healthy weight. Take pragmatic steps, guided by your GP, to manage your stress.

“A really big favour people can do for themselves is to avoid drinking too much alcohol and to quit smoking. Don’t forget to go for your medical check-ups where blood pressure monitoring is integrated into care when you visit your local Netcare Medicross GP.

Dr Brits recommends that all adults get their blood pressure checked at least every year. “But, if there are any chronic conditions that increase your risk, your blood pressure should be checked each time you visit your general practitioner to have your chronic medication reviewed and renewed. If any of the risk factors exist for a young patient, screening should start even before adulthood.”

Dr Brits recommends that an ECG to evaluate the heart should be done yearly for all high risk patients. “It’s important to screen for hypertension regularly because early intervention by your doctor will reduce long-term complications. Don’t despair if you have existing medical conditions that are putting you at risk because your doctor can help you take care of those. Sound advice and guidance are available to assist all our hypertensive patients.”

From one mother to another

Wed, 07 Aug 2024 09:34:05 GMT

Breastmilk donation – a priceless gift

To give cuddles, care and plenty of nourishment – the most natural expectations of a mother are not always possible when her new baby needs hospitalisation, but breastfeeding women have an opportunity to help the newborns of other mothers with vital nutrition.

Nyasha Mhuru Rukure is one such parent-in-need. Her baby boy Liam was born last month at just 29 weeks old and was admitted for intensive care at the Rahima Moosa Mother and Child Hospital. For Nyasha, the journey to the hospital is a hurdle that she often cannot overcome meaning that Liam’s urgent need for breastmilk must be met another way.

It is here that the new human milk bank at the facility, established in partnership with Netcare, makes an immeasurable difference in the life of Liam and many other tiny patients like him, says Verena Bolton, a neonatal nurse and national coordinator of Netcare Ncelisa human milk banks.

Ivy Nyarkoah, here with her daughter Bregail, is paying it forward despite tragically losing Bregail’s twin brother, and is donating her excess breastmilk after an extremely premature birth experience, following which the babies received donor breastmilk for the first few days of life.

“Breast milk donors who have been tested for safe donation are a lifeline for babies admitted in hospital neo-natal intensive care units (NICUs), helping to ensure that they receive the specialised nutrition their bodies need – often in a fight for their life,” she says.

Qudsiyah Kassim, a registered dietician who manages newborn nutrition in the hospital’s NICU adds that breastmilk is crucial in preventing infections and other complications but many mothers in the public sector struggle with the logistical and financial difficulties preventing them from seeing and feeding their little one every day.

“While Netcare has historically supported public sector facilities with donated breast milk from the five national Netcare Ncelisa human milk banks, the establishment of an on-site milk bank is an important step for the Rahima Moosa Mother and Child Hospital. This will allow them to recruit donors directly at the facility and manage the processing, in partnership with Netcare,” explains Bolton.

Paying it forward

In the spirit of paying it forward, Ivy Nyarkoah is donating her breastmilk to the human milk bank at Rahima Moosa Mother and Child Hospital while her baby girl, Bregail – who weighed just 820g at the time of her birth – is admitted there.

Ivy, a first time mother, endured heartbreak shortly after giving birth to extremely premature twins at 28 weeks – a boy and a girl. Her son tragically did not survive but despite the ongoing pain of his loss, she is determined to make a difference in the lives of other babies by donating breast milk, as much as she is able to.

“When my babies were born they desperately needed the right nutrition and while we waited for my milk to come in they received donor breast milk – a gift which I am really grateful for. This experience has encouraged me to donate and having the milk bank here at the hospital means I am able to do it easily.

“Bregail is incredibly strong, she weighs 1.3kg and it seems like she may be coming home with us any day now. I plan to continue donating milk even after that and dropping it off every two weeks. After all, if others are willing to donate then why not me?” she concludes.

For more information about applying to donate breast milk directly to Rahima Moosa Mother and Child Hospital please contact the dietitian’s department on 011 470 9245.

To apply to donate breastmilk to one of the five Ncelisa milk banks at Netcare hospitals around the country, please visit the Netcare website or visit 086 143 5787.

Excellence in cardiac care with an eye on the future

Thu, 01 Aug 2024 16:13:33 GMT

(From left to right) Cardiologist Dr Sanjay Maharaj, resident cardiothoracic surgeon Dr Jehron Pillay, Netcare St Anne’s hospital general manager Sharon Singh and physician Dr Devan Gounder at the opening of the specialised cardiac care unit at Netcare St Anne’s Hospital.

Dedicated, world class heart unit boosts KZN capacity

Specialised cardiac care capacity in the KwaZulu-Natal Midlands has received a shot in the arm with the launch of a dedicated unit at Netcare St Anne’s Hospital.

“In recent months, on a daily basis, the city has had a shortage of cardiac beds. This initiative helps to address the growing need for specialised cardiac care here while ensuring timely and effective treatment in a state-of-the-art facility,” said general practitioner Dr Ellesh Narbharam Soni, who is the branch chairperson for the SA Medical Association (SAMA) in the KZN Midlands.

The specialised cardiac care unit, which strongly focuses on excellence in patient care through multidisciplinary specialist collaboration and advanced technology, will help alleviate this need for cardiac patients and enhance the quality of care available in Pietermaritzburg and its surrounding areas.

The frequent lack of beds has meant local patients must be transferred to hospitals out of town. The unit also complements Netcare St Anne’s Hospital’s existing facilities for cardiac patients, including a high-tech cardiac catheterisation laboratory and a fully equipped cardiac theatre.

“The opening of the new unit represents a culture of innovation, compassion, and excellence in cardiac care. It emphasises the importance of our multidisciplinary team, and we, as the general practitioners, form part of this team to help provide comprehensive cardiac care to our patients, ensuring holistic treatment and improved outcomes,” Dr Soni said at a ribbon-cutting ceremony hosted at the hospital and attended by specialist doctors, general practitioners, nurses and other support staff.

Resident cardiothoracic surgeon Dr Jehron Pillay, who has been at the forefront of establishing the new unit, said their team has developed an impressive spectrum of cardiac care complementary to the work others are doing in the field. “We’re doing advanced heart failure therapy, advanced catheterisation and advanced lung surgery, including transplantation.”

He paid tribute to the healthcare workers at Netcare St Anne’s Hospital, describing them as “a diverse, capable team with the potential to develop the unit to be on a par with anything in the world”.

Dr Pillay explained that the facility’s high-tech catheterisation laboratory houses sophisticated diagnostic imaging equipment used to visualise both the vascular system and the chambers of the heart. This enables cardiologists to diagnose specific cardiovascular conditions accurately, guiding their treatment through minimally invasive interventions.

“While the equipment we already have is state-of-the-art, we’ll be developing it continually. We are also planning more training to further upskill our team,” said Dr Pillay.

Speaking at the launch, the chairperson of the Netcare St Anne’s Hospital physician advisory board, resident physician Dr Devan Gounder, said the unit has a dynamic array of medical professionals on hand, including resident cardiologists Dr Yuvashnee Govender and Dr Kyi Shein.

“Not only does the facility have the support of local cardiologists and cardiothoracic surgeons and the hospital’s management team, but we also have a highly skilled multidisciplinary team available to assist with other non-cardiac complications. These specialists include intensivists, general physicians, pulmonologists, neurologists and nephrologists. Our cardiac ICU and ward nurses have recently received further advanced training to provide quality care to our patients in accordance with strict treatment and infection protocols.”

Commenting on the new development, resident cardiologist Dr Yuvashnee Govender said: “This has been a long awaited and much needed development for the people of Pietermaritzburg and surrounding areas. I am excited about the introduction of a dedicated cardiology discipline at the hospital as it holds the potential to significantly improve the quality of care for our cardiac patients. This development is not just an important milestone for the hospital, but a beacon of hope for the entire community. I am looking forward to working closely with the highly motivated and skilled cardiac team to deliver the best possible outcomes for our patients.”

Netcare St Anne’s Hospital general manager Sharon Singh said the unit adds significant value to the hospital’s wide range of care offerings and will support the work being done at Netcare St Anne’s Hospital, which is the only private level one trauma facility in the province.

According to Singh, having additional beds available in the new specialised cardiac care unit will enhance the hospital’s ability to administer person centred care to those admitted with cardiac-related symptoms through the trauma centre. “Our evidence-based approach is enhanced by our high-tech digital tools, resulting in a treatment plan specific to each patient. No two hearts are the same. Therefore, no two treatment plans can be the same,” Singh says.

Singh paid tribute to their dedicated nursing staff who have undergone specialised training to prepare them for the opening of the unit.

“It is so gratifying to see the synergy between the different specialists and various departments, always placing the patient at the centre of all our efforts.”

The road to NHI needs a safety belt

Mon, 29 Jul 2024 08:29:51 GMT

Craig Comrie, Principal Officer and Chief Executive of the Health Funders Association

Funding healthcare resources cannot be left to government alone

A journey starts with the destination, and then we plan how to get there. The route we choose using the means available – particularly in city traffic or South African healthcare – determines when we can expect to arrive at our intended destination.

As South Africans, we have set our destination as a future of healthcare equality, but the route mapped out for us in the NHI Act is potholed, long, and winding…

As the Health Minister points out, structural imbalances between private and public healthcare must be addressed. However, the fork in the road ahead could put us on the highway to equalising healthcare to the detriment of existing scarce healthcare resources, which may result in more rationalisation of services for those who truly need them.

The President’s recent call for collaboration with the private sector could be the safety belt our health system needs, provided these conversations include private health funders and lead to meaningful legislative amendment and policy direction.

The key to this collective journey towards equality must be to level up the quality of healthcare rather than compromise patient care for all. This is necessary to ensure South Africa does not lag behind international medical and technological developments and skills.

Long overdue regulatory enhancements that could make basic medical aid benefits affordable for all full-time employed South Africans are within arm’s length, offering a sustainable shortcut towards universal healthcare objectives and the realisation of equal access to a full, quality healthcare system in South Africa.

Like petrol, world-class healthcare does not come cheap and equitable healthcare does not mean that money alone creates equity. With extensive expertise in a competitive, service-oriented approach to managing healthcare needs and resources, private health funders remain an attractive partner to the full realisation of universal healthcare coverage.

Keeping pace with modern medicine and maintaining advanced services in the country to benefit an expanding number of South Africans will require significant private healthcare partnerships for the immediate to indefinite future.

There is no free ride in healthcare, public or private. To help precipitate a greater equilibrium, more employed people must be on the bus that contributes taxes to provide for those reliant on public services, preferably without drawing on the public health purse themselves.

Updating regulations to provide protection against financial risk and cost drivers currently facing medical schemes, such as anti-selection and an outdated basket of Prescribed Minimum Benefits (PMBs) or health cover as a mandatory employment benefit, would dramatically improve the affordability of belonging to a medical scheme and expand its benefits to more people thereby relieving the pressure on public facilities.

Considering the scale of South Africa’s health needs, we will need capable leadership and governance with an attitude of cooperation to elevate the quality of care available to all. The social solidarity principles that underpin how medical schemes operate provide an opportunity for the advantages of not-for-profit private health funding partners to support the journey towards universal health coverage objectives.

Spreading ‘paws-itivity’, four paws at a time, for patients living with cancer

Tue, 23 Jul 2024 13:10:56 GMT

Therapy dog Honey enjoys a special moment with Mrs Penelope Wiggill at Netcare Olivedale Hospital’s radiotherapy unit.

Photo credit – Songi Langeni of Artfelt.

Furry care team are putting smiles on patients’ faces

A rare form of healing has taken root in the radiotherapy unit at Johannesburg’s Netcare Olivedale Hospital, where therapy dogs are doing more than hospital rounds by transforming the essence of patient care and bringing joy to patients living with cancer.

Commenting on the programme, Netcare’s Cancer Care quality manager, Dr Julie Herold, says, “These unconventional therapists, with their wagging tails and gentle spirits, bring an unparalleled sense of comfort, joy and warmth to patients in ways that no conventional treatment can.”

Orlando, a beautiful Golden Retriever, and his charming colleague Honey, a Labrador, are therapy dogs on a mission to bring comfort. Prioritising patients' health and safety, the dogs are fully vaccinated, impeccably clean and groomed, and dressed in their ‘TOP Dogs’ uniforms. They visit the radiotherapy unit at Netcare Olivedale Hospital on the first Monday of every month between 11h00 and 12h00, offering tender loving care and a morale boost to patients undergoing radiation treatment for their cancer.

Dr Herold notes that the presence of therapy dogs in radiotherapy units, like the one at Netcare Olivedale Hospital, aligns with a growing trend in the healthcare industry. “Dr Cindy Aitton, the Head of Netcare’s Cancer Care division, is a strong advocate of this initiative and has played a crucial role in its implementation across Netcare facilities. Our ultimate goal is to extend the benefits of animal therapy to all our radiotherapy units, enhancing patient care and wellbeing.

“Research indicates that on a physical level, therapy dogs can help lower blood pressure, increase beneficial hormones, and decrease stressful hormones. But the real benefit is on a psychological level, as therapy dogs can help with stress relief and ease feelings of loneliness and depression. The interaction with the dogs gives patients some sense of normality and loads of selfless love and affection when coming for their radiotherapy treatment. Interacting with the dogs is also meaningful and impactful for our staff, who thoroughly enjoy their presence. The therapy dogs bring joy and touch the lives of our patients and our staff, brightening up their day at work. It is lovely to see everyone welcoming the dogs as they walk around the hospital greeting familiar faces,” says Dr Herold.

The comforting effects of animals have been noticed throughout the years, with Florence Nightingale recommending "a small pet animal" as a good companion for the sick. A growing number of studies, including “The ‘pet effect’ in cancer patients: Risks and benefits of human-pet interaction” (Mei Mei Chan, Gonzalo Tapia Rico 2019) for The Royal Adelaide Hospital, support this anecdote with evidence that animals really can aid in the healing process, particularly for patients who are facing the challenges of a long therapeutic journey.

Radiation therapy unit manager at Netcare Olivedale, Nancy Tshishimbi, has seen the difference in patients since the TOP Dogs programme was introduced earlier this year: “Bringing therapy dogs into our radiation unit has transformed the experience, opening a whole new world for patients. You can see their eyes light up with joy when they see the four-legged therapists.”

“The dogs are extremely well behaved and gentle, and the difference in patient morale is clear; these dogs bring a sense of calm and happiness that traditional treatments alone cannot provide,” adds Nancy.

Wendy Carter, TOP Dogs area coordinator for Johannesburg, says the therapy dogs all have exceptional temperaments and are assessed continuously. “These dogs must be calm, gentle, and responsive to the needs of individuals experiencing physical and emotional stress.

“TOP Dogs recruits their members from the public who are willing to volunteer with their pets, together as a human-dog team. Critical in the selection of the dogs is that they have an already existing confidence and calmness around other dogs, people and unusual surroundings. At TOP Dogs, we often say therapy dogs are “born”, not “bred”. Our ethos is outlined in the Therapy Dog Bill of Rights to ensure that the wellness of our pets when performing the role of therapy dogs is always upmost in the handler’s mind. A gentle demeanour suitable for interacting with patients of all ages is most important. Handlers, too, undergo training to ensure they can effectively manage their dogs and support the patients they serve.

“Patients can choose whether to interact with the dogs at all. Depending on their needs, the dogs may place their paws on the patient’s arm or hand or rest a head on the patient’s lap. Some of the dogs will ‘speak’ on command,” says Wendy.

She explains that extremely rigorous hygiene protocols are observed to ensure that the health and wellbeing of patients are in no way compromised. “Dogs are bathed and groomed 24 to 48 hours before hospital visits. They have their teeth cleaned, mouth fresheners applied, and even their nails filed. They are also sprayed with an anti-bacterial spray. As they enter the reception area of the radiotherapy unit via a separate entrance, their paws are sanitised to remove the dust they may have picked up on their paws when crossing the car park. After touching the dogs, the hands of the patients are also sprayed with an anti-bacterial cleanser as a further precaution.

“We have positively impacted the lives of hundreds of people in need, and our dearest wish is to continue improving the lives of young and old in all stages of health,” concludes Wendy.

The Touch Our Pets Therapy Dogs, known as TOP Dogs, and their handlers are part of a volunteer animal-assisted therapy programme established in 2008 and are well known for the good they do in the communities they serve. This form of complementary care is increasingly common in hospitals, rehabilitation and frail care centres, children’s homes, homeless shelters, and hospices. Wendy and her team also do ongoing rehabilitation work with stroke and major accident victims while visiting facilities such as Netcare Rehabilitation Hospital, Netcare Milpark Hospital and others. Follow this link to read more about TOP Dogs and the vital work they do – https://www.therapytopdogs.co.za/

Ready to take life by the horns after second transplant

Thu, 18 Jul 2024 05:36:27 GMT

Milestone 200 ^th kidney transplant for UCT Private Academic Hospital

In a landmark 200th kidney transplant for UCT Private Academic Hospital, a young man who has consistently defied the odds now has another chance at a full, healthy life – his father stepping up to the plate as his kidney donor.

Thirty four-year-old Kevin Vicars was born with renal complications, which – according to his doctor at the time – were incurable and meant that he likely had just weeks to live. His shattered parents took him home to love and care for their precious boy as long as time would allow but Kevin rallied and remembers a happy, normal childhood apart from some regular blood tests.

“In fact, the very first time I was ever hospitalised was when I had my first transplant at the age of eight after my health took a downturn the year before. That transplant gave me an additional 25 years, which is far longer than expected, with a deceased donor kidney.”

Kevin Vicars (right) is raring to take on the next chapter of life following his recent kidney transplant. His father John (left) is the donor who gave him another chance at life in a landmark 200th kidney transplant for UCT Private Academic Hospital.

“This allowed me to live a full, active life, so much so that I represented South Africa in the 2007 World Transplant Games in Bangkok, where I won a gold medal for squash – in part due to training hard but also thanks to the support of my parents, Professor Mignon McCulloch who saw me through my first transplant and my nephrologist Dr Piers Stead who continue to play a huge role in my journey,” he says.

Professor Elmi Muller, a transplant surgeon practising at UCT Private Academic Hospital, notes that at this milestone for the hospital, the Vicars family stands as a shining example of what good health can mean, not only for a transplant recipient but also for a donor – even later in life.

“Kevin’s father, John, is 67 years old, but he has worked hard at being in good shape to give his son the best possible chance with this kidney transplant. Transplantation is not always feasible and is never an easy process for donor or recipient, but maintaining good health can make all the difference,” she notes.

Now, after his second transplant, which took place in April this year, Kevin is embracing his next chapter with renewed energy. He is already back in fitness training, taking the ups and downs of recovery in his stride.

“It’s a process, but I am feeling good, and I’m ready to take life by the horns. Now that I’m in my 30s, I am thinking about settling down, starting a family and travelling more. My father has blessed me with the gift of his kidney and is doing amazingly well himself. I intend to show him my gratitude by living my best life,” says Kevin.

Hospital’s history of transplant achievements

Reflecting on the hundreds of patients and loved ones whose lives have been touched by the transplant programme at UCT Private Academic Hospital, Prof Muller notes that this has also included many high-risk patients who require specialised solutions.

This has led to the centre offering the only private ABO incompatible kidney transplantation programme in the country, further meeting the needs of high-risk patients as well as giving patients more options when it comes to identifying potential donors.

Dr Zunaid Barday, a nephrologist practising at the hospital explains that ABO incompatible transplantation solves the problem of certain blood group incompatibilities between recipients and donors, which is a key factor in ensuring that the recipient’s body does not reject the donor kidney.

“In the simplest terms, we use a highly specialised and efficient type of medical technology that specifically filters out the antibodies from a recipient’s blood prior to transplantation, making it possible for them to receive a kidney from a person with a blood type that would otherwise be incompatible. This means that the pool of potential donors is much larger, so waiting times for a donor can be dramatically reduced, giving many more people a better chance at life,” he says.

Prof Muller notes that when the programme was started in 2011, there was a need for a second centre in the Western Cape area in addition to Netcare Christiaan Barnard Memorial Hospital.

“Furthermore, I was keenly aware of the dire need among HIV positive recipients for HIV positive donors at the time – a project that Netcare fully supported, and which has proven to be essential for changing and saving the lives of so many people since,” she says.

A priceless, lifesaving gift

Prof Muller points out that while the centre has developed expertise in high-risk patients within the team, many of the transplants they perform are for low or intermediate risk patients, such as Kevin. She urges people to consider putting themselves forward as donors to help save lives.

“Think twice before you count yourself out as a potential living donor because you may well be the person who can make that difference – look at this case, John Vicars is an older donor, and it has worked wonderfully,” she points out.

Kevin strongly shares this sentiment and urges people to register with the Organ Donor Foundation. “My dad has given me a priceless gift, and before him, it was my deceased donor, so I consider myself living proof that it is no terrible thing to save lives, even when one’s time on earth has come to an end.

“Prof Muller and the team at UCT Private Academic Hospital are amazing and have all been super attentive throughout this process. Thank you to them for taking such great care of my dad and I,” he says.

Commenting on the 200 ^th kidney transplant, Mande Toubkin, general manager emergency, trauma, transplant and CSI at Netcare congratulated the team. “Thank you to the remarkable transplant team at UCT Private Academic Hospital for always striving to do more. This incredible milestone is testament to your dedication to providing our patients with the best possible care – congratulations to you all, this is certainly an achievement to celebrate,” she concluded.

Protect yourself, know the warning signs of TB

Wed, 10 Jul 2024 06:35:52 GMT

Around 30% of South Africans have dormant tuberculosis

Many people don’t realise that the leading cause of natural death in South Africa is tuberculosis (TB) despite it being curable. This underscores the urgent need to boost awareness not only of this potentially fatal illness but also the crucial importance of completing TB treatment.

According to specialist pulmonologist Dr Rajesh Bodasing of Netcare uMhlanga Hospital, about 30% of South Africa’s population has latent, or dormant, TB.

“This means a person has been exposed to TB but has no symptoms at all as their immune system has managed to keep the disease under control. This is quite common in South Africa because we are in a high TB endemic area.”

Dr Bodasing explains that TB can be contracted at any age. “The general symptoms to look out for are fatigue, fever, a persistent cough, weight loss, and very pronounced night sweats. Patients sometimes disregard the symptoms they are experiencing and think the fatigue may be due to stress. Unfortunately, people often ignore their chronic cough as well, and so TB is generally diagnosed late.”

He stresses that the most important thing a person can do if their symptoms don’t go away after being ill is to seek medical help early. “Most times, within a week or two of viral infection, your symptoms should completely resolve. If your symptoms are prolonged, you must see your doctor.”

A clinical examination and a chest x-ray are usually the first steps in confirming or eliminating TB infection.

“If the chest x-ray suggests TB, the next step is to do a sputum test. It’s easily done, and the results from most laboratories take one or two days. We normally take that as a confirmatory test if the symptoms, the x-ray and the sputum tests suggest TB.”

Active TB means the person is experiencing symptoms of TB, explains Dr Bodasing. “When your body’s immunity can’t keep the disease under control, this leads to active TB. It’s normally picked up on a blood test or on a Mantoux test on the skin of the forearm to see if there is a positive reaction for TB infection. With active TB comes the symptoms, like a persistent cough, a fever and night sweats.”

Dr Bodasing warns that TB can affect anybody. “Generally, with active TB, your immune system is low, either from an infection or medication causing immune suppression. The HIV+ population have a higher risk of contracting TB. Overcrowding and poor nutrition are also risk factors.”

The standard regime for TB treatment is a cocktail of drugs. “Generally, for TB of the lungs, we treat the patient for six months. If the patients comply and take their full course of medication as prescribed, it is largely an effective treatment.

“Unfortunately, in South Africa, our cure rate for TB is low. This is due to multiple factors like late diagnosis and poor medication compliance among patients. People start feeling better and stop taking their medication, mistakenly thinking they no longer need it.

“Although it is very important for patients to finish their treatment, most unfortunately don’t complete the treatment, leading to multiple problems around the spread of TB and drug resistance.” Dr Bodasing says that both multidrug-resistant (MDR) and extremely drug-resistant (XDR) TB are present in South Africa. Patients with MDR and XDR TB are usually referred to specialised treatment centres.

“There are two very promising developments in the fight against TB. Firstly, TB can be difficult to diagnose; however, the emergence of tests for the rapid diagnosis of TB means that people can start treatment earlier,” he says.

“There are also exciting developments regarding a more effective vaccine for TB. Although children receive the BCG vaccine at birth and in childhood, it helps prevent serious TB infection and TB meningitis, but it has minimal effect in adulthood.

“Fortunately, there is a lot of new research and advancing clinical trials for new TB vaccines. These provide hope as if we can prevent TB, the incidence and the spread of this threat to health could be dramatically reduced.”

Top global award for Netcare St Anne’s stroke care centre of excellence

Mon, 01 Jul 2024 06:58:59 GMT

Diamond status from World Stroke Organisation and Angels Initiative

The World Stroke Organisation (WSO) Angels Initiative has awarded Netcare St Anne’s Hospital top level Diamond status recognition for excellence in emergency stroke care for the first quarter of 2024.

“We are honoured to be part of the global community of stroke centres working every day to improve the quality of stroke treatment, with the ultimate aim of securing the safest, most appropriate care to promote the best possible outcome for each person presenting with stroke,” says Sharon Singh, hospital general manager of Netcare St Anne’s Hospital.

Lifesaving standards in stroke care

According to WSO Angels Initiative, worldwide every half hour a person who suffers a stroke and could have been saved, either passes away or suffers lifechanging brain injury, because they were not treated in a hospital that follows the internationally recognised criteria in stroke management.

Netcare St Anne’s Hospital, an accredited level 1 trauma centre, is the first Netcare hospital in KwaZulu-Natal to earn Diamond status and the only WSO Angels hospital award winner in the Msunduzi district. The Diamond WSO Angels award is the highest in the tiers that acknowledge hospitals meeting the WSO stroke criteria, focusing on optimal patient outcomes.

Teamwork and a passion for excellence in stroke care earned a Diamond WSO Angels Award for Netcare St Anne’s Hospital. Hospital general manager Sharon Singh is pictured with neurologist Dr Zaheer Sacoor who will attend the awards ceremony in Dubai later this year, unit manager of Netcare St Anne’s Hospital emergency department Sr Nobuhle Mhlongo and nursing services manager Sr Precious Shelembe.

“Hospitals recognised by WSO Angels Initiative are validated as equipped to provide the full spectrum of diagnostic and interventional services for the identification and treatment of stroke 24 hours a day according to the strict protocols required by the European Stroke Organisation Enhancing and Accelerating Stroke Treatment [ESO East] and WSO,” says Zasskia Wiese, Netcare’s national stroke programme manager.

To qualify for the awards, hospitals must register with and submit data to the RES-Q quality of stroke care registry, an initiative of the ESO East that now includes WSO and is the basis of the international awards evaluation criteria. This registry allows for international benchmarking and continuous improvement and monitoring to ensure consistency of quality stroke care.

Netcare St Anne’s Hospital resident doctor Dr Zaheer Sacoor, a neurologist who has been instrumental in the establishment and success of Netcare St Anne’s Hospital’s stroke management programme, will accept the Diamond Award on behalf of the hospital at the 16 ^th World Stroke Congress in Abu Dhabi, United Arab Emirates, in October.

The Congress brings together stroke professionals, researchers, members of stroke support organisations and policymakers from around the world where the latest findings on stroke care techniques and clinical guidelines are presented to build international expertise to help reduce the burden of stroke.

“Stroke has been a focus of attention in neurology, and we felt patients in Pietermaritzburg and surrounds should be offered the revolutionary therapies now available, including new medications and an entire spectrum of opportunities to prevent damage as early as possible from the time a person starts experiencing symptoms of stroke,” Dr Sacoor says.

“Time is brain”

“Any suspected stroke should be treated with severe urgency and emergency medical attention, as once a stroke occurs the person starts losing an average of 1.9 million brain cells per minute, representing loss of functions such as mobility, speech, and may be life altering or even life threatening.

“In the medical stroke management community we say ‘Time is brain’ when it comes to stroke because the sooner blood flow to the affected part of the brain, or reperfusion, can occur, the better for the person’s ultimate outcomes and chances of survival.

“With support from the Angels Initiative, Netcare and Netcare St Anne’s Hospital management, Sharon Singh, emergency department unit manager Sister Nobuhle Mhlongo and the team from our level 1 trauma centre, as well as the wider medical community in the KwaZulu-Natal Midlands, we are driven to further grow excellence in stroke care.

“From the moment a patient comes to the emergency department, the training and clinical protocols promote early recognition of stroke symptoms, which are treated as a priority. The patient is then sent for a scan so we can determine the most effective intervention for that particular type of stroke and initiate treatment as soon as possible,” Dr Sacoor says.

“This Diamond Award is recognition of a huge team effort, including very well trained physicians, multidisciplinary collaboration and dedicated nursing staff, and is a testament to the passion for saving lives and ensuring the best possible quality of life for people after a stroke.”

“We congratulate the team on this important achievement and recognition of excellence in stroke care at Netcare St Anne’s Hospital,” Singh says.

“We encourage everyone to get to know the signs of stroke, which is a medical emergency, with the acronym BE FAST.”

B is for Balance: difficulty in maintaining balance

E is for Eyes: changes in vision

F is for Face drooping

A is for Arm weakness

S is for Speech: difficulty talking

T is for Time to get help immediately – every second counts.

“We are grateful for the leadership, expertise and dedication to stroke care that is continually striving to do the best for each patient, and the hope this signifies for the community of the KwaZulu-Natal Midlands and beyond whom we serve,” Singh concludes.

South African women at higher risk of perinatal depression

Fri, 28 Jun 2024 07:29:26 GMT

Screening is important to identify mothers who need help

South Africa faces a perinatal depression crisis, with mothers three to four times more likely to be affected than their global counterparts.

“Statistics indicate that between thirty and forty percent of South African women will experience perinatal depression compared to a global rate of ten percent,” says Psychiatrist Dr Bavi Vythilingum, who practises at Netcare Akeso Kenilworth, Cape Town.

To address what is becoming a growing health concern, she believes all women should be screened for perinatal mood symptoms during pregnancy and for postnatal depression after giving birth.

“Perinatal depression is an umbrella term covering depression both during and after pregnancy. We refer to it as perinatal depression because many women who have depression during pregnancy go on to develop postnatal depression. Also, postnatal depression is a risk factor for depression in subsequent pregnancies, so the term perinatal depression covers all these periods,” adds Dr Vythilingum.

She warns that perinatal depression can have serious consequences for both mother and baby. “The mother experiences extreme suffering, emotional pain, difficulty bonding with her baby and, at its worst, thoughts or acts of self-harm and suicide.

Dr Bavi Vythilingum

“In terms of the baby’s health, depression during pregnancy is associated with risks of high blood pressure, of preterm delivery, and of babies not growing and developing as well as they should. Postnatal depression, if left untreated, is one of the biggest risk factors for mental illness in the affected mother’s children, particularly as they become young adults. It interferes with the mother’s ability to bond with her baby and her ability to act sensitively and responsively to her baby, which can have marked effects on the development of the child. Perinatal depression affects the whole family and has a generational impact on mental health.

Risk factors

“The biggest risk factor for perinatal depression is having had a previous episode of perinatal depression. Other risks include having a history of mental health disorders such as depression or anxiety. A substance or alcohol abuse disorder, particularly if the woman is still using substances during pregnancy, is another serious risk factor. These women are considered high risk and should be treated with care and empathy. Another risk factor is having an unwanted baby, although this should not be generalised to unplanned pregnancies as many pregnancies that are unplanned are greatly welcomed. Other factors, like having an unsupportive partner or where there is intimate partner violence, also contribute to the risk of perinatal depression,” notes Dr Vythilingum.

Recognition and hope

According to Dr Vythilingum, the good news is that perinatal depression can be treated effectively. “The first step is to recognise perinatal depression. This is why it’s important for all women to be screened during pregnancy and after giving birth. There are simple, accurate screening tools available to identify signs of perinatal depression.”

If a diagnosis of perinatal depression is reached, the mother and family should receive holistic multidisciplinary treatment with support from all their healthcare providers, including the gynaecologist, the paediatrician, and the clinic sister, for example.

Perinatal depression can be treated with psychotherapy, also known as talk therapy, and medication. “Talk therapy is very effective, particularly for mild to moderate depression, and many women benefit from this. However, for moderate to severe depression or for a mother who has thoughts of suicide or harming herself or her baby, medication is indicated,” Dr Vythilingum adds.

“Nowadays, there are many medications that are very safe to use during pregnancy and breastfeeding. Mothers can take these medications safely and get better; there is no need for them to suffer. Where appropriate, taking prescribed medication if you have moderate to severe perinatal depression is better for you and the baby because it gets you well and allows you to really take care of yourself and your child.”

Dr Vythilingum stresses that mothers should be supported and affirmed, not just in practical terms like cooking a meal or looking after the baby, but also through giving them emotional support and reassuring them that they are good mothers, although they are ill during perinatal depression.

“It’s crucial that we recognise perinatal depression for the serious health problem it is, and through greater awareness help affected mothers by providing the treatment and support that they deserve,” she says.

In any mental health emergency, or for advice in accessing mental health care for yourself or a loved one, please reach for support. Netcare Akeso offers a 24-hour crisis line on 0861 435 787. Trained counsellors are available to talk to you without judgment and can guide you through the various options for assistance. The South African Anxiety and Depression Group (SADAG) also provides a 24-hour suicide crisis helpline on 0800 567 567.

Abnormal bleeding during and after pregnancy

Tue, 25 Jun 2024 08:04:25 GMT

When should pregnant women be concerned?

Dr Mzuvele Archwell Hlabisa, an obstetrician and gynaecologist practising at Netcare Kingsway Hospital, says while many people don’t realise that bleeding can occur for over a third of pregnant women due to various reasons, it’s crucial to always ascertain the exact cause.

“While some bleeding is normal in the postpartum period after childbirth, too much bleeding can be life-threatening. It’s not always easy for a woman to determine whether what she is experiencing is normal or not, but a good rule is that any bleeding in and around pregnancy should be checked by a healthcare worker.”

He says that around 35% of women experience bleeding in the first trimester. “As the pregnancy continues, the possibility for bleeding decreases, so it’s reassuring when they get past their mid-trimester, which is the period ranging from 13 to 28 weeks of gestation.”

He warns that bleeding could indicate a miscarriage or a threatened miscarriage. “Bleeding accompanied by severe pain could be related to placental abruption, which is a serious pregnancy complication in which the placenta separates prematurely from the womb. These conditions require urgent assessment by a healthcare worker.”

Obstetrician and gynaecologist,
Dr Mzuvele Archwell Hlabisa

Spotting

In the earliest part of pregnancy, some women may experience spotting called an implantation bleed when the embryo burrows into the wall of the uterus. He explains that generally, the quantity of blood determines whether it is considered spotting or not. “Spotting is usually under a teaspoonful. It can also be caused by a cervical infection, a urinary tract infection or even haemorrhoids during pregnancy. Sexually transmitted infections can also result in bleeding.”

Cause for concern

He warns that the heavier the bleeding, the more concerning the underlying cause could be. “If a pregnant woman experiences any bleeding lasting for an hour or any associated severe pain in her upper or lower back, that may signal a serious problem that requires assessment by a healthcare worker immediately,” Dr Hlabisa says.

“Women might also experience symptoms of anaemia such as headaches, weakness and dizziness. These are danger signs that mean she needs healthcare quickly. There could be reduced blood flow to the placenta, which could be life threatening for the baby. Anaemia could also lead to a preterm delivery.” He cautions that even bleeding which is not severe can have a long-term neurological effect on the baby.

What to expect at the hospital

Dr Hlabisa explains what to expect when seeking medical care for bleeding during pregnancy. “An internal examination may be needed to assess the cause of the bleeding. The woman may have their urine tested for the presence of any blood or have their blood tested to check whether they’re becoming anaemic or to see if there are any underlying bleeding disorders. A basic ultrasound may be done to assess the foetal wellbeing.”

Treatment for abnormal bleeding during pregnancy can be as simple as bedrest, abstinence from sex or treatment with antibiotics if it is caused by a cervical infection, for example. “Anaemic mothers can be given iron tablets, iron infusions or even blood transfusions. The supplements women are advised to take during pregnancy also help to reduce the risk of becoming anaemic.”

If a pregnant mother has an abrupted placenta, she will need immediate delivery. “The treatment for bleeding due to placenta praevia where the placenta is attached low in the uterus, depends on the gestation and how significant the bleeding is. The different treatments are tailored towards the causes.”

After the birth

Regarding postpartum bleeding, Dr Hlabisa explains that immediately after delivery, it’s normal for women to experience bleeding and cramping as the uterus begins to shrink back to its normal size.

“Some women describe this as similar to a moderate menstrual period initially. As the days go by, the flow reduces, and after a week, some women experience no bleeding and then start bleeding again a few weeks later.”

He stresses that in the first six weeks after delivery, it is considered normal to have some bleeding, “but if bleeding causes the mother to have symptoms of anaemia like a headache, weakness or dizziness, the bleeding is probably abnormal.”

Bleeding can also occur from an episiotomy, which is an incision to the birth canal, a tear, or when a piece of the placenta is left behind. Infections can also result in bleeding following pregnancy. “The only way to determine the reason for the bleeding is for the mother to return to medical care.”

The risk factors for abnormal blood loss after childbirth include having a big baby, having twins, a difficult delivery or a prolonged second stage of labour. “An underlying gynaecological condition like uterine fibroids also carries a higher risk of bleeding, while hypertension may mean a higher risk of developing an abrupted placenta. If you have an underlying blood disorder or you are on blood thinners because of a health condition, these may all increase your risk,” explains Dr Hlabisa.

He stresses that it is imperative for women who notice abnormal bleeding to go to their gynaecologist, general practitioner, or nearest medical facility without delay. “Women can help their doctor differentiate between normal postpartum bleeding and abnormal bleeding that requires medical attention by monitoring the rate of their bleeding and taking note of symptoms such as weakness, a fast heartbeat, or light-headedness associated with any amount of bleeding,” Dr Hlabisa says.

“When in doubt, seek help from your medical practitioner without delay.”

Seasonal vaccines: Don’t stop at flu

Tue, 04 Jun 2024 19:18:54 GMT

Be fully protected with pneumococcal vaccination

As seasonal viruses start making their way across boardrooms, classrooms and all the spaces between, children and high-risk individuals must urgently receive the flu and pneumococcal vaccines to avoid serious illness, hospitalisation, and potentially fatal complications.

This is according to Josua Joubert, Chief Executive and Principal Officer of CompCare Medical Scheme, who notes that pneumococcal vaccination is strongly recommended for children younger than two years and adults older than 65 years, as well as those with underlying organ dysfunction, chronic heart, lung, liver, or kidney disease, and immunocompromised conditions.

CompCare noted a 10% increase in pneumonia admissions among its member base for 2023 compared to the previous year.

Dr Simangele Nkosi

“Overall, in 2023 the number of CompCare members claiming for pneumonia was higher in proportion compared to the number of incidents reported for southern Sub-Saharan Africa. This above-average trend could be easily reduced with vaccination, which is covered as a benefit by the Scheme,” he observes.

Dr Simangele Nkosi, Private Practitioner and CompCare Trustee, says that although numerous factors may contribute to shifts in recorded cases, vaccination remains the most effective defence against pneumococcal diseases.

Driving down the numbers

“The pneumococcal conjugate vaccine (PCV) protects against the bacterium Streptococcus pneumoniae, which causes many illnesses, from ear infections to meningitis, sepsis and, of course, pneumonia among others. Since being introduced into the expanded immunisation programme for infants and children in South Africa in 2009, children younger than five years experienced a 33% reduction in pneumonia-related deaths.

“Our adult population has also experienced some indirect benefits of infant vaccination. However, a substantial proportion of vaccine-preventable pneumococcal disease continues to occur in adults, particularly in those with underlying comorbidities or risk factors for developing respiratory infections.

“Furthermore, research shows that 32% of patients admitted for community acquired pneumonia had a cardiovascular event within 30 days. Common health concerns such as smoking, hypertension, diabetes, high cholesterol, influenza, and pneumococcal disease are well known as risk factors for ischaemic heart disease and for even inducing cardiovascular events,” she emphasises.

Dr Nkosi clarifies that while high-risk individuals must be vaccinated, it has also proven to be highly beneficial for those aged between 18 and 64 years to be vaccinated. Studies show a 77% reduction in community-acquired invasive pneumococcal disease (IPD) with the PCV13 vaccine, which protects against 13 types of pneumococcal bacteria.

There is also a 59% reduction in IPD cases with the PPSV23 vaccine in this age range – the pneumococcal polysaccharide vaccine, which protects against 23 types of pneumococcal bacteria. In addition, this vaccine has resulted in a 74% reduction in pneumococcal disease.

Joubert encourages all South Africans to consult their healthcare professionals about their vaccine requirements and the most appropriate choice based on age and risk profile.

“Medical scheme members covered for pneumococcal vaccination have every reason to use this preventative benefit, which medical schemes such as CompCare have purposefully included and paid for to protect member health.

“Preventative care benefits like these also assist members in conserving the funds of their medical scheme, which, after all, belong to the member base. Along with the flu vaccine, it really is one of the simplest and most effective ways to dramatically reduce your chances of serious illness and hospitalisation while reducing unnecessary healthcare costs,” concludes Joubert.

Prominent cardiologist’s passing a loss to KZN healthcare

Thu, 30 May 2024 17:49:44 GMT

Dr Surendra Singh (11 April ‪1955 – 16 May 2024)

Colleagues pay tribute to highly respected Dr Singh

The passing of esteemed cardiologist Dr Surendra Singh (11 April ‪1955 – 16 May 2024) at the age of 69 after a short illness is a tremendous loss to healthcare in KwaZulu-Natal, the communities he served and everyone who knew him.

“We wish to express our sincere condolences to Dr Singh’s wife, Professor Shanta, and his children Rajiv, Ameet and Rhea,” said Netcare uMhlanga Hospital general manager Wendy Beato.

“We mourn the passing of an exceptional healthcare professional and a man of stature. Dr Singh was highly respected and much loved by his colleagues, patients and the staff and management of Netcare uMhlanga Hospital, where he has practised for several years.

“Dr Singh will be deeply missed by all who had the privilege to know him,” she says.

After qualifying as a cardiologist in 1990, Dr Singh embarked on a journey during which he harnessed the power of his knowledge to heal others. Known for this brilliance both as a man and a doctor, he possessed a rare combination of exceptional expertise, humility and deep caring.

“Dr Singh’s dedication to his patients was evident throughout his career, and he continued to provide much valued service at Netcare uMhlanga Hospital until he became ill. His passing leaves a deep void for all who knew him and the countless patients whose lives he touched throughout his career.

“Dr Singh’s legacy as a caring healthcare provider and respected cardiologist will endure. Through his considerable dedication and expertise, he improved and saved lives while inspiring a new generation of healthcare professionals. His passion for healing and deep commitment to his patients will be forever remembered. Although his time with us was cut short, the impact of his life’s work will continue to be felt for many years to come,” Beato concluded.

Increase in children diagnosed with autism

Thu, 30 May 2024 16:58:48 GMT

Helping parents better understand children on the spectrum and their needs

As the prevalence of autism diagnoses increases, Dr Nerica Ramsundhar, a neurodevelopment paediatrician practising at Netcare St Augustine’s Hospital in Durban, sheds light on the signs and symptoms that parents should be on the lookout for.

“Just in the last five or six years we have seen the numbers of those diagnosed with autism go from one in 56, to the most current statistics of one in 36 children, according to the US Center for Disease Control (CDC) guidelines for 2023. Autism also affects more males than females,” says Dr Ramsundhar.

“People with autism have neurodevelopmental differences which play out in the way they socialise and communicate. It’s often accompanied by repetitive behaviours and fixated interests. It can also be seen in the way the person responds in sensory processing.”

Dr Ramsundhar explains that those on the spectrum may communicate in their own way. “This impacts conventionally expressive language, which is our ability to talk; receptive language, which is our ability to understand; and non-verbal communication like facial expressions, eye contact, gestures, and body language.”

Dr Nerica Ramsundhar is neurodevelopment paediatrician practising at Netcare St Augustine’s Hospital.

She says how children on the spectrum use expressive language is highly varied. “A child may have fluent speech but we need to assess if they are using their language to converse and connect with someone in a functional manner.

“For instance, we consider whether the child’s conversation allows a to-and-fro exchange on the same topic or whether there are utterances that are undirected, not purposeful, delayed or even scripted, where the child relays something they’ve heard previously. Other signs might include making up their own words or having a singsong quality to their speech.”

Dr Ramsundhar says some children with autism might have an affinity for languages other than their home language. Others may not respond to their name or do so inconsistently. They could also experience auditory processing differences.

“It’s fairly common for such children to make less eye contact and certain children may not point, which is otherwise a common gesture for communication.”

Dr Ramsundhar says children with autism often don’t express emotions through their facial expressions, which can appear to be flattened or muted and limited in range. “Repetitive behaviours like hand flapping, jumping, body twirling and object spinning can also be seen.”

She stresses the importance of understanding restrictive behaviours for children on the spectrum. “Parents and caregivers should understand that these children thrive on routine and familiarity, which gives them comfort. Often, children with autism don’t like change. They may want things placed in a certain way. If the order is changed, they may become very upset.

“They want things to be simple and binary and may have a problem understanding knowledge that is applied. Autistic children can sometimes have fixated interests, which means they are preoccupied with a particular hobby or topic, such as cars, dinosaurs, buttons, or stones. This can be so all-consuming that it impacts the child’s ability to connect with others.”

She adds that some children with autism might display altered social interaction, so they may avoid social interaction or be overly friendly. “Taking turns, sharing, and functional play with toys may be some areas where this is picked up.”

According to Dr Ramsundhar, an early clue is when a child does not latch on easily while being breastfed or has a fragmented sleep pattern. “The baby may not be easy to soothe, and swaddling that may have worked with other babies may not work for those who are predisposed to being on the autism spectrum.

“It may not be easy to wean the child. As they get older, we see decreased eye contact and often an inconsistent, delayed, or no response to their name being called, whereas other children respond to their name from as early as six months. They may take longer with their expressive language, with their gestures being decreased. They don’t clap hands, blow kisses or wave bye-bye.”

During play, children may display a late interest in play materials. “They may prefer to be alone or to parallel play. They might be on the outskirts, watching their peers interact. Their play is often repetitive. If parents see that their child finds it difficult to regulate their emotions – where change precipitates meltdowns – then I’d recommend investigating the cause to best support the child.”

Neurodevelopmental paediatrics is a sub-specialty that focuses on conditions that impact a child’s development and behaviour, including autism.

“When diagnosing children, we conduct a parental interview, looking at the pregnancy, birth, developmental and medical history, and the past three generations of the family. We discuss the family’s thoughts about play, sociability, repetitive behaviours, or processing differences. This interview should be conducted away from the child.”

She then conducts an interaction and observation session with the child. “We look at how the child interacts, how they show interest in their parents, if they ask for anything from those in the room, the level of their vocabulary or expressive language and whether the expressive language is coordinated with gestures, for example,” she says.

“We also conduct a clinical examination looking for anything that could explain why the child is manifesting this way. We check for neurological factors that could have precipitated autism, like epilepsy, cerebral palsy, a traumatic brain injury or even syndromic or genetic causes. The clinical examination is extremely valuable in the entire assessment.”

Dr Ramsundhar emphasises that children with autism and their families need support from their communities. “It’s about simple gestures, caring and kindness,” she concludes.

Stop the spread of colds and flu

Tue, 28 May 2024 09:10:14 GMT

Good hygiene habits provide defence against illnesses

It is that time of year when everyone around us is sniffling, coughing, and generally just feeling ‘under the weather’ with seasonal ailments.

“While this is to be expected, particularly as the weather cools down, it is worth remembering that influenza can be dangerous for some people and can easily spiral out of control if you don’t take care of yourself,” cautions Dr Peter Makhambeni, chief clinician of the National HealthCare Group , administrators of MediClub Connect ™.

“While most people recover within a week without requiring medical attention, influenza is not to be underestimated as it can lead to severe illness, hospitalisation, and death, especially in older adults, infants, pregnant women, overweight individuals, and individuals with chronic medical conditions,” he adds.

Dr Peter Makhambeni

Preventing colds and flu

“Looking back on the COVID-19 lockdown of 2020, it is interesting to note that South Africa had no flu season. The very practices that protected us from COVID-19, like hand sanitation, wearing masks, and social distancing, also proved to be powerful allies against the spread of the flu.

“So, if anything, COVID taught us a valuable lesson: strict hygiene and maintaining our distance when sick can be our strongest defences against the spread of illness. By maintaining these good habits, we can help to contain not just COVID, but other infectious illnesses too, including colds and the flu.

Tips for preventing the spread of infectious diseases

Wash hands regularly
Sanitise hands
At work sanitise workstations
When experiencing symptoms, protect co-workers from infection by keeping safe distances and wearing face masks when interacting with colleagues.
For those who can, work from home for as long as you have symptoms.

“Also, the flu vaccine is one of the best ways to protect yourself from the current flu strains doing the rounds. If you get infected with influenza, your symptoms will be much milder than if you were not vaccinated. So, if you have not yet gotten the flu vaccine, do so as soon as possible as it takes a good two weeks to build immunity,” he adds.

Is it a cold, or is it the flu?

According to Dr Makhambeni, most people do not distinguish between the common cold and influenza, or the flu, as it is often referred to. Understanding the difference is crucial, as treatment and general care differ.

“There are several strains of the flu, which is caused by the influenza virus and is spread through the air when people cough or sneeze. One can also get the virus from touching something that has the virus on it and then touching one’s mouth, nose, or eyes,” he notes.

The symptoms of flu include fever, feeling feverish/chills, a cough, sore throat, runny or stuffy nose, muscle or body aches, headache, and tiredness.

According to the National Institute of Communicable Diseases (NICD), the 2024 flu season came early, and in the past couple of weeks, South Africa has already seen a significant rise in influenza cases. One of the strains, the H1N1 variant – which some people refer to as ‘swine flu’ – is particularly prevalent. While COVID-19 is no longer the threat it was in 2020 and 2021, it is essential to remember that it has not gone away.

The symptoms of the common cold are usually milder than those of the flu. Most people experience only a runny or stuffy nose, provided that a secondary infection does not complicate their condition. The common cold can be caused by over 200 viruses, with Rhinoviruses being the most common cause.

Colds and flu are more common during the colder months, as viruses survive much better in cold weather. In addition, people tend to spend much more time indoors and huddle close to one another because of the cold weather. If one of the people in the room has a virus, it can spread to others quickly.

Treatment for colds and flu

“As doctors, we are often asked by patients to prescribe antibiotics. However, because viruses cause colds and flu, it is important to remember that antibiotics, designed to treat bacterial infections, are ineffective in treating colds and flu.

“Colds and flu are best treated symptomatically, and if you get the flu, it is important, first and foremost, to get ample bed rest and drink more fluids,” suggests Dr Makhambeni.

“Contact your healthcare practitioner, especially if you have a chronic condition, if your symptoms worsen, or if you are not feeling better with rest in a few days.”

MediClub Connect ™ believes in empowering members with the knowledge and tools to protect their health. That's why our plans provide interactive access to doctors and nurses on WhatsApp and physical consultations on referral. By staying connected with healthcare professionals and maintaining good hygiene habits, you can keep yourself and your loved ones safe from colds, flu, and more.

Spotlight on SA expertise at largest interventional cardiology conference

Fri, 24 May 2024 07:47:02 GMT

Interventional cardiologist and associate professor at the University of Cape Town’s Medical School Professor Farrel Hellig and cardiologist Dr Pieter van Wyk

Live educational procedures broadcast to EUROPCR 2024

In the main arena of EuroPCR 2024, the world’s foremost interventional cardiovascular conference in the French capital, Paris, all eyes were on two South African cardiac specialists nearly 9 000km away performing minimally invasive heart procedures from the state-of-the-art catheterisation laboratory (cath lab) at Netcare Sunninghill Hospital in Johannesburg.

Selected as the only site outside of Europe to be featured in this international conference, video footage was streamed live to delegates as renowned interventional cardiologist and associate professor at the University of Cape Town’s Medical School Professor Farrel Hellig and cardiologist Dr Pieter van Wyk performed two live procedures.

“The objective of the annual EuroPCR conference is to provide a practical course designed to educate interventional cardiologists from all over the world on procedural techniques,” says Prof Hellig, who is well known for sharing his knowledge generously with colleagues in South Africa and internationally.

The cath lab at Netcare Sunninghill Hospital includes a permanent installation of cameras and software allowing us to transmit live cases anywhere in the world, or to record procedures to show later for teaching purposes, and is the only such installation in Africa.

This year was the fourth time Prof Hellig and the Netcare Sunninghill Hospital cath lab team have been invited to share live transmissions to the EuroPCR annual conference, which was held this year from 14 to 17 May.

In the first of the live educational cases that Prof Hellig and Dr Van Wyk performed transmitted live to the conference in Paris was a left atrial appendage (LAA) closure.

“An LAA is a pocket originating from the left atrial chamber of the heart where, under certain conditions, blood clots can form and can lead to a stroke,” explains Dr Van Wyk.

“Normally, this condition can be treated with blood thinning medication, but in patients who cannot tolerate anticoagulants, minimally invasive closure of the LAA provides a viable alternative to blood thinners in appropriate cases. It is therefore crucial to build international skill in this technique to reach more patients requiring this minimally invasive option worldwide,” he says.

For the LAA closure technique to be demonstrated at EuroPCR 2024, the catheter wires are inserted via the femoral vein in the patient’s thigh and guided to the heart, puncturing through the muscular wall of the heart from the right atrium to the left to gain access for placing a plug to seal off the LAA pocket, thereby containing the stroke risk it presents.

In the second live educational case, Prof Hellig and Dr Van Wyk performed a highly specialised anterograde chronic total occlusion to clear a completely blocked coronary artery.

“All this is done through the radial artery with the image of the catheter wires guided from the patient’s arm to the heart. The audience at the EuroPCR conference were able to see the angiogram and the same screens we were looking at, as well as our hands and the equipment,” Prof Hellig says.

In addition to the delegates attending the EuroPCR conference in person at the Palais des Congrès in Paris, the 12 live transmissions from the eight selected cath labs extend the educational reach of the procedures to many more international cardiology delegates online via EuroPCR 2024’s e-learning platform.

“Professor Hellig, Dr Van Wyk, and the exceptional cath lab team at Netcare Sunninghill Hospital, your recognition at this global conference is a true honour,” says Dr Erich Bock, acting managing director of Netcare’s hospital division.

“This accomplishment is a testament to the innovative and compassionate care you provide every day, which will enrich other specialists with the skills to treat these life-threatening heart conditions elsewhere in the world.

“We are grateful to these highly respected specialists for making these world-class techniques available in South Africa, and for the advanced cath lab technology that makes these lifesaving interventions possible. Through your dedication, you not only enhance the lives of countless patients but also inspire a new generation of cardiologists in Africa,” Dr Bock concludes.

For more information on EuroPCR 2024, please visit https://www.pcronline.com/Courses/EuroPCR

Quality healthcare needed now as President signs NHI Act

Tue, 21 May 2024 10:21:54 GMT

Multiple roads to Universal Health Coverage based on social solidarity

The process towards fulfilling the promises of the National Health Insurance (NHI) will be a complex and unprecedented process that will necessitate extensive reorganisation of the healthcare sector. As such the experience for most South Africans will not meaningfully change for years to come with hopes having been raised of achieving Universal Health Coverage (UHC) through the NHI Act.

“There are various paths towards Universal Health Coverage [UHC], and collaboration with private healthcare funders can bring the benefits of more equitable access to quality healthcare to millions more South Africans,” says Craig Comrie, Chairperson of the HFA.

“The signing of the National Health Insurance (NHI) Bill into law by President Cyril Ramaphosa will shape South Africa's healthcare future, yet at present there is no threat to medical scheme members’ benefits as the implementation of the NHI Act will be constrained by significant financial and structural constraints and complexities, not to mention legal challenges.

“Until the NHI Fund and public healthcare system are ready to support quality, dignity-affirming healthcare, private health cover could offer an effective means of elevating the standards of care and extending access to millions more South Africans. With the finalisation of long-awaited regulations such as those pertaining to Low Cost Benefit Options (LCBOs) and regular Prescribed Minimum Benefit reviews, real and lasting progress towards the goals of UHC could be made,” Comrie says.

“We remain concerned about the long-term implications of certain sections of the NHI Act and its ramifications for the quality of healthcare for all South Africans, the sustainability of the healthcare system, and by extension, the rights of patients to quality care.

“What is needed is for all in the healthcare sector to unite our efforts to build a workable integrated funding system incorporating multiple funding streams and collaborative engagement to benefit everyone in South Africa. There are workable alternative approaches which can achieve universal healthcare without compromising the freedom of individuals to choose how to fund their healthcare needs,” he notes.

“Where constitutional and other legal issues exist, we will take the necessary action to protect the constitutional rights of individuals and their medical scheme benefits,” Comrie says.

“The NHI Act in its current form will not achieve equity in healthcare and there are better ways to achieve the genuine objectives of Universal Health Coverage. We take the duty to protect access to quality healthcare in line with citizens' constitutional rights very seriously and will not be deterred.”

Mind the mindfulness gap

Mon, 20 May 2024 12:12:38 GMT

Stop the train to focus your attentionStop the train to focus your attention

2024 In an era of 24 hour digital distraction, people – especially youngsters – need to build the skill of purposefully choosing where to focus their attention rather than habitually allowing it to be pulled in multiple directions.

This is according to Dr Tessa Roos, a specialist psychiatrist and mindfulness teacher practising at UCT Private Academic Hospital, who notes that there is compelling evidence connecting changes in human brain structure to the many digital interactions and distractions that now form part of our reality.

“Younger generations, in particular, are finding it difficult to actively direct and maintain their focus because their experience of the digital world predisposes them to distraction, far more so than for previous generations. Mindfulness presents a very practical and immediate way of addressing this problem,” she says.

Dr Roos notes that mindfulness has become a buzzword and is often misconstrued as requiring a calm environment or a quiet mind to practice it.

“When I started giving mindfulness talks, I did online searches for supporting mindfulness imagery and came across countless misleading images, like people meditating on the beach. There seems to be a false impression that mindfulness is about being in a serene state, but it is actually for the frustrated person caught in traffic, the exhausted person trying to get their baby to sleep – people who are stuck on the hamster wheel and coping with the many challenges of daily life,” she explains.

Jacqui Wigg, an educational professional who teaches mindfulness with Dr Roos, adds that mindfulness is not about creating a completely calm and empty mind but rather about becoming aware of one's thoughts and emotions instead of being swept away by them.

“By developing mindfulness, you can use thought as a tool, rather than getting lost in thought. It is about having agency over your awareness and choosing how you respond. This is a subtle shift, but with practice over time, it can change your experience of life.”

Jacqui Wigg is an educational professional who teaches mindfulness with Dr Roos

True mindfulness

According to Dr Roos, mindfulness – as defined by Jon Kabat-Zinn, a US professor emeritus of medicine and mindfulness expert – is the awareness that arises through paying attention in the present moment, on purpose and non-judgementally.

“This can start with something as simple as noticing the sensation of your feet on the floor, for example. Unlike a fight-or-flight response, you are aware of your thoughts and emotions and actively choose where to focus your attention at that moment,” she says.

“Mindfulness's non-judgmental aspect relates to accepting your reality. That does not mean you should stop making positive changes in your life – rather, it’s about starting from a place of acceptance instead of spending your energy on wishing things were different,” says Wigg.

“By starting with the intention of acceptance in mindfulness practice, you can free up energy for being with things as they are, which allows capacity for growth and change.”

Stopping the train

Dr Roos adds that acceptance and non-judgement directly relate to developing self-compassion and greater understanding.

“Many people are shocked to realise just how many of their thoughts are self critical when they start paying attention to them in everyday situations. This could be a case of being at the gym and going down the rabbit hole about how your body compares to the bodies of other people or getting lost in thought on the drive home about what you should have said during an argument long after it has passed.

“Mindfulness can help you stop that train and put your focus elsewhere, such as feeling your muscles as they stretch and contract while you exercise or observing the irritation that arises within you and choosing to chuckle at your own humanness. After all, we are all human. By noticing and accepting your experience in the moment, you can actively choose to move forward with your thoughts and actions instead of remaining in a spiral of self-criticism,” she says.

Dr Roos says that while numerous apps and other resources exist to develop mindfulness on your own, it has multiple layers and can be difficult to implement on your own, so the input of a community or a teacher is recommended.

“In simple terms, you could start by selecting an ordinary task such as brushing your teeth, feeling the sensation of the bristles, and tasting the toothpaste. When you notice your mind wandering, bring it back to toothbrushing. However, building up the practice of mindfulness and finding anchors for your awareness requires ongoing development, which is much more easily done when you are not going it alone.

“Practicing mini-mindful moments in a controlled environment and with guidance can help you build truly effective mindfulness that you can apply to your life in a bigger way. There are times when life can be unpleasant, and we can’t always change that, but we can be mindful and choose where to focus our attention,” she concludes.

For more information about the mindfulness course offered by Dr Tessa Roos and Jacqui Wigg, please visit www.capemindfulness.com .

Surviving the night of the hyena

Thu, 02 May 2024 05:47:26 GMT

Frans Ndlovu shows the scars he was left with from the hyena attack, thanking the multidisciplinary team of doctors and nurses at Netcare Pholoso Hospital who worked day and night to save his life. Mr Ndlovu has returned to work and is able to drive again with a special dispensation.

Trauma system in action after wildlife attack

An unsuspecting Frans Ndlovu was lying on the cool floor with his door open to catch the evening breeze after a 40°C day spent guarding the wildlife against poachers on a Musina game farm during a heatwave in November.

“It was very, very scary, but I am alive,” Mr Ndlovu, a father of two, says of the night he narrowly survived an encounter in the dark with a brazen hyena.

“I was sleeping soundly, and it was a huge shock being attacked in the dark. The animal had my head in its jaws; it was so powerful, and I could feel its teeth in my eye as it dragged me from my room.”

Remarkably, through the pain and shock of the experience, Mr Ndlovu managed to catch hold of a nearby pole as he was being dragged towards the bushes, and he held on with all his strength while screaming for help.

“The people staying in the neighbouring rooms came out to help me, and they fought the hyena off.”

According to Mr Ndlovu’s employer, Izak Nel, the animal reportedly would not let go until one of the men broke a chair over it, and even then, it did not retreat. Bleeding profusely from his head and shoulder, Mr Ndlovu was rushed to a local hospital, where doctors initially stabilised him before he was transferred by helicopter to the emergency department at Netcare Pholoso Hospital in Polokwane.

Dr Vusi Khosa, who has worked in emergency medicine since 2013, says time was critical for Mr Ndlovu’s massive injuries. “It was a life-threatening situation, and the treatment required was complex. On his face, part of the facial muscles were torn away, and the bone was splintered from the crushing fracture due to the force of the hyena’s bite,” says Dr Khosa.

The spotted hyena has one of the strongest bites of all carnivorous mammals, measuring approximately 1 100-pound force per square inch (that is, 77.3kg per square centimetre), according to BBC Science Focus.

“A CT scan revealed the full extent of his injuries, and it was fortunate that the doctors who initially treated him in Musina recognised the need for multidisciplinary expertise and referred Mr Ndlovu to the level II trauma centre here at Netcare Pholoso Hospital.”

Trauma Society of South Africa (TSSA) accreditation of the facility certifies that it has the necessary medical expertise and systems aligned with international best practice in trauma medicine to provide 24-hour emergency care, even in potentially life-threatening and complex cases such as Mr Ndlovu’s.

Shortly before 6am on 26 November 2023, Mr Ndlovu arrived at the hospital via medical helicopter transfer and the trauma team was activated

“In line with established trauma protocols, emergency surgery addressed the most time-critical aspects and the wounds were cleaned and flushed, and we started antibiotics because animal bites can go septic easily and progress to septic shock, which can be fatal,” Dr Khosa says.

That evening just before 7pm, maxillofacial surgeon Dr James Masipa, ophthalmologist Dr Isaac Lesenya and plastic and reconstructive surgeon Dr Puritan Madzhia then began the painstaking task of reconstructing the left side of Mr Ndlovu’s face in a lengthy nine-hour emergency procedure that was completed shortly before dawn at 03:45am the following day.

The team had to remove the last residue from the splintering, crushing force of the hyena’s bite in preparation for Dr Masipa to reconstruct the areas of the eye socket and complex facial structure.

“Time was not on our side, and without a moment to spare for preparation, we had to move in with precision to assist Mr Ndlovu,” Dr Masipa says.

“After the traumatic injury he had sustained, Mr Ndlovu needed quite extensive facial reconstruction, including a forehead flap to rebuild his upper and lower eyelid, although later the damage to his eye, unfortunately, proved too extensive for it to be saved,” Dr Madzhia says.

“As with any bite, animal or human, the bacteria from the mouth causes a severe risk of infection, and we had to be deeply mindful of this during the surgery – this was a case where antibiotics were crucial for his survival and healing,” she says.

Mr Ndlovu spent 22 days recovering at Netcare Pholoso Hospital. “My employer brought my wife and children to visit me at the hospital, and that helped me to cover more quickly. I knew I had to get well for them,” he says.

"It's incredibly heartening to witness Mr Ndlovu's survival and the remarkable healing he's undergone despite the severity of his injuries,” Dr Khosa emphasises. "To witness a father restored to his children is profoundly rewarding for us as medical professionals."

Reflecting on his harrowing ordeal, Mr Ndlovu believes he has much to be grateful for: “First of all, I want to thank the hospital and the doctors for taking good care of me, as well as for the people who fought off the hyena to save me. I’m thankful to my employer and manager for taking action fast, or I wouldn’t be alive today, and to my wife and family for supporting me through this.

“This experience has not changed my belief that wildlife should be protected. These animals are part of nature and provide the livelihood to support my children,” concludes a thankful Mr Ndlovu.

Hidden potential danger lurks in the soil

Mon, 29 Apr 2024 12:36:53 GMT

Tetanus vaccination can be a lifesaver

Parents, home gardeners, and those who work with soil and animals should be aware of the need for staying up to date with regular tetanus vaccinations.

“The speed of onset of tetanus was recently highlighted when a keen home gardener developed symptoms just five days after working with compost with their bare hands,” says Dr Pete Vincent of Netcare Medicross Tokai.

Tetanus from Clostridium tetani, gram positive bacillus can be picked up from soil or compost. Sometimes referred to as ‘lockjaw, Dr Vincent points out that tetanus is a highly preventable disease.

“The tetanus vaccination is readily available, and I strongly urge people to check they are covered by this important vaccine, as contracting tetanus is a horrific experience, and it can also sometimes be deadly if not addressed in time,” he says.

“As general practitioners, we need to consider the potential risk of tetanus for any injury our patients may come to us with and check whether their tetanus vaccinations are up to date. If they aren’t, or if they can’t remember when last they had a vaccination, the doctor will ask them to get inoculated. This provides a full ten years of protection.”

He explains that the tetanus vaccination comes in two forms. One is a single vaccination called Tetavax. The other, Adacel Quadra, is a combination vaccine with three other ingredients that give the patient protection against polio, diphtheria, whooping cough, and tetanus.

Tetanus frequently asked questions

When should you consult a doctor if you’ve hurt yourself?

Dr Vincent stresses that if you haven’t had a tetanus inoculation within the past ten years or can’t remember when last you had one, you should see your doctor straight away.

“If your wound is dirty, deep, has foreign objects in it, or was caused by contact with an animal, see your doctor immediately. This also applies if there has been any contact with soil or anything potentially contaminated with animal or human faeces, rust, or saliva. A contaminated wound will require a consultation with a doctor even if your tetanus shot is up to date,” says Dr Vincent.

“If you’re diabetic or immunocompromised, these would also be reasons to go to your doctor as soon as possible to be safe.”

However, if you’ve had a tetanus shot in the past ten years, and your injury is shallow, small and clean, you can most likely care for your wound at home.

Where are the bacteria that cause tetanus found?

Tetanus is caused by a bacterium called Clostridium tetani. Its spores live in soil and faeces, often in a dormant state, until they find a suitable place to grow. They can enter the body through a break in the skin, from even the smallest wound, cut or burn. “The bacterium is found in compost, manure and dust and can be present in the blood and body fluids of infected animals,” Dr Vincent adds.

Dr Vincent cautions that newborn babies are susceptible to tetanus if proper umbilical hygiene isn't maintained, emphasising the importance of keeping the umbilical cord stump clean and dry.

How serious is tetanus?

“Tetanus has an incubation period of seven to ten days. It releases a toxin which affects the nerves associated with muscles.”

Dr Vincent stresses that tetanus can be potentially fatal. “Don’t take a chance on it. It can result in death, even in healthy people. Rather, let your doctor assess the situation and advise on your treatment plan.”

Why is tetanus also called lockjaw?

Tetanus often begins with slight spasms in the jaw and face muscles, which can cause the jaw to lock in place.

What other severe symptoms of tetanus do sufferers experience?

Dr Vincent explains that during the resulting muscle spasms, a person with tetanus can experience severe breathing problems. “The spasms can be so severe that they even have the potential to cause broken bones. A person with tetanus can develop pneumonia or a pulmonary embolism, which can lead to death. Tetanus can also be fatal when the spasms damage the nerves that control breathing, the heart or other organs.”

Added benefits of the combination vaccine for grandparents

“The importance of Adacel Quadra is that it is the only adult vaccination which also gives protection against whooping cough,” explains Dr Vincent. He strongly suggests that grandparents receive this vaccination every ten years, especially if there is a new grandchild on the way.

“This then provides the newborn with a cocoon of protection from whooping cough as their mother would receive the vaccination at 37 weeks gestation at each pregnancy. The father should have received the vaccine with their first child.

“The cocoon effect helps to ensure that everyone who has contact with the newborn is protected against whooping cough and, therefore, will not be at risk of passing on the disease, which could be truly devastating.”

New facility to strengthen mental health services in Limpopo

Thu, 25 Apr 2024 11:14:37 GMT

Netcare Akeso partners with local doctors

A strategic partnership between Netcare Akeso , the mental health division of the Netcare Group, and two Limpopo doctors has laid the way for the establishment of a new psychiatric facility in Polokwane to significantly enhance private mental healthcare capacity in the province.

“The accessibility of mental health and allied services is an integral component of overall health and wellbeing support, and it is our honour to be partnering with local health stalwarts Dr Rhulani Khosa and Dr Peters Mathebula to grow these vital services in Limpopo,” says Emma Hooyberg, commercial manager of Netcare Akeso.

The new facility is being developed in phases by the Networth Group, a Polokwane investment and development company, with the first phase comprising 87 beds for inpatient admissions, including 15 adolescent beds, as well as 18 consulting rooms for doctors and allied professionals, providing a comfortable setting for outpatient mental health services.

Just 1.5km away from Netcare Pholoso Hospital , the chosen 1.5-hectare site allows for synergy between the new facility and the hospital’s level II trauma centre. Designed for future expansion, its strategic location perfectly meets the growing mental healthcare needs of the provincial capital.

At a sod-turning ceremony on Thursday, 25 April 2024, it was announced that construction of the new facility will formally commence in mid-May.

“The concept for Netcare Akeso Polokwane originated in 2019 but was temporarily delayed during the pandemic. The need for mental health services has further increased globally and in the region,” Dr Mathebula says.

“The construction and necessary preparations for commissioning and inspection by the Department of Health [DOH] is expected to take approximately 18 months. If all goes according to schedule, we aim to be ready to open for admissions in early 2026,” Dr Khosa adds.

Given the scarcity of private specialised mental health services in the region, the facility will cater to the needs of patients from Limpopo and further afield, including neighbouring countries.

The appointment of a well-known construction company and other service providers from the community is set to invigorate the local economy while promoting job creation and community development.

“Once completed and approved by the DOH, Netcare Akeso Polokwane’s core team of experts will include psychiatrists, psychologists, occupational therapists and a social worker, supported by skilled and experienced nursing staff,” Hooyberg says.

“We are grateful for the warm support this project has already received from healthcare professionals, and we look forward to the day when people requiring treatment for anxiety, depression, and other mental health conditions can start benefitting from the services that will be provided at Netcare Akeso Polokwane.”

Protect your family with the latest flu shot

Mon, 22 Apr 2024 07:48:28 GMT

Southern Hemisphere’s 2024 influenza vaccine has arrived

With influenza season fast approaching, stock of this year’s flu vaccine is currently available in South Africa.

“There are different forms of flu caused by various virus strains, and each year the influenza virus mutates. A new vaccine is developed and needed every year for us to remain protected,” says Dr Cathelijn Zeijlemaker, a family physician and medical director of Netcare’s Primary Care division.

Worldwide, between three and four million people fall seriously ill with influenza each year, resulting in hundreds of thousands of deaths. The World Health Organization (WHO) and the Department of Health’s National Institute of Communicable Diseases (NICD) recognise vaccination as the most effective way to prevent flu. Most at risk are those with a chronic condition, the elderly, pregnant women, and small children.

“If you are living with someone vulnerable, you should consider vaccination, as this will prevent you from spreading the flu, and so protects your loved ones. This is also why every year Netcare encourages their healthcare personnel to receive the influenza vaccination.

“Each year in September, the WHO’s technical consultants advise which strains of the influenza virus should be included in the next year’s flu vaccine for the Southern Hemisphere to ensure that the protection provided is up to date.”

The influenza vaccine does not cover all the common colds that one is exposed to during the winter season. Though the symptoms are similar, these are milder and shorter in duration.

Symptoms of influenza commonly include body aches, fever, nasal congestion, tiredness and coughing and stop you from continuing with your normal daily activities. Children tend to have the highest rates of seasonal flu infection, which can lead to wider transmission within communities.

“Although most people start to feel better after a few days of rest, influenza can cause severe prolonged illness and complications. It is therefore very important to seek medical advice if you are not getting better, start to feel worse or experience chest pains or shortness of breath,” she says.

“To beat the seasonal flu, it is worthwhile having your annual influenza vaccine early, as it takes approximately two weeks for your body to develop full protection. Although the peak flu season usually coincides with the colder weather in winter, it is unpredictable when a flu outbreak will occur,” she says.

Dr Zeijlemaker points out that it is not uncommon for the influenza vaccine to give mild side effects, like redness, mild swelling, and pain over the injection site, or a mild fever, mild rash, headache, or body aches. These begin soon after vaccination and are usually mild and short-lived. As with other medications, there is always a small chance of a severe allergic reaction.

“Make sure you tell your doctor about your recent medical history before your vaccination, or if you are feeling unwell, as you may be advised to postpone the vaccination,” she says.

Those who should consider vaccination include

Anyone with a chronic medical illness or weakened immune system;
Anyone older than 65;
Those who have been diagnosed with cancer;
Women currently pregnant or planning a pregnancy;
Infants and young children.

In addition to having the flu shot, tips to help prevent the spread of flu include:

Wash your hands thoroughly and regularly
Avoid contact with people who are ill
Stay at home when you are unwell
Cover your nose and mouth with a tissue or the crook of your arm when you sneeze or cough.

“Prevention is always preferable to a bout of seasonal flu, and the doctors practising at Netcare Medicross facilities countrywide are here to take care of your family’s every primary healthcare need all year round,” Dr Zeijlemaker says.

Contact your local Netcare Medicross Medical and Dental Centre to book your family’s influenza vaccinations.

Is your workstation working against you?

Tue, 16 Apr 2024 10:13:02 GMT

Dangers of sitting for extended periods cause for real concern

Desk-bound individuals who spend most of their workdays seated need to prioritise posture and regular body breaks or risk spinal injury, chronic disease and mental health issues, among numerous other serious concerns.

According to Dr Bonke Sumbulu, a general practitioner at Netcare Medicross The Berg in Bergbron Johannesburg, ‘sitting is the new smoking’ may not be an accurate comparison. However, the dangers of continued sitting for long periods are cause for very real concern.

“The effects of sitting at your desk all day may not be immediately apparent, but over time, ongoing sedentary behaviour impacts various vital functions of the human body, which requires movement to maintain health,” she says.

Musculoskeletal risks

Dr Sumbulu points out that back and neck pain are among the more noticeable complaints of desk-bound work, but this can result in a heightened risk of muscle and spine ailments in the long term.

“Sitting for extended periods can cause certain muscles to weaken while others become tight, leading to imbalances that contribute to stiffness and discomfort, particularly if you are sitting incorrectly. Adjusting chair height, desk height, the position of the monitor and keyboard, and the placement of the mouse are essential for supporting neutral body postures and reducing strain.

“Repetitive strain and poor posture, on the other hand, can increase the risk of discs slipping or herniating, causing pain, numbness, or weakness in the back and neck. These symptoms can also occur with spinal stenosis or the narrowing of the spinal canal.

“Furthermore, spinal discs can become permanently damaged, with continuous pressure accelerating wear and tear and resulting in Degenerative Disc Disease. Likewise, neck arthritis, or cervical spondylosis, involves the degeneration of the vertebrae in the neck. Both conditions lead to chronic pain and limited movement.”

Dr Sumbulu notes that lack of movement can result in muscle atrophy and weakness, particularly in the muscles of the legs, core, and back. This reduces spinal and joint support, further increasing the risk of musculoskeletal pain, injuries, and postural problems.

“Regular breaks from sitting and exercises to strengthen the muscles and the spine can help to prevent these conditions. Weight-bearing exercise helps maintain bone density and strength, an important preventative step against bone loss and osteoporosis later in life,” she says.

Chronic disease

“Prolonged sitting reduces calorie burning, which can lead to weight gain and obesity, both risk factors for hypertension as well as diabetes.

“A sedentary lifestyle is linked to metabolic changes, such as insulin resistance and the imbalance of lipids such as cholesterol, which can further increase the risk of diabetes and heart disease. Lack of physical activity also affects blood circulation and overall cardiovascular health, further contributing to the development of these conditions and others, such as blood clots and deep vein thrombosis (DVT). Poor blood circulation may also lead to varicose veins and leg swelling,” says Dr Sumbulu.

According to Dr Sumbulu, physical activity is crucial for regulating metabolism and managing blood sugar levels. “Reduced metabolic rate can, over time, increase the risk of obesity, insulin resistance, and type 2 diabetes.”

“A lack of movement can impair lymphatic circulation, increasing the risk of infections and inflammation. Remaining seated for extended periods on an ongoing basis may also contribute to digestive issues such as constipation and bloating,” she says.

Mental health

Dr Sumbulu highlights that physical activity is likewise important for mental health. “Being active releases endorphins, our ‘feel-good’ hormones, and can boost serotonin—a neurotransmitter that helps regulate mood, sleep, and appetite. Physical activity has also been proven to reduce levels of stress hormones, such as cortisol and adrenalin, and to promote relaxation.

“Overall, a lack of physical activity can disrupt the delicate balance of factors that influence mood regulation, leading to feelings of lethargy, irritability, and low mood. Incorporating regular exercise into one's routine can help promote emotional well-being and improve overall quality of life. Team sports have the added benefit of social connection, which has been shown to have a positive impact on mood.

Get proactive on your wellness at work

Dr Sumbulu suggests incorporating activities like stretching, walking meetings, standing desks, and desk exercises such as squats or leg lifts to counteract the adverse effects of sitting all day. She notes that regular physical activity outside work hours is also crucial for overall health.

“By prioritising good desk health, you can mitigate the adverse effects of sedentary desk work. A good place to start is to utilise a suitable chair, maintain proper posture, incorporate regular walks and stretches, take the stairs over the elevators or escalators, and cultivate a healthy office environment with ample fresh air and sunlight whenever feasible,” she concludes.

More affordable medical scheme cover needed for the missing middle

Tue, 09 Apr 2024 08:57:38 GMT

Craig Comrie, Principal Officer and Chief Executive of the Health Funders Association

Growing access to quality healthcare is non-negotiable

Expanding healthcare access in South Africa demands meticulous resource allocation, which is crucial for delivering the calibre of service essential to upholding the human dignity of our entire population, according to the Health Funders Association (HFA).

“Defining what constitutes value in healthcare cannot be separated from the quality of life of the person on the receiving end, the standard of healthcare they receive and whether the patient’s suffering is eased and their daily functioning restored without unnecessary delay,” says Craig Comrie, chairperson of the HFA, a professional body representing medical schemes and their members.

“At this pivotal moment in South African healthcare, it is essential that the quality and quantity of healthcare services are defined and configured in a sustainable balance to ensure South Africa’s world-class healthcare skills and assets, which are largely privately funded, are retained, nurtured and grown to accommodate the country’s wider healthcare needs.”

“The regulatory framework if reformed as recommended by the Health Market Inquiry, which started a decade ago, could create more practical and sustainable improvements to universal healthcare coverage for South Africans and provide more affordable healthcare for medical scheme members and greater access to those without cover. This will avoid the growing number of individuals who cannot afford healthcare cover and are placing additional pressure on already over-burdened public health facilities, a situation that is less than” he says.

Comrie points out that medical scheme members contribute substantially to the public health system as taxpayers and make very little use of State services, thereby freeing up resources for those who are dependent on public health.

"Despite the predominantly negative attention directed towards National Health Insurance (NHI), it's imperative to acknowledge its potential for significantly improving accessibility to quality healthcare. While criticisms abound, it's crucial to recognise the positive impact it could have in extending affordable, high-quality private healthcare to millions more South Africans if appropriately implemented.

“There is full agreement that quality healthcare should be extended to all South Africans, and we see great potential for medical schemes as a collective to assist in elevating the standards of healthcare afforded to all employed South Africans and their families,” he says.

“At best, it will take decades until South Africa’s future health system is capacitated to replace the services currently provided by medical schemes in their entirety, and we see this as an opportunity to work together to build quality healthcare overall.

“With the outstanding regulatory gaps addressed, we could create health cover solutions for the many employed South Africans for whom medical aid is unaffordable at present. Comparatively well off enough not to be reliant on the State, this missing middle could be accommodated through private health funding employment benefits, at least until the NHI system is geared to provide adequate care for all,” Comrie says.

Finalisation of the Low-Cost Benefit Options (LCBO) framework and regular reviews of Prescribed Minimum Benefits (PMBs) to complete the existing health funding regulations would considerably reduce costs while maximising relevance for the wide-ranging needs of South Africans in a more economically viable manner.

The HFA points out that making medical scheme membership more affordable through rational regulatory means would help keep many employed people healthy, actively contributing to the economy, and keeping them out of the hospital by providing meaningful access to healthcare for a larger proportion of the population.

“An important point here is that tax incentives in the private sector which are currently targeted and have in real terms been reduced may be more effectively spent by individuals accessing healthcare where they choose rather than dictating where and how they access healthcare, as envisaged in the NHI Bill. In the end, consumers often know where they get best bang for their healthcare buck.

“Until the NHI system is fully equipped to provide a level of care approaching this for everyone, private health funding is ready to help shoulder this responsibility to realise the goals of universal health coverage.

“The practical truth may be that the NHI will remain limited to what the country can afford, but this need not define the entire extent of healthcare services that individuals will continue to require. We strongly appeal to the President and policymakers not to disregard the spectrum of opportunities for making progress towards universal health coverage with prudent revisions of the existing regulatory framework.”

World Health Day Emphasises Human Rights’ Crucial Role in Cancer Risk Reduction

Fri, 05 Apr 2024 05:22:49 GMT

There is a direct link between human rights and preventing the spread of cancer, says Lorraine Govender, National Manager: Health Programmes of the Cancer Association of South Africa (CANSA) , commenting on this year’s World Health Day theme: My Health, My Right .

Colorectal cancer (also known as colon cancer) awareness is being campaigned by CANSA during April, and its key messages align with the theme of World Health Day which takes place on 7 April this year.

“Health is everyone’s fundamental right,” says Govender. “There are three key concepts in the Universal Declaration of Human Rights that play a vital role in reducing the risk of cancer: health and wellbeing, food, and education.”

Human Rights and Preventing Cancer

CANSA considers the right of access to sufficient healthy food and water to be the first step in illustrating how human rights influence cancer risk reduction. “Part of our role is to constantly raise awareness about the inequalities and human rights issues that impact cancer care and risk reduction in South Africa,” says Govender.

“Many South Africans cannot afford healthy food and, out of necessity, subsist on food with a high sugar content and low nutritional value, sometimes leading to obesity and increasing the risk of cancer.”

Govender says that educational programmes are critical. “The more educated people are, the more likely it is that they will eat the right food, rich in fruit and vegetables and avoid processed meat and lessen red meat intake. They will also engage in physical activity, avoid obesity, stop drinking alcohol and using tobacco products and pay attention to the warning signs of cancer.”

She adds that South Africa also needs stronger policies and legislation, for example, The Control of Tobacco Products and Electronic Delivery Systems Bill, which can assist in lowering cancer-causing compounds (carcinogens) and the risk of cancer.

Colorectal Cancer Incidence Increasing

In South Africa, the increase in negative lifestyle choices, such as, eating more processed meat and less fruit and vegetables, not being active, smoking and alcohol consumption, may have led to a dramatic increase in the incidence of colorectal cancer among both men and women. In 1989, it was the 10th most common cancer diagnosed in men and women. Fast forward to 2019 and the National Cancer Registry ranked it among the five foremost cancers, second among men and third among women .

“What makes matters worse,” says Dr Fatima Bhabha, a general practitioner and colon cancer survivor, “is that there often aren’t symptoms in the early stages of colorectal cancer, and when symptoms do occur, they are often misdiagnosed. This means that many people are diagnosed only when the disease has progressed to an advanced stage.”

Early Detection

“People who suspect they may have colorectal cancer should speak to their healthcare provider as soon as they can,” says Dr Bhabha. “Treatment is more likely to be successful if the disease is caught in its early stages.

“That said, even if people don’t think they have colorectal cancer, they should have regular screenings for the disease. Studies have shown that screening can reduce both the incidence and mortality through early detection and the removal of precancerous growths. Also be aware of any blood or abnormal changes as these must be investigated.”

Screening methods include stool-based tests which are non-invasive. The most common of these tests is the faecal occult blood (FOB) test which detects hidden blood in the stool which may indicate the need for further testing. FOB tests are available at certain CANSA Care Centres – CANSA will provide a referral letter to your health care provider for further investigation.

Further Risk Factors

There are other factors that may increase the risk of developing colorectal cancer in addition to lifestyle choices. Most cases present in people in their fifties or older, so the risk of developing it increases with age. Family history also plays a part. A history of colorectal cancer or certain genetic conditions, such as, Lynch Syndrome and familial adenomatous polyposis (FAP) can increase the risk. Another risk is a personal history of previous incidence of colorectal cancer or the presence of certain types of growths or polyps.

Common Symptoms

These include changes in bowel movements, such as, diarrhoea, constipation, or narrowing of the stool; blood in the stool (rectal bleeding), that is either bright red or dark and tarlike; abdominal cramps, pain or bloating that won’t go away; unexplained weight loss that is sudden and not due to a weight-loss diet; feeling constantly tired and lacking energy, even with enough rest and iron deficiency anaemia due to chronic bleeding, causing fatigue, weakness and paleness.

Where To Get Support

CANSA offers an online lifestyle risk assessment tool that helps to identify lifestyle factors that may increase cancer risk. It also provides recommendations on how to change behaviour to lower cancer risk.

Several colorectal cancer patients have a portion of their bowel and/or colon removed and need a permanent stoma (opening in the abdomen that connects to the digestive or urinary system to allow waste to be diverted from the body). CANSA provides support to patients adapting to living with a stoma as well as offering a range of stoma products and accessories. The CANSA Tele Stoma Support Service offers online consultations for stoma patients and their families. Call CANSA Help Desk 0800 22 66 22 to make an appointment.

In partnership with Medtronic, CANSA has produced a colorectal cancer awareness video featuring two people who discover how their lifestyle choices have affected their colorectal health and the symptoms they should not ignore. View the video at https://youtu.be/zq8xHbvFR4E .

Raising the volume on kidney health

Wed, 03 Apr 2024 06:22:27 GMT

Step into the heart of compassionate renal care at National Renal Care (NRC): Pictured here is our centre at Netcare Alberton Hospital in Johannesburg, which is one of 71 such NRC facilities countrywide. With our dedicated team of nephrologists, technologists, and nurses, you'll find personalised support and expert guidance at every step of your dialysis journey. Experience the difference with NRC – where care meets convenience.

National Renal Care sounds the call to stem ‘silent epidemic’

March 14 marks World Kidney Day. Health and kidney care provider National Renal Care (NRC) is sounding the call for heightened awareness and proactive management of kidney health to confront the escalating threat of kidney disease in South Africa.

Highlighting the stark reality uncovered by a 2019 sub-Saharan African study, Dr Chevon Clark, chief executive officer of NRC, stresses the urgent situation. "Some four years ago, chronic kidney disease already impacted more than 1 in 10 South Africans, 12.9% of our population, surpassing rates in East and West African countries. The importance of early detection and proactive intervention cannot be emphasised enough, as every day without timely action worsens the situation for those affected by kidney disease."

Chronic kidney disease marks a perilous stage where kidney function deteriorates to a point where life hangs in the balance, relying on interventions like dialysis or kidney transplants. Tragically, it often lurks undetected until it reaches advanced stages, compounded by a lack of awareness," she cautions, urging swift collective action to confront this urgent challenge head-on.

Understanding the silent threat of kidney disease

According to Dr Clark, understanding the silent threat of kidney disease is crucial to making a meaningful difference.

“Through education and proactive measures, we can empower individuals to protect their kidneys. At NRC, we understand only too well that living with chronic kidney disease is a lifelong journey, and we are, therefore, there to offer support and guide patients throughout their kidney health journey – from risk assessment and preserving kidney function to advanced disease management,” she says.

Dr Clark shares three essential tips for better kidney health:

Early intervention saves lives: Regular screenings are crucial, especially for those with underlying health conditions.
Knowledge is power: Stay informed about your kidney health.
Advocate for yourself: Be proactive in your healthcare journey and seek personalised care.

Dr Chevon Clark, chief executive officer of National Renal Care (NRC)

Tips for kidney health

Stay active: Regular physical activity promotes circulation and overall wellbeing.
Nourish your body: Maintain a balanced diet rich in fruits, vegetables and lean proteins to support kidney function.
Avoid harmful habits: Limit consumption of alcohol, tobacco and other substances that can exacerbate kidney damage.
Stay hydrated: Drink six to eight glasses of water daily to support kidney function and flush out toxins.
Monitor vital health indicators: Keep tabs on your blood pressure and blood sugar levels, and manage these closely with your treating doctor.

Unlocking the secret of kidney health

Our kidneys silently perform a vital role in keeping our bodies toxin-free and balanced. As filters, healthy kidneys eliminate dangerous toxins, remove excess fluid from the body and maintain acid-base balance. Without this crucial process, our bodies would become overwhelmed with waste products, leading to severe health consequences.

Chronic kidney disease, unfortunately, is incurable. Yet, early detection can significantly slow its progress and delay the need for dialysis. High-risk individuals should prioritise annual kidney health assessments to catch any issues early on. Healthcare practitioners play an essential role in diagnosing and treating kidney conditions, often recommending lifestyle changes to inhibit disease progression.

The critical risk factors for kidney disease include uncontrolled hypertension, diabetes, smoking, alcohol and drug abuse, trauma, infections and certain cancers. Maintaining a healthy lifestyle and regular check-ups are paramount for prevention and early intervention.

“In South Africa, high blood pressure is the leading cause of kidney disease, responsible for 60 to 65% of cases. Individuals with hypertension, diabetes, or a family history of kidney disease face heightened risks and must remain vigilant.

Get to know your risk factors to manage them better, and ensure that you have regular check-ups with your healthcare provider to maintain healthy blood pressure levels and minimise kidney damage,” she suggests.

You’re not alone

Individuals with kidney disease are not alone, and support is available every step of the way through the Healthy Start programme.

“The primary function of this educational programme, which is unique to NRC, is to educate patients with early-stage kidney disease to help slow the progression to prevent complete kidney failure. We also assist patients who approach us when they need dialysis with a range of options suitable for their needs,” she explains.

“Dedicated to achieving optimal patient outcomes, we're continuously exploring advancements in renal care, which is supported by well-established services such as haemodialysis and peritoneal dialysis. Complementing this approach are patient-centric services, exemplified by our dedicated mobile app, facilitating active patient engagement and providing convenient access to pathology results and kidney-friendly recipes.”

The NRC digital ecosystem, anchored by the NephrOn health record system, ensures seamless care coordination across diverse healthcare touchpoints, guaranteeing unmatched efficiency and continuity of care. With a network spanning 75 dialysis centres across South Africa, NRC strives to set the standard for accessibility and inclusivity in renal care while providing convenient lifesaving therapy to patients regardless of location or circumstance.

"National Renal Care stands at the forefront of the battle against kidney disease, advocating for early detection, proactive management and patient empowerment," concludes Dr Clark. "Together, let's raise awareness, promote kidney health and improve the quality of life for kidney patients.”

For more information, please visit https://nrc.co.za/.

Ryan’s love of music restored, thanks to cochlear implant

Thu, 28 Mar 2024 06:05:40 GMT

Ryan Kurt Williams, of Leonsdale in Cape Town, is pictured with his mother Nicolette after his recent cochlear implant at Netcare N1 City Hospital that has allowed him to hear with much greater clarity.

Young man faces the future with new confidence

A young man with a passion for music is experiencing sound clearly for the first time since early childhood, thanks to a cochlear implant that has restored his hearing made possible by a team of caring medical professionals and the Netcare Foundation.

“Ever since the implant was turned on, I could hear sounds, new things that I had never heard before,” says Ryan Williams, 20, a month after his cochlear implant was activated.

Professor James Loock, an Ear, Nose and Throat (ENT) surgeon and the audiology team of the Tygerberg Hospital and University of Stellenbosch Cochlear Implant Unit (THUSCIU), identified Ryan as an ideal candidate to benefit from a cochlear implant.

“We believe Ryan was born with normal hearing, but from the age of three he developed some progressive hearing loss. In 2012, by age eight, his hearing was severely affected. As a consequence of this hearing loss his speech and language development was delayed,” Prof Loock explains.

Ryan was diagnosed with enlarged vestibular aqueduct syndrome, which affects the inner ear and thereby the auditory sensory information (sound) received by the brain. For four years, Ryan used hearing aids which only helped to a limited extent, but allowed him to be educated orally, rather than in sign language. He also relied heavily on lip reading.

“We could see that Ryan is a bright, ambitious young man who has a promising future, and a left cochlear implant would be of tremendous benefit to him. However, it would require a resource intensive specialised procedure and a cochlear implant device,” adds audiologist Marge van Dyk.

Supported by HearUs, a non-profit organisation that provides support to those in need of cochlear implants, the THUSCIU team was determined to find a way to help Ryan, and approached the Netcare Foundation with motivation to assist the young man, who aspires to study and enter a career in law enforcement.

“Working together with Prof Loock and THUSCIU over many years, the Netcare Foundation has seen the life changing value cochlear implants have had for other young people,” says Mande Toubkin, Netcare’s general manager of trauma, transplant and corporate social investment.

The Netcare Foundation is the CSI arm of the Netcare Group, enabling those who need it most to access quality healthcare, emergency medical services, specialised surgery, as well as human milk banks for the distribution of donated breastmilk to premature babies.

“When we heard about Ryan’s situation and the transformative difference this could make to his life, we jumped at the opportunity to fund his device and assist Prof Loock and his colleagues to make Ryan’s procedure possible at Netcare N1 City Hospital,” Toubkin says.

Ryan and his mother Nicolette thanked Prof Loock and the medical team, Netcare Foundation, audiologist Marge van Dyk of THUSCIU, anaesthetist Dr Gavin Jones and everyone who contributed to securing the cochlear implant for him.

“We are very grateful to the doctors and nurses, and everyone at Netcare N1 City Hospital. They were very nice to me when I was there for the operation,” Ryan says.

“Since my device was turned on, it’s been going very, very well. I love listening to music, even though I struggled to hear before. Now with the cochlear implants I can hear so much more clearly – for the first time I can actually hear the lyrics and the different layers of sound in the music,” he says.

Nicolette says she noticed a marked difference in her son once the cochlear device was switched on. “Since his hearing improved, he has been so much calmer and it is wonderful to see that he has more confidence in himself. My heart is full of gratitude towards each and every person involved who made it possible for Ryan to hear, and for him to follow his dream of studying to become a traffic officer,” Ryan’s mother says.

“I would like to personally encourage other people with hearing loss not to give up. There are a lot of different ways to solve problems and if you persevere and never lose hope, you can achieve things that you never thought possible at first,” Ryan concludes.

Support for young adults as they fly the nest

Mon, 25 Mar 2024 09:19:43 GMT

The five Ps of a smooth transition to independence

Leaving home to become an independent adult should be an exciting time for any young person but for some, worrying about how they will cope away from the family home can be traumatic.

Vashnie Sithambaram, a clinical psychologist practising at Netcare Akeso Umhlanga, says that with proper planning and the help of supportive parents, this milestone can be accomplished with minimal anxiety.

“Moving out of home is undeniably one of the most significant transitions in a young adult's life. It marks a pivotal moment of independence and self-discovery, offering boundless opportunities for personal growth and new experiences. While it can be daunting to venture into uncharted territories, it's also an exhilarating journey filled with endless possibilities.

“As you embark on this adventure, feeling excitement and apprehension is natural. However, with the right mindset and preparation, this transition can be transformed into a time of happiness and fulfilment. With that in mind, we would like to share some valuable advice to navigate this important milestone effortlessly, leaving behind any stress and uncertainty,” says Sithambaram.

These five Ps can be a helpful framework to navigate this significant milestone:

Be Proactive in helping a young adult craft the best way to leave home.
Turn the logistics of the move into a family Project , involving the parents and young adults to help the process go smoothly.
Plan every detail as meticulously as you can.
Prepare the young adult physically and emotionally for independence.
Stay Positive about their ability to be self-sufficient. Remember, the more prepared you are for any challenges that could arise, the more confident and less fearful the young adult will be.

Sithambaram gives her top tips for families to consider as they navigate the anxiety around the looming separation and new challenges this life stage brings.

Sithambaram gives her top tips for families to consider as they navigate the anxiety around the looming separation and new challenges this life stage brings.

Preparing for independence: essential advice for young adults

Don’t rush to leave home. It’s a momentous decision, so plan for it well in advance.
Consider things like finances, accommodation, and what support is available to you.
Speak to others who have successfully navigated the challenges you may face. Learn from their experiences.
Ask yourself about the physical, financial, and emotional advantages or disadvantages of moving out and see how your answers align with your goals.
Acknowledge that stress, anxiety, panic, loneliness, depression or homesickness are all normal emotional responses to a change or adjustment period.
Not knowing how to run a new home, finding a job and being financially secure can be stressful. Even the most confident people have these same fears. Reach out to your support systems for help.

“It’s so important for the young adult to be aware of challenges they may face away from the safety net of a family home. Preparation is key to navigating these, and here are my top tips on how to cope emotionally,” says Sithambaram.

Embracing change: Tips for adjusting to life away from home

Leave home on good terms with family members who love and support you. Leaving on bad terms or after an argument can often make moving out more challenging.
Visit or phone home when you feel homesick. This could mean scheduling video calls every week until you find your feet.
Make a list of the concerns you have with possible ways to resolve them.
Be proactive about making friends. Other young people who may work with you or a supportive social group, especially if they are of the same age group, can ease loneliness and help with the transition to independence.
Develop a routine. Find new activities, like going to the gym or starting a hobby and explore your new environment to help you feel more comfortable and confident.
Make your home feel like home. Your family home is often based on your parent’s interests, and your new space is an opportunity to reflect your identity. Take the time to figure this out for yourself so you can create a space where you feel safe and comfortable.

Sithambaram points out that parents can help their adult child develop independence by accepting that it is natural for young people to leave home. “Don’t let your anxieties about this important step towards adulthood cloud your judgement in preparing your child for life outside the family home,” she stresses.

Tips for parents on how to help their child leave home with confidence

Set goals and timelines once the right age approaches. This gives the adult child time to plan and organise themselves financially with your assistance.
Help your child build a budget. Give them responsibilities, like getting them to make their own doctor’s appointments and pay for some of the things they need themselves. This will build their confidence.
Prepare them for the reality of chores and household responsibilities. Teach them to cook and let them participate in the daily running of the home.
Change the dynamics. Give them the privacy and autonomy with the responsibility that comes with adulthood. Let them know you have confidence in them to be responsible adults.
Reassure them that the family home will always be there for them when they need support.
When you find you are a new empty-nester, be kind to yourself. Realise that while you will miss your child, your newfound freedom presents an exciting phase in your life and can be very rewarding.

Rapid rectal surgery recovery with robotics – and sunlight

Wed, 20 Mar 2024 08:01:51 GMT

Netcare Waterfall City colorectal robotic surgeons: (Left to right) General surgeon Dr Bhavesh Gordhan, visiting head of minimal access and robotic colorectal surgery at the European Academy of Robotic Colorectal Surgery (EARCS), Professor Amjad Pravaiz, and specialist general and bariatric surgeon, Dr Sudha Naidoo, performed Mr Horn’s robotic-assisted procedure at Netcare Waterfall City Hospital.

Precision tech and the sun’s healing power for lower colon resection

The latest robotic technology and the earth’s ancient sun both played a role in the rapid post-surgical recovery of a man being treated for rectal cancer. One of Colin Horn’s greatest concerns when he was diagnosed was that he might need a colostomy bag after the surgery to remove the 124mm section of his lower colon where the tumour was growing.

“I have a positive mindset generally, and I had been under the knife for a quadruple heart bypass years ago. When Dr Sudha Naidoo and I discussed the options and potential risks of the surgery to remove the diseased part of my colon, my single biggest fear was that I would be left reliant on a stoma and colostomy bag and how that would affect my life,” says Mr Horn, 74.

“When a person has rectal cancer, the surgical field is very close to the nerves involved in sphincter function, bladder control and erectile function. The robotic assisted approach makes a difficult surgery deep in the narrow confines of the pelvis a little easier to perform, and the capabilities of this technology fortunately, allowed us to avoid these critical nerves and the need for a stoma in Mr Horn’s case,” explains robotically trained general and bariatric surgeon Dr Naidoo.

Dr Naidoo and fellow da Vinci Xi robotic accredited general surgeon Dr Bhavesh Gordhan performed the low anterior resection procedure at Netcare Waterfall City Hospital in October 2022, with Professor Amjad Pravaiz, proctor and head of minimal access and robotic colorectal surgery at the European Academy of Robotic Colorectal Surgery (EARCS).

Colin Horn is pictured enjoying fish and chips while watching the sunset with his wife Bev on a recent holiday to Pringle Bay. Mr Horn was surprised at how quickly he was able to get back to daily life after having robotic-assisted colorectal surgery for cancer at Netcare Waterfall City Hospital in 2022.

The flagship da Vinci Xi is the latest robotic surgical system and the fourth generation of the pioneering da Vinci produced by Intuitive and locally distributed by Medhold.

“The system allows us to be deeply immersed in the surgical field, with the visuals magnified ten times and in 3D so we can see much better than the human eye. The system enables us to work precisely and comfortably in the narrow confines of the pelvis through small punctures in the skin without placing much pressure on the abdominal walls,” Dr Naidoo says.

“After Mr Horn’s procedure, we placed him in the intensive care unit for observation and initial recovery, and the next day he was already upbeat, walking around and talking – we even had to ask him to take it easy. With the traditional or laparoscopic approach to this operation, recovery tends to take longer, and patients often require more postoperative pain medication.”

“I went into the theatre just before noon and woke up at 11 pm that night, not feeling too bad, although I was not sure where I was at first. I was in ICU for three nights, with the nursing sister at my bedside, monitoring me 24 hours a day as Dr Naidoo wanted to be cautious,” Mr Horn recalls.

“I had been dreading the surgery and the recovery, but it was all good – unbelievably good. The doctors were very kind to my wife and me, and it meant a great deal to me in easing the stressful situation,” he says.

After four nights in Netcare Waterfall City Hospital, Mr Horn was discharged, and a week and a half later, he returned to Dr Naidoo for a check-up and to remove his stitches.

“Although the marks left by the incisions were only approximately 25mm, Dr Naidoo said the wound might open slightly, and I was most intrigued when he advised me to sit in the sun for 10 minutes for the next few days to help it bind and heal – and he was absolutely correct.

“After robotic assisted surgery with the pinnacle of state-of-the-art technology, now to be using the natural power of the sun - which is billions of years old - as part of the process struck me as quite an astounding contrast,” Mr Horn says.

Dr Naidoo adds that the healing properties of fresh air and sunshine are well documented. Within weeks of the operation, he was back to enjoying walking around his home suburb of Lonehill, Johannesburg, as recommended for his heart health.

Mr Horn’s oncologists prescribed a course of radiation therapy and chemotherapy to attack any remaining cancer cells after the tumour and affected section of the colon was removed. Dr Naidoo advised that he avoid nitrates and processed foods going forward and have annual scopes, MRI and CT scans, and blood tests to monitor his condition carefully.

“I was surprised how quickly I was able to get back to my usual activities after the operation, and I’m very grateful that I was referred to Dr Naidoo and was a candidate for this advanced option at Netcare Waterfall City Hospital, where I was very well looked after,” Mr Horn says.

Dr Naidoo emphasises that the da Vinci Xi robotic surgical system cannot independently move or perform any action. “We always have two robotically trained surgeons present as part of the team for these procedures, and Dr Gordhan and I always work together on robotic assisted surgeries. We are in full control at all times; it is a superb tool that allows us to operate with less physical trauma,” he says.

“While any surgical procedure has some risk, many potential complications associated with traditional surgery are avoided. Internationally, a lot more procedures are being done with the robotic assisted approach, however it is only recommended as an option where there is clear benefit in terms of the complexity of the surgery and where it is appropriate for the individual patient’s condition,” Dr Naidoo notes.

Apart from the colorectal procedures, Dr Gordhan and Dr Naidoo also utilise da Vinci Xi’s superior technology for pelvic organ prolapse and rectal organ prolapse repair procedures.

Managing director of Netcare’s hospital division, Jacques du Plessis, says the applications for robotic surgical technology have grown rapidly in recent years. “It is very gratifying to see the difference these sophisticated procedures are making to patients like Mr Horn and how investment in this technology is paying off in terms of extending the capabilities of robotic surgeons practising at Netcare hospitals.”

Top tips to prevent pink eye

Wed, 20 Mar 2024 07:05:44 GMT

No need for alarm over KZN outbreak

Following a recent warning by the KwaZulu-Natal Department of Health about an outbreak of pink eye in parts of the province, Netcare Medicross is assuring residents that while there is no need for alarm, understanding more about this eye condition is important to prevent spread and complications.

General practitioner Dr Nishen Gounder, who practises at Netcare Medicross Malvern, explains all your family needs to know about this.

What is pink eye?

“Pink eye, or conjunctivitis, is the inflammation of the thin membrane, called the conjunctiva which covers the whites of the eye and the inner part of the eyelid. It can be caused by a viral or bacterial infection, an allergic reaction or environmental irritation,” Dr Gounder says.

“These can cause the delicate eye membrane to become red and inflamed, resulting in discomfort including itching, pain, swelling, fluid discharge and a scratchy or gritty feeling, as if there is sand in the eye,” he says.

“The cause of pink eye can be either viral or bacterial, both of which are highly contagious and easily spread in communities or schools through close contact and hand contamination. The public can play its part by helping to ensure pink eye does not spread further.”

Viral pink eye

Viral pink eye can be caused by various viruses, including the virus that causes the common cold symptoms. Pink eye is very contagious. It spreads through contact with infected secretions from the eye, and often the second eye becomes infected within 24 to 48 hours.

“Many people will have mild symptoms which will settle without intervention within a week or two without additional treatment. The redness, irritation and tearing usually settle first, but one may experience some morning crusting of the eyes a little longer,” he says.

“If one uses contact lenses, it is always important to come and see your GP if you notice symptoms to exclude other possible serious causes, like the infection of the cornea,” says Dr Gounder.

Bacterial pink eye

“While not as contagious as viral conjunctivitis, bacterial conjunctivitis is also highly contagious. but the symptoms differ from those of viral infection, with a yellow, white or green discharge common throughout the day. In the morning, one will wake with the eye being ‘stuck shut’ with a crust of dried discharge. An antibiotic in the form of drops or ointment, as prescribed by a GP, is needed to treat this condition effectively.”

Other serious symptoms that need immediate medical attention

Pain and tenderness of the eye
Vision disturbances
Sensitivity to light or difficulty keeping the eye(s) open
Other symptoms such as severe headache with nausea

Ten top tips for preventing and treating pink eye

If you suspect you or your child may have pink eye, visit your Netcare Medicross general practitioner and seek their guidance on treating the condition.
Make sure your doctor provides a sick note while you wait for the pink eye discharge to stop, usually after 24 hours of antibacterial treatment.
To protect yourself against pink eye infection, be strict in general hygiene practices. Remember that handwashing with soap or alcohol-based sanitising is an effective way to keep you and your loved ones safe from pink eye and many other infectious illnesses.
Where possible, avoid contact with people who have pink eye. Avoid physical contact, such as shaking hands, sharing pens, phones, touch screens, and makeup.
If you’re exposed to someone with pink eye, wash your hands often with soap and water and change your bedlinen daily. Don’t share facecloths, towels, or pillows.
Stop using contact lenses as soon as you suspect you may have pink eye.
Seek medical advice immediately if you experience severe pain, a change in your vision, any sign of pus or if you notice intense redness in your eyes.
Immunocompromised patients, such as those on cancer treatment or biological agents and those living with HIV and diabetes, should seek advice from their treating doctor as early as possible.
If you are diagnosed with pink eye, wash your hands often and do your best to prevent infecting those around you at home.
It’s important that babies and young children see a doctor as soon as their caregiver notices symptoms of the condition.

To book an appointment with a Netcare Medicross Medical and Dental Centre near you, visit https://www.netcare.co.za/search?path=medicross_medical_dental or make use of the Netcare App.

Baby Lily-Anne – our pot of gold at the end of life’s rainbow

Wed, 13 Mar 2024 05:14:38 GMT

Lily-Anne Robinson overcame the rare and life-threatening condition of gastroschisis following a specialist procedure at Netcare Krugersdorp Hospital, and today is a joyful baby with a bubbly personality.

Multidisciplinary specialist care comes through for babies in crisis

Looking at Lily-Anne Robinson, a busy baby girl with a flair for keeping everyone around her constantly occupied, you would never know that within her first year of life, she has already overcome a rare, life-threatening condition.

According to paediatric surgeon Dr Mathys Human, who practises at Netcare Krugersdorp Hospital, gastroschisis is a rare defect in the abdominal wall, which results in a baby being born with the intestines outside the abdomen. For every five to ten thousand babies, just one is born with the condition.

Dr Human notes that the mortality rate of gastroschisis in developing countries can be extremely high at over 80%. The cause is not yet known, and despite the rarity of the condition, the hospital saw three little patients over a six-month period, all of whom survived without any major complications.

While there were some serious bumps in the road for Lily-Anne, her mother, Barbara Dunn, never wavered in her belief that her daughter would defy the odds and flourish, joining the ranks of numerous infants with serious conditions who overcome adversity.

Dr Mathys Human, a paediatric surgeon practising at Netcare Krugersdorp Hospital, notes that a multi-disciplinary approach is key to achieving successful outcomes for neonatal patients facing this and other serious conditions.

“From early on, Lily-Anne’s journey was not what we expected, starting with a routine pregnancy check-up when we were excited to discover her gender. It was during this appointment that we found out she had gastroschisis. A few days later, I was sitting in a specialist consultation, discussing the timelines of a planned early caesarean section and treatment to try and ensure my baby’s survival,” says Barbara.

Delivered two months premature, the fight had only just begun for little Lily-Anne, who underwent her first major operation at one week old.

Dr Human explains the importance of a multidisciplinary approach, which encompasses paediatric and paediatric surgical expertise, specialised neonatal intensive care nursing, physiotherapy, and dietetics, to provide infants with this condition with the optimal opportunity for success. The involvement of a paediatric surgeon from the outset and their presence at birth is furthermore deemed critical.

“Treatment for gastroschisis is often a staged procedure where a special bag is first placed over the intestines immediately after birth, and three to five days later, once it is established that the baby is sufficiently stable, surgery is performed to place the intestines within the abdominal cavity,” he says.

“Gastroschisis babies usually take approximately a month to start normal feeding due to slowed intestinal function, during which time they have to be fed intravenously – this often puts these babies at high risk of developing life threatening sepsis. Lily-Anne had a particularly prolonged hospital stay as she developed further complications that required additional surgery before she could be discharged.

“She came through it well, and we are pleased that she and our two other little gastroschisis patients have all had a positive outcome, in no small part thanks to my colleagues at the hospital, paediatricians Dr Alex Ogugua, Dr Heinrich Koekemoer and the rest of the treatment team.

“There is usually a follow-up surgery around the age of two to address any hernia defects, which are common in such a complex condition, but aside from this, they will all continue with life as normal,” he notes.

Barbara says that as a first-time mother, the journey was particularly daunting and that while Lily-Anne had a rockier start to life than most, she has proven to be highly resilient and is a joyful baby whose personality shines brightly.

“Lily-Anne certainly knows how to keep us busy, and even though we’ve only just recently celebrated her first birthday, she is already starting to develop a bit of an attitude,” laughs Barbara.

“Looking at what we went through and where we are now, I encourage any other parents struggling with a difficult newborn condition to hang on to that pot of gold at the end of the rainbow because things do get better. A huge thank you goes to our support system and the specialists and treating team for getting us there,” she concludes.

A nurse’s journey: Learning to live with epilepsy

Mon, 11 Mar 2024 12:25:42 GMT

(Left to right:) General surgeon Dr Nicole van der Westhuizen is pictured at the ER Consulting Inc epilepsy awareness drive at Netcare Olivedale Hospital recently, with Registered Nurse (RN) Tamara Moyo and emergency department unit manager RN Stephanie Ajodhya.

ER Consulting Inc and Netcare Olivedale Hospital highlight epilepsy awareness

A cancer survivor and nurse who was diagnosed with epilepsy in adulthood says knowledge is power when it comes to this relatively common neurological condition.

ER Consulting Inc, which manages the emergency department at Netcare Olivedale Hospital, recently shone the spotlight on epilepsy awareness to coincide with Epilepsy Week, from 12 to 18 February 2024.

Registered nurse Tamara Moyo shares her personal story of learning to live with epilepsy after being diagnosed in 2022 to encourage and inform others about this neurological condition, which affects one in every 100 people in South Africa, representing approximately half a million South Africans based on a total estimated population of 52 million.

“I survived cancer in 2021, and in August 2022, I moved to Johannesburg to start my new job at Netcare Olivedale Hospital. On 19 November, I had my first seizure,” Nurse Moyo recalls.

“It came as a shock, as I had never experienced anything like that before. I woke up so confused and had a severe headache, and I had bitten my tongue and was bleeding,” she says.

“The scariest part was not remembering what had happened before that, and I thank God I had the support of my family and colleagues. This led me to be diagnosed as epileptic and beginning treatment.”

Nurse Moyo says although it is difficult to adjust to life with epilepsy, she has empowered herself with knowledge about her condition. “It really helps to do research because learning to understand epilepsy better helps me to improve my lifestyle and identify what triggers my seizures to manage the condition as best possible,” she says.

“I have learnt that two of my main triggers are excessive noise and not getting enough sleep, and I’ve also learnt to recognise how I feel just before a seizure. Sometimes, this has prevented the seizure or at least allowed me to get to a safe place before it starts.”

Other common triggers for epileptic seizures include flashing lights, missed meals, hormonal changes, or stress and anxiety.

“I’m telling my story in the hope that someone will find encouragement in learning to live with their epilepsy because it is not an easy road. My advice is to keep taking your medication as prescribed, get to know what triggers your epileptic seizure and keep going for regular checks with your neurologist or treating doctor because your treatment needs may change over time.”

What to do if someone is having a seizure

Would you know what to do if you found someone having a grand mal seizure? Be prepared with this list of Dos and Don’ts.

DO THIS:

Loosen constrictive clothing around the person’s throat.
Remove sharp or hard objects, including furniture near the person, that might cause injury.
Remove spectacles if the person is wearing them.
Reassure any bystanders who may have gathered and are upset by what they’re witnessing, and ask them to give the person space while keeping a close eye on the person having the seizure.
Position the person so that they lie on their side in the recovery position, if possible, so that any fluid can drain from their mouth.
Call an emergency medical services provider, such as Netcare 911 on 082 911 or via the Netcare app, if the person having a seizure is pregnant.
Call an emergency medical services provider if the seizure lasts longer than three minutes.

WHAT NOT TO DO:

Do not panic.
Do not try to put your fingers or any object into the person’s mouth during the seizure.
Please do not hold the person down or restrain them.

ONCE THE SEIZURE IS OVER:

Check that the person is breathing normally. At this stage, you may need to help clear any obstruction from the person’s mouth with your finger and put the person in the recovery position. This means laying the person on their side, with their mouth angled downwards so that any fluid or vomit will drain out of the mouth instead of blocking the airway.

Allow the person to rest.
People are frequently confused or drowsy after a seizure or have a severe headache. Reassure them and stay with them until they are fully alert and recovered.
Only offer them food or drink once they are fully alert.
Check the person has not sustained any injuries during the seizure.

Joburg mom’s secret triumph over breast cancer

Fri, 08 Mar 2024 05:36:44 GMT

A new breast care unit has been established at Netcare Garden City Hospital to provide multidisciplinary support to patients throughout their breast cancer journey, from diagnosis to treatment and reconstruction.

Celebrating life after treatment and reconstruction

A mother whose selfless determination to shield her daughter from the news of her breast cancer diagnosis during her child’s grade 11 year is celebrating life with a heart full of gratitude.

“This time last year, the future was uncertain. Many people think of death when they think of cancer, and I did not want the stress about my health to affect my daughter’s academic performance,” says the 50-year-old woman from Johannesburg.

“I tried to hide it, but she is a very smart teenager and, on some level, I think she knew. I also did not want to tell her until I knew I was going to be OK, and I am so thankful to God that I don’t need cancer care for now and I am feeling strong again,” she says.

“I have been on a medical aid scheme for some time, but because I had always been a generally healthy person it never occurred to me to go for a mammogram. I felt some tension next to my neck sometimes, and I went to the doctor thinking it was perhaps due to stress. When it did not improve, my general practitioner told me to go for a mammogram,” she recalls of the events leading to her diagnosis.

An area of suspicion on the mammogram led her to have a needle biopsy, which revealed malignancy. She was referred to Dr Adnaan Variava, a medical oncologist who is part of the multidisciplinary breast cancer team at Netcare Garden City Hospital led by specialist breast surgeon Prof Herbert Cubasch and plastic and reconstructive surgeon Dr Nebil Lahouel.

In addition to Prof Cubasch, Dr Lahouel and Dr Variava, the multidisciplinary team includes radiation oncologist Dr Uzma Majeed, radiologists, consulting psychologists, social workers and dieticians working together so that the person can focus on their recovery. The team also works closely with the nuclear medicine department.

“The shock of a breast cancer diagnosis can be overwhelming in itself, and we have established a unit at Netcare Garden City Hospital offering a complete multidisciplinary healthcare team to support patients throughout every aspect of their treatment through to reconstruction,” says Prof Cubasch.

“The most important member of the team, of course, is the person who is being treated. As a unit, we all provide our input on the options available to help the person reach an informed decision on what is right for them as an individual.”

“I am so grateful that I was referred to these caring doctors, who said to me from the start, ‘We are here for you, allow us to help you’. I didn’t know anything about cancer, and they gave me support on this journey that was unlike anything I’ve ever experienced in healthcare before,” the cancer survivor recalls.

“I found it especially comforting when Prof Cubasch and the psychologist at the hospital told me that I hadn’t personally done anything to cause this. No one goes out looking for cancer, and it took me some time to fully realise that it can happen to anyone,” she says.

Dr Variava prescribed chemotherapy to shrink the tumour over the next seven months, but first Prof Cubasch and Dr Lahouel had to surgically insert a port in order to help make the chemotherapy treatment delivery as convenient and comfortable as possible.

“I could feel the effects of chemotherapy on my body, but I prayed, and although it was hard, I kept strong. Although I didn't have an appetite, I forced myself to eat the foods they recommended to get all the nutrients my body needed.”

By July 2023, the chemotherapy had reduced the cancer to the point where she could no longer feel the lump, and she was ready for surgery to remove the remaining cancerous tissue and lymph node.

“After a few months, I was feeling a lot better. My nails and skin were returning to normal, and my scar healed. I had an appointment with Dr Lahouel to discuss the options for reconstruction.”

“Breast augmentation or reconstruction after cancer can either involve an implant to replace the lost breast tissue or, as in the case of this patient, a breast reduction or breast lift on the other breast can create the desired aesthetic balance. This contributes to higher patient satisfaction after surgery, having the cancer removed and breast lifted, with the added advantage of a younger breast shape than before surgery,” Dr Lahouel explains.

“God led me to this team of doctors who have come halfway around the world to help women here in South Africa, and they really did a beautiful job. I consider myself lucky to have found doctors who gave me hope to keep a positive mindset, and I thank God for keeping me strong on this journey to where I am today,” the breast cancer survivor says.

“I want to take this opportunity to encourage women to talk to their doctors about breast cancer and go for mammograms as often as their medical aid allows because cancer can be beaten, especially if it is diagnosed early.”

For more information about the Netcare Garden City Specialized Breast Team, contact the unit on (010) 157 0173 or (011) 495 5208 or via email at specializedbreast@gmail.com.

Colleagues pay tribute to respected and beloved trauma surgeon

Tue, 05 Mar 2024 05:43:17 GMT

“Dr Vicky Jennings was the epitome of what a surgeon should be”

With deep sadness, Netcare paid tribute to internationally respected and locally beloved trauma surgeon Dr Vicky Jennings who passed away on Sunday, 3 March 2024.

“Dr Jennings, the Clinical Lead in Trauma Surgery at Netcare Milpark Hospital, was the embodiment of selfless, caring and committed service, dedicating her life as a surgeon to her patients in the public and private sector,” says Dr Richard Friedland, chief executive officer of Netcare.

“We give thanks for Dr Jennings’ extraordinary life and career, and we extend our heartfelt condolences to her children, partner and family, and all who loved her.

“She loved her work and what she described as her privileged life, often praising her colleagues, patients, friends and loved ones for making her journey an extraordinary one.”

Dr Jennings trained at the University of Pretoria and subsequently in surgery at the University of the Witwatersrand before following her passion to become a registered sub-specialist trauma surgeon in December 2017. As well as serving as the Clinical Lead in Trauma Surgery at Netcare Milpark Academic Trauma Centre, she also worked as the Deputy Head of Trauma Surgery at Chris Hani Baragwanath Academic Hospital.

Dr Jennings was a highly regarded member of the Association of Surgeons of South Africa (ASSA) and the Trauma Society of South Africa (TSSA), and was recognised internationally by the International Association of Trauma Surgery and Intensive Care (IATSIC). Recently, she was made a Fellow of the American Association for the Surgery of Trauma (AAST).

“Not only was Dr Jennings a mentor to those who had the privilege of working alongside her in South Africa, but also to doctors and emergency medical personnel in many countries around the world, where she shared her passion through her lectures,” Dr Friedland says.

Prof Ken Boffard, Director of Trauma at Netcare Milpark Hospital Academic Trauma Centre, described Dr Jennings as “the epitome of what a surgeon should be: caring, passionate and skilled, she always gave of her best, and was highly regarded by all who were treated by her, worked with her, and had the privilege of knowing her”.

“Always enthusiastic, always caring, and special to all with whom she came into contact, Dr Jennings was an outstanding teacher locally and internationally, a sought-after mentor and role model for the next generation of trauma surgeons. She will be sadly missed,” Prof Boffard concluded.

Plastic surgery made all the difference for patient with dog bite injury

Fri, 23 Feb 2024 08:44:33 GMT

Dr Aobakwe Segwe is pictured with her beloved Pomeranians, Simba and Nala, after recovering from a dog bite to her face requiring plastic surgery with Dr Brian Monaisa at Netcare Pinehaven Hospital.

Serious bite to the nose delays doctor’s 40th birthday celebrations

Turning 40 is a significant life event for any woman, and for Dr Aobakwe Segwe, a specialist radiologist from Midrand, it was no different. She’d planned special celebrations for her 40th birthday in July last year, but just a week before, her hopes for her dream birthday were shattered when an excited young dog caused a serious injury to her face.

Usually the one caring for those needing treatment, Dr Segwe was forced to be on the other side of medical care as a patient, when her attempt to pet a relative’s seemingly-friendly dog resulted in a serious injury to her nose.

Dr Segwe explains: “My cousin owns a spirited one-year-old Doberman, Chase. On that day, he seemed excited and in good spirits. I had no reason to be afraid of him at all. But, when I leaned forward to say goodbye to him, he jumped up towards my face.

“I felt the hard thud as he connected with my nose. It really didn’t feel like he’d bitten me. But, when I looked in the mirror, I saw to my horror that I had a serious injury, and through the wound I could see my nasal bone. We rushed straight to the emergency department at Netcare Pinehaven Hospital in Krugersdorp.”

For her, it was a humbling and profound experience being on the other side of the doctor patient relationship. Dr Segwe says the staff leapt into action and took care of her immediate medical needs, even before they began the administrative part of her admission.

“Although I was in some distress, I knew I had to keep calm. Later in the surgical ward, the highly skilled and compassionate staff took wonderful care of me.” She stayed at the Netcare Pinehaven Hospital for a week, under the care of world-renowned plastic surgeon, Dr Brian Monaisa.

In theatre that Monday, Dr Monaisa examined Dr Segwe and based on what he saw, devised a care plan for the way forward.

Dr Monaisa described the bite wound as “quite devastating”. “There was skin and nasal cartilage missing. I had to reconstruct the right half and the tip of the nose. I used a forehead flap, which would be the standard choice to do that.”

Dr Monaisa explained that the procedure involves turning down a piece of skin from the forehead above the eyebrow and pivoting it vertically downwards to resurface the nose. He also used hidden cartilage from Dr Segwe’s ear to help reconstruct her nose.

“With Dr Segwe’s 40th birthday fast approaching, our problem was that you have to wait three weeks before you can attach the forehead flap. That can be emotionally difficult for the patient and this is where patient counselling becomes very important,” Dr Monaisa says.

“We did the flap division four weeks later and this was followed by a couple of minor touch ups. With black skin, hyper-pigmentation can be a problem but this was addressed with topical treatment and we achieved a good result.”

For Dr Monaisa, the best part of his job is seeing his patients recover and being pleased with the result of their surgery and treatment. “It’s a fantastic feeling. Plastic surgery is not necessarily about treating life or death situations, but rather it’s about the quality of a person’s life,” he says.

“Getting back to Dr Segwe’s case, the nose is in the centre of the face. It’s the first thing people see. An injury like this can affect a person’s self-esteem and image, so it’s really important to do it right. The reward for me is patient satisfaction and a good quality of life. We want to restore the patient’s confidence, so they not only look good, but feel good too.” He explains that it’s also important to tell the patient about any risks attached to the procedure.

Although Dr Monaisa lives some considerable distance away from Netcare Pinehaven Hospital, he says the fact that the hospital is so well run, clean and spacious, means it’s an obvious choice for him to run his busy practice from. “I’ve been here since 2017 and the people and the staff are excellent. There’s just a beautiful vibe here.”

Dr Segwe reluctantly had to take time away from her high-powered job for a few months to recover from her ordeal. “We had to hire an additional radiologist to cover at the practice to ensure there were no disruptions to our services. In our field, there’s no room for error. It was a very stressful period, but fortunately, I’m blessed with an amazing team at the practice.”

After what was a very traumatic injury, Dr Segwe has been left with only a faint scar. “I never thought I’d be in a situation where I’d have to undergo plastic surgery. Being a medical practitioner, you’re acutely aware of all sorts of risks. But, I had faith in my chosen specialist and his team which gave me the confidence that I would get through this.”

Dr Segwe is a doting owner of two adored Pomeranian dogs, Simba and Nala. She admits that the incident with Chase has made her more cautious around dogs. While she was sad that her much-anticipated birthday plans had to be postponed at the time, she has much to look forward to, including a Maldives birthday trip in March and a “girls’ trip” to Italy in July.

A grateful Dr Segwe said her real happy ending was that she was “forced to pause and appreciate every little thing in my life”. “I have a renewed laser focus for what I aim to achieve in life.” She also acknowledged that she has a deepened love and appreciation for her family, friends and colleagues who supported her through her ordeal.

“The exceptional nurses and doctors at Netcare Pinehaven Hospital really carried me through this with their professionalism, gentleness and kindness.”

Africa’s breast cancer centre of excellence hailed once more

Fri, 02 Feb 2024 08:07:40 GMT

Netcare Milpark Breast Care Centre of Excellence received high praise from the American College of Surgeons’ National Accreditation Program for Breast Centers (NAPBC) recently. Radiation oncologist Dr Karen Motilal, founder and breast disease specialist Prof Carol-Ann Benn and the head navigator Sr Zamokuhle Mguli are members of Africa’s first and only recognised breast care centre of excellence.

International acclaim for quality and safety in breast cancer care

As one of the most common cancers in South Africa, one in 27 women will be affected by breast cancer in her lifetime.

Renowned breast specialist surgeon and breast disease specialist Professor Carol-Ann Benn and the team at the Netcare Milpark Breast Care Centre of Excellence are a beacon of hope for women, men and teenagers facing a breast cancer diagnosis.

Ahead of World Cancer Day 2024 on 4 February, Africa’s first and only breast care centre of excellence has once more been recognised by the American College of Surgeon’s National Accreditation Program for Breast Centers (NAPBC). The centre based at Netcare Milpark Hospital in Johannesburg’s accreditation is extended until 2026.

“We heartily congratulate Professor Benn and her team for consistently upholding the highest standards in care for breast cancer treatment. Their relentless pursuit of excellence in advancing cancer care, aligning with international best practices and achieving remarkable milestones has placed the formidable team at the Netcare Milpark Breast Care Centre of Excellence at the forefront of breast cancer care globally,” says Dr Cindy Aitton, head of Netcare’s Cancer Care division.

“Amid the stress of being diagnosed with breast cancer, a person should not have to worry about navigating various healthcare professionals at different facilities to confirm whether the treatment and care they are receiving is sound, safe and right for them,” says Professor Benn, who founded the centre with Netcare in 2001.

Netcare Milpark Breast Care Centre of Excellence is one of just three breast centres outside the United States to achieve accreditation from the NAPBC, granted only to programmes that are demonstrably committed to providing the best possible standards of care to patients with breast cancer.

“I cannot give 100% to any programme, but [Netcare Milpark Breast Care Centre of Excellence] is the closest I’ve ever come,” was the powerful endorsement on the centre’s assessment from the NAPBC’s chief accreditor Dr Toan Thien Nguyen from Florida.

The quality of care patients receive at the centre is continuously monitored and has been since it was first accredited in 2017. Every three years, the NAPBC conducts a site visit as part of its rigorous reaccreditation process.

“The multidisciplinary team approach is central to the NAPBC’s stringent requirements for the structure of care. Interdisciplinary collaboration provides the reassurance of various specialists and practitioners putting their heads together to carefully consider the options available for the most important person: the patient,” Professor Benn says.

“This ensures each clinical decision is carefully weighed from multiple perspectives holistically, and this is proven to guide better outcomes.”

The services of the Breast Care Centre of Excellence are also represented at the breast units of Netcare Alberton, Netcare Linksfield, Netcare Olivedale and Netcare Park Lane hospitals through member specialists who are part of the accreditation.

Once again, the NAPBC hailed Netcare Milpark Breast Care Centre of Excellence as a prime example that would be incorporated into the NAPBC’s international best practices guideline to help empower other centres worldwide to serve their patients better.

Accredited units have to collect data and feedback on outcomes while ensuring high standards of care across 29 measures on an ongoing basis. NAPBC centres collate data to refine evidence-based processes to drive better care for patients at any stage of cancer.

“Both locally and globally, Prof Benn’s clinical leadership provides a blueprint for breast cancer units to aspire to. The warmth of the experienced cancer care team and the sense of community at the centre is a source of added comfort,” Dr Aitton says.

“When accessing care at a NAPBC-accredited centre, a person is guaranteed comprehensive treatment, and Netcare Milpark Hospital offers the convenience of numerous state-of-the-art treatments available at the same facility.”

Breast cancer treatment at the centre includes access to information on clinical trials and new treatment options, genetic counselling and psychosocial support, financial guidance, rehabilitation services, and survivorship care.

“We keep in touch with each person for life. We know from experience that you don’t go through an experience like supporting someone through breast cancer treatment without developing a lasting relationship,” Professor Benn says.

“In South Africa, we do unfortunately see the consequences of limited public awareness of breast cancer. We need to encourage open conversations about breast cancer. Self-examination is important too, however, regular mammograms remain the best way to detect breast cancer as early as possible. Talk to your doctor or clinic about your individual breast cancer risk and recommended screening.”

Robotics offers ‘mind blowing’ advances in colorectal surgery

Fri, 05 Jan 2024 07:22:30 GMT

Dr Daniel Surridge, a colorectal surgeon specialising in minimally invasive techniques, recently completed robotic assisted procedures for the treatment of rectal and colon cancers.

Netcare Milpark Hospital invests in latest cutting-edge robotic advances

A robotic assisted colorectal surgery programme is bringing the advances of world-class minimally invasive treatment options to Johannesburg’s iconic Netcare Milpark Hospital.

“Technology is not merely a nice-to-have in healthcare; where there is a compelling benefit for patients, it becomes imperative,” says Dr Richard Friedland, chief executive officer of Netcare.

"We are investing in sophisticated equipment such as this flagship da Vinci Xi robotic surgical system alongside our Netcare group-wide digitisation programme because Netcare is all about improving health outcomes and people’s quality of life through evidence-based and data-driven health and care.”

“We congratulate Dr Daniel Surridge on successfully completing the extensive training and proctor surgeries to achieve accreditation to operate with the advanced da Vinci Xi robotic system,” says David Stanton, general manager of Netcare Milpark Hospital.

Dr Surridge, a colorectal surgeon specialising in minimally invasive techniques, recently completed robotic assisted procedures for the treatment of rectal and colon cancers, including removal of a lymph node and pelvic floor repair surgery for prolapse, among other complex procedures for benign disease.

“Making the leap from laparoscopic surgery to robotic assisted approach, I have found the level of detail this system allows amazing. There is so much more we can do for colorectal conditions with incredible precision: ‘precision surgery’ is what the robotic system is about,” Dr Surridge says.

“I recently returned from the 17th European Colorectal Congress in St Gallen, Switzerland, where international colleagues presented excellent results and discussed the profound differences this kind of robotic surgery has made to patients.

“The impact this technology is having in our field of medicine is mind blowing, tangibly demonstrated in the statistics on quicker discharge home after surgery; patients are mobile and able to get on with their normal lives sooner. In addition, the literature shows that patients report considerably less postoperative discomfort,” he says.

“With less blood loss and fewer complications, people spend less time in hospital after colorectal robotic assisted procedures. The bigger picture presented in the international statistics indicates considerable cost efficiencies associated with robotic assisted procedures.”

He points out that the robotic system cannot perform surgery or do anything independently; rather its every movement is controlled by the skilled surgical team. The da Vinci Xi performs additional safety checks, further complimenting the surgeon’s skill.

“The patient is left with only tiny punctures in the skin, where the very slender instruments far more agile than the human hand pierce the skin to access the surgical site deep within the body. The three-dimensional high-definition imaging shows each tiny nerve and blood vessel with exceptional clarity for enhanced precision,” Dr Surridge explains.

Netcare has expanded its robotics programme nationally to include colorectal, urology, urogynaecology and cardiothoracic surgical applications, investing in state-of-the-art technology and training.

The specialised colorectal unit at Netcare Milpark Hospital provides experienced care for conditions relating to the digestive tract, from the exit of the stomach, covering the large intestine, including the rectum up to the anus.

“We thank Dr Surridge for pursuing da Vinci Xi accreditation and mastering the latest technology and developments in colorectal surgery for the benefit of our patients. The establishment of the new unit aims to provide the optimal environment for people requiring such procedures in South Gauteng and surrounding provinces,” Stanton concludes.

Osteoporosis: 1-in-3 women and 1-in-5 men at risk

Mon, 11 Dec 2023 06:42:55 GMT

Hormones, menopause, and bone health

Osteoporosis – a condition where bone is lost faster than the body can replace it – can affect men as well as women and is not the preserve of old age alone. Awareness of individual risk and the factors influencing bone deterioration from a young age can help prevent this progressive disease.

“There is a misconception that osteoporosis affects older women only, but bone loss is something we all need to consider from a young age and take the appropriate steps to prevent it,” says Dr Rushdah Lariza Khan, a gynaecologist practising at Netcare Garden City Hospital.

According to the National Osteoporosis Foundation of South Africa (NOFSA), in South Africa one in five men are at risk of developing the condition, although women are at greater risk with a one in three chance.

Seven tips for protecting your bone health:

Get enough calcium: women should have 1 000 mg daily, and increase to 1 200 mg from the age of 51; men should have 1000 mg daily.
Vitamin D: Our bodies need this important vitamin for bone strength, and supplements may be needed to achieve the recommended 600 international units (IU) of vitamin D per day, increased to 800 IU from age 71.
Protein: The building blocks of healthy bones require sufficient protein.
Exercise: Do resistance training (for example weights, elastic bands and water exercises) and weight-bearing exercises (such as walking, running, dancing, aerobics or tennis) at least three times a week.
Adjust lifestyle: Quit smoking and limit alcohol intake. Maintain a healthy weight.
Appropriate use of hormone replacement therapies for women, at the correct age.
Have your individual risk assessed, especially if you have other comorbidities.

Gynaecologist, Dr Rushdah Lariza Khan

“The rate at which your body replaces bone tissue is influenced by hormones. People who have hormone-related disorders such as overactive thyroid or parathyroid glands, disorders of the pituitary gland, reduced oestrogen or testosterone should discuss the implications for their bone health with a doctor and regularly screen for early signs of bone density loss,” Dr Khan says.

“As a gynaecologist with the patients I see, the hormone changes that happen at menopause directly affect bone mineral density; however, women in their mid-twenties can start showing signs of deterioration. Athletes or women who miss their menstrual periods for six months or longer from excessive dieting or exercise may lose bone density,” Dr Khan explains.

“After menopause, the levels of the female hormone oestrogen fall, leading to a rapid decrease in bone density. When women younger than 45 experience menopause or have a hysterectomy with removal of ovaries, this affects their oestrogen levels and, therefore their risk of developing osteoporosis,” she says.

Hormone replacement therapy [HRT] is the most commonly prescribed treatment for managing the symptoms of menopause and prevention of osteoporosis, depending on the woman’s health profile. Where other types of treatment are indicated, the patient is referred to a physician.

“It is so important for women to seek medical advice when they start menopause, especially if it is early menopause. Although there are both benefits and potential risks with any medication, gynaecologists are specially trained to prescribe the correct HRT for the individual patient depending on their individual situation, while it is needed.

“HRT is safe when correctly prescribed by a specialist, with yearly follow ups, including an annual mammogram,” she advises.

HRT in the form of patches, gels or sprays does not increase the risk of developing blood clots, although the tablet form can. Recent studies indicate HRT does not increase the risk of heart disease or stroke, provided the therapy starts within 10 years of the last menstrual cycle and before the age of 60.

“Our bodies change as we get older, and women in their 60s should regularly discuss their need for HRT and review their treatment options with their gynaecologist or treating doctor to manage the potential risks, including osteoporosis, as appropriate for optimal healthy ageing.”

Bell ringing ceremony inspires hope

Wed, 06 Dec 2023 08:16:55 GMT

Supported by his partner Stewart, Mr Kacey Padayachee has maintained an inspiring positive attitude throughout his treatment for pancreatic cancer. They are pictured at Mr Padayachee’s bell ringing ceremony at the radiation therapy unit at Netcare Milpark Hospital to mark the final session of his course of radiotherapy.

Defying cancer: The triumph of positivity

When Mr Kacey Padayachee rang the bell at Netcare Milpark Hospital radiation unit to signal the end of his course of radiation therapy, he rang it not only for himself but as a symbol of hope for the many other people at various stages of their own cancer treatment journeys.

“When I was first diagnosed with pancreatic cancer, I cannot describe how daunting it felt, and I had no idea what to expect,” Mr Padayachee says.

Just a year after his diagnosis, the 63-year-old events company director from Johannesburg completed a six-week course of radiation therapy at Netcare Milpark Hospital’s radiation unit as part of his treatment plan in combination with chemotherapy.

“Surgery was not an option for Mr Padayachee’s advanced pancreatic cancer,” says radiation oncologist Dr Dino Chetty, who practises at the radiation unit situated at Netcare Milpark Hospital, as well as Netcare Olivedale and Netcare Unitas Hospitals.

“He underwent a course of chemotherapy to shrink the cancer, then I prescribed a course of technologically advanced radiation therapy combining Intensity modulated radiotherapy [IMRT] and Image guided radiation therapy [IGRT] to help control the cancer and prevent it from causing further pain and jaundice.

“This approach enables us to deliver a higher radiation dose to the cancer with great precision while minimising the dose to healthy tissue. In this way, the risk of side effects of treatment is reduced, both in short- and long-term,” Dr Chetty explains.

When a person completes their course of radiotherapy or chemotherapy at Netcare Milpark Hospital’s radiation or chemotherapy units, it is tradition to ring a bell to celebrate this achievement with people who have supported them, according to Netcare Milpark Hospital radiation therapy unit manager Marianne Menevissis.

“We are fortunate to meet many remarkable people in the radiation therapy unit, and Mr Padayachee is one of those exceptional individuals who always has a smile on his face, and throughout his course of treatment, he has been a beacon of hope,” she says.

“The bell ringing ceremony shines a light not only for the person who has completed their treatment and their loved ones, but it becomes a beacon, inspiring others to conquer their own challenging days,” Menevissis says.

“If I can do it, you can do it,” Mr Padayachee said, encouraging other patients who have yet to finish their courses of treatment.

As per the tradition, Mr Padayachee rang the bell four times, triumphantly exclaiming the values each ring represents: “Hope! Victory! Strength! Recovery!”

Surrounded by patients, Netcare Milpark Cancer Care staff and his partner, Stewart, who supported him throughout, Mr Padayachee stood as an inspiration for all – wearing his characteristic smile as always.

“I did not initially realise the difference the bell ringing ceremony makes to patients. However, I have not seen one person who has not been ecstatic to finish their course of therapy,” Dr Chetty adds.

“The milestone of completing one aspect of treatment gives a person a major psychological boost. Although you may not find it written in textbooks, in my experience, a positive mindset does help a person to remain motivated through their cancer treatment,” he says.

“There are a lot of things one cannot control in life generally, and when it comes to cancer. There is excellent value in shifting your focus to what you can do in any given situation. As Mr Padayachee demonstrated, a positive mindset can make a significant difference.

“It is also important to appreciate the gift of close social support if you are lucky enough to have family and loved ones. Many people draw strength from their faith and previous experiences to get through the difficult times in their cancer journey.”

Netcare Milpark Hospital’s Cancer Care Centre provides a comprehensive range of treatments with a caring and experienced multidisciplinary team equipped with state-of-the-art technology to provide customised treatment, and holistic, supportive care centred around each patient’s specific type and stage of cancer and their unique circumstances and needs.

“I hope that sharing my journey can have even a small positive effect for someone who has had to go through the horror and emotional challenge of a cancer diagnosis,” Mr Padayachee says.

“I am grateful to Dr Chetty, oncologist Dr Z Laher and the caring team at Netcare Milpark Hospital radiation unit, and to my partner and family for their support. We want the world to know that healing and recovery are possible with abundant love, care and a positive outlook.”

“Mr Padayachee faced his diagnosis and treatment with bravery, simply asking ‘What next?’. He’s inspiring to both staff and patients with his attitude of hope and positivity that shines brightly for all to see, and I have no doubt this has helped him in his journey and aided in his recovery,” Menevissis concludes.

Saving Sekani: paramedics praise mom’s CPR

Mon, 27 Nov 2023 09:00:32 GMT

Paediatric intensivist Dr Palesa Monyake and Sekani Nzima, who made a full recovery thanks to his mother’s knowledge of CPR and the medical teamwork from Netcare 911 and everyone involved in his care at Netcare Waterfall City Hospital.

Learn CPR, mom urges after saving toddler from near drowning

A toddler has made a full recovery after a near-fatal drowning thanks to his mother’s knowledge of cardiopulmonary resuscitation (CPR) and professional, caring medical teamwork.

“Our children, their cousin and some friends, including our neighbour’s daughter, were playing far away from our new pool, but when one of them came inside looking for a plaster Sekani must have been trying to follow her,” says his mother, Thandokazi Nzima.

“Suddenly, we heard the neighbour’s child, Rethabile Lehodi, screaming for help ‘Sekani fell in the pool’. It was such a shock that my sense of time became completely distorted. I was praying and praying as I ran to where she had pulled my boy out of the water and, through prayer, I became calm and was able to start performing CPR.

“I am a mining engineer, and although I attended CPR training, I’ve never had to perform it on a person – let alone my own son. I had to adjust the pressure for such a young child, and I wasn’t sure if I should interrupt CPR to turn him over. It was a frightening situation as a mother,” she says.

A neighbour called Netcare 911 for emergency medical assistance, and the Emergency Operations Centre helped coach Mrs Nzima on what to do for her 18-month-old son until help could arrive on the scene at their home near Silver Lakes in Pretoria East.

“Eventually, he coughed and showed signs of life. It didn’t take long for the ambulance to arrive, and it was as if everything came together to save Sekani,” she says.

“Arriving to find that Sekani was breathing was a relief, although he was not breathing as well as we would have liked,” Netcare 911 intermediate life support practitioner Wikus de Jager says.

The team checked his vital signs, and when Sekani was stable enough, he was transferred to the ambulance, where the team continued to give him oxygen while warming the little boy.

“We knew he was not out of the woods yet, and based on Sekani’s condition and the distance to the most appropriate hospital for his needs in peak hour traffic, the decision was made to airlift Sekani to Netcare Waterfall City Hospital via Netcare 911 helicopter emergency medical services (HEMS),” Netcare 911 advanced life support paramedic Jacques Andersen adds.

“The mother’s CPR was the game changer for Sekani. Most definitely, it was a deciding factor in her son’s survival and outcome, and I would encourage everyone to learn basic CPR as you never know when it could help to save a life,” he says.

“By the grace of God, there is a cul-de-sac right outside our house where the helicopter could easily land. My heart stood still as I saw my son being loaded into the helicopter, and I called out to him, ‘Sekani,” and a moment later, from inside the ambulance, I heard him cry out to me – it was such a relief to hear him responding,” Mrs Nzima says.

HEMS emergency care practitioners Megan Ellis and Tim Shipster looked after Sekani, keeping him warm and ventilated, on the journey to Netcare Waterfall City Hospital, where a specialist-led team was ready and waiting.

“It is extremely stressful for any parent when their child has a serious medical emergency. This was very time sensitive, and Sekani needed to be treated at a specialist facility. We assured the parents we would take the best possible care of their son,” Ellis says.

“Credit is due to the Netcare 911 ground crew who recognised the seriousness of Sekani’s condition and activated the airlift protocols to get him to the specialised paediatric intensive care unit at Netcare Waterfall City Hospital in the shortest possible time. Paediatric intensivist Dr Palesa Monyake is incredible; she and the team immediately placed Sekani on an oscillator machine to support his breathing.”

“We couldn’t be sure how long Sekani’s air supply had been cut off for a while in the water, and so we were very worried about the potential for brain damage,” Dr Monyake says.

Sekani was placed in a neuroprotective state, including a medically induced coma, and his temperature was kept cool to give his brain the best chance to heal from the hypoxia. The paediatric ICU team led by unit manager Sr Jabulile Nxumalo are highly experienced in the critical care of children.

“We recognised the parents’ pain and strong faith during the long days and nights ahead. What I appreciated from the first time we met Mrs Nzima and her husband was that they wanted to understand what was happening and whether their son would make a full recovery. At that stage, doctors were uncertain if their child would have a neurological impairment,” Sr Nxumalo says.

“In the paediatric ICU, we walk this journey with parents because the uncertainty can be very hard to cope with. As a nurse, I understand the medical environment, but if I go into a bank, I don’t understand the terminology used there, and so as a team, we try to guide and support the parents and help them interpret and navigate the care their child needs. It is the most rewarding thing for us to see a child go home fully recovered to their parents.”

“A few days later, Sekani developed severe aspiration pneumonia from the pool water in his lungs,” adds paediatric pulmonologist Dr Denise Parris, a key member of the paediatric ICU team who kept careful watch night and day as the parents prayed for their son’s recovery.

“Eventually, he turned the corner and was well enough to leave intensive care for high care and was then discharged home,” Dr Parris says.

“We are grateful to our ancestors, and to God for guiding the hands that saved Sekani. From our nine-year-old heroine neighbour Retabile who found him in the water, and the teamwork from the Netcare 911 operations centre, ambulance and helicopter medics, and Dr Monyake and the team who cared for him during his stay in hospital,” Mr Nzima says.

“Sr Jabulile and her team kept us grounded, calm and reassured, no matter how panicked we were, they kept their cool and remained professional. It's really not an easy thing to do, but the team was consistent at it. Our little boy was loved and cared for dearly, and my heart is full to have gone on this journey with the Netcare Waterfall City Hospital’s paediatric ICU team.”

Sekani’s sister, Asante, says she was very worried about her little brother. “I felt sad when Sekani was in hospital, and I am so happy he is back at home now and he can play again like before.”

“Now Sekani is fully recovered and as mischievous as ever. Anyone who sees him now would never imagine what he has been through in the last few months. We would strongly encourage everyone to learn at least the basics of CPR, things could have turned out very differently for us if we didn’t have this skill,” Mrs Nzima says.

Child drowning prevention toolbox

“Drownings can happen at any time of year, and in South Africa, we see a marked increase during the summer months,” says Netcare 911 spokeswoman Sarah Kekana.

Prevent drowning tragedies with these practical tips:

Learn life-saving skills, including the basics of swimming and cardiopulmonary resuscitation (CPR).
Know who to call in an emergency. Be prepared for any medical emergency with Netcare 911 on 082 911 and download the Netcare App, which includes Netcare 911 emergency call and geolocation functions and a 60-second callback option.
Fence ponds, pools and water storage: Install a four-sided isolation fence at least 1.2m high with a self-closing and self-latching gate to control access to bodies of water.
Be on the lookout. Drownings happen quickly and quietly. Never leave children to supervise each other, a responsible adult must always watch out for children near a pool, Jacuzzi or natural body of water.
Stay within arm’s length of children under four around water.
Don’t drink or be distracted by work, phone calls, technology, or anything else that may absorb your attention when watching children.
Fit a pool net immediately after swimming and replace it every time.
Don’t rely on armbands, floating toys, inner tubes, or devices to keep children safe.
Teach children to swim, but never leave them unsupervised around water.
Consider installing alarms. Various water alarms, such as a floating pool alarm or external security beams, can be installed to add to the precautions of fencing and supervision.
Beware of drains. Children must be kept away from pool or Jacuzzi drains as hair or limbs could become trapped in the suction.
Toilets, bathtubs, water features, fish tanks, pet water bowls and buckets. Children can drown wherever there is access to water, and a baby can drown in just 2.5cm of water.

Registered nurse Dikeledi Ramatlo, Enrolled Nurse Tholakele Dhladhla and unit manager of the paediatric ICU at Netcare Waterfall City Hospital Sr Jabulile Nxumalo are pictured with drowning survivor Sekani Nzima during a recent check up.

Mrs Thandokazi Nzima pictured with her son Sekani while he was recovering in Netcare Waterfall City Hospital.

Robotics turning the tables on prostate cancer

Fri, 24 Nov 2023 05:33:07 GMT

Urologists Dr Hannes Brummer and Dr Johan Coetzee are pictured with the latest da Vinci X robotic surgical system recently installed at Netcare Greenacres Hospital.

State-of-the-art da Vinci X now in E Cape

The high precision of robotic assisted surgery for localised prostate cancer is redefining the quality of life for men, with the latest fourth generation da Vinci X robotic surgery system installed at Netcare Greenacres Hospital, bringing this state-of-the-art technology to the Eastern Cape.

“There is no going back now – robotic surgery is advancing to such an extent that we can turn the tables on prostate cancer by completely removing cancerous tissue while sparing the nerves controlling erectile function and urinary continence and with minimal time off work needed for the patient,” says Dr Hannes Brummer , a urologist practising at Netcare Greenacres Hospital.

Dr Brummer and fellow urologist Dr Johan Coetzee have completed over 650 robotic assisted prostatectomies at the hospital since 2017 with a previous model of the da Vinci system.

“One of the major obstacles to early detection of prostate cancer is that men often don’t proactively go for regular screenings, sometimes out of fear for what the consequences may be. These days, if prostate cancer is detected early before it has spread, it is a curable disease,” Dr Coetzee says.

“With the robotic approach, a prostatectomy is a minimally invasive procedure that no longer needs to be a major disruption to life. The incidence of prostate cancer is rising, and we appreciate Netcare investing in highly sophisticated equipment so that we can offer surgical options that are comparable with the best technology available anywhere in the world, right here in the Eastern Cape.”

“When we started using the first da Vinci system six years ago, we were blown away by its capacity to enhance the surgeon’s control and accuracy. Now, we are seeing a further step forward in the technology far beyond what we could have imagined a few years ago,” Dr Brummer adds.

The new da Vinci X enables the surgeon to operate using slender instruments more dexterous than the human hand through tiny punctures in the skin. This robotic system has further enhanced magnified 3D imaging capabilities, with a large fixed-focus area at the highest resolution, making the nerves, blood vessels and tumour visible with even greater clarity than before.

The team had special training to become familiar with the enhanced features of this flagship version of the surgical system, and “the transition has been very slick”, according to Dr Coetzee.

The evolution of the da Vinci system and its capabilities are opening possibilities for other surgical applications higher in the abdomen, including partial nephrectomy. A partial nephrectomy, also called “kidney-sparing” surgery, is where surgeons remove diseased tissue, or a tumour, from a kidney while retaining as much healthy kidney tissue as possible.

“Laparoscopic partial nephrectomies are highly technical, and we can see great potential for robotic assisted surgery to refine this procedure, and others, in future,” he says.

Dr Louis van der Hoven, Netcare’s Cape regional manager, congratulated Dr Brummer and Dr Coetzee on completing their training to further develop robotic surgery options for urology in the Eastern Cape and neighbouring provinces.

“The power of technology to augment what is humanly possible is bringing a new dimension to doctors' expertise and surgical skill. We are thankful to Dr Bummer and Dr Coetzee for keeping abreast of these latest developments for the benefit of the patients we serve,” Dr Van der Hoven concludes.

Improved stroke outcomes must be a common goal

Thu, 16 Nov 2023 06:15:34 GMT

The multidisciplinary team at Netcare Pretoria East Hospital aims to improve quality of life for patients who have suffered a stroke. Pictured (left to right) are physiotherapist Richard Maseko, neurologist Dr Themba Tshabalala, speech therapist Mariandi Pretorius and occupational therapist Anri van Renssen.

Hope for better quality of life with fast multi-disciplinary care

Playing down serious symptoms in the hope that they will subside is one of the gravest mistakes a person can make. Not only does this lessen the potential to save the life of a patient in the case of a stroke, but also reduces their chance to retain their independence thereafter.

Dr Themba Tshabalala, a neurologist practising at Netcare Pretoria East Hospital, notes that prompt multi-disciplinary intervention in the case of a stroke can dramatically improve a person’s quality of life. He stresses the need for greater awareness around this in South Africa, where 10 people suffer a stroke every hour, according to figures from the Heart and Stroke Foundation of South Africa.

“Mobility, cognitive ability and communication are all too often diminished by a delay in seeking medical attention – a consequence that also impacts the mental wellbeing of the patient, resulting in anger and frustration. This understandable emotional response is often transferred onto those responsible for their care at home, which can be highly stressful for the carer too,” he notes.

Dr Tshabalala explains that a stroke most commonly occurs when a blood clot blocks the supply of blood to the brain – an ischemic stroke. It can also be caused by a burst blood vessel, causing bleeding in the brain – a haemorrhagic stroke. This results in damage to the affected areas, which can be fatal.

The size of a stroke and its location in the brain are closely linked to its severity, and individuals with uncontrolled co-morbidities often fare less well than those starting from a healthier baseline, he notes.

Multi-disciplinary care

Commenting on the need for multi-disciplinary intervention, Dr Tshabalala notes that because the brain damage caused by a stroke has an interrelated effect on even the most basic functions, it is crucial to begin rehabilitation as soon as the patient is medically stable.

He explains that outcomes are greatly improved if a patient has the immediate attention of a neurologist, a physiotherapist, an occupational therapist and a speech therapist, as this brings specialised focus to the different areas of life that are affected. Consulting a mental health professional is also advisable for both the patient and the caregivers at home due to the lifechanging effects that stroke can have.

“Speech-language therapists help patients with the ability to consume solids and liquids safely and efficiently when experiencing difficulties with the muscles that support this function. This is one of the first interventions that needs to take place after admission. This can mean anything from assisting a severely affected patient to swallow to establishing a nutritious diet that they are able to eat without aspirating or choking,” says Mariandi Pretorius, a speech therapist practising at Netcare Pretoria East Hospital.

“Naturally, we also treat communication deficits such as trouble understanding, trouble speaking, and cognitive impairments that affect problem solving, memory, and higher-level thinking skills, although this can be one of the last functions to improve. Including a patient's family in their care from the outset is central to effective communication and continued progress at home.”

Pretorius notes that achieving positive outcomes is dependent on the interplay between her role and those of her colleagues. For example, for a patient to have the ability to eat or drink something safely, diet or texture modifications and correct positioning of the body are required, which is dependent on physiotherapy, occupational therapy and dieticians.

Richard Maseko, a physiotherapist and part of the team at Netcare Pretoria East Hospital, adds that a multi-disciplinary team is vital to the recovery of a stroke patient. For instance the ability of a patient to swallow plays a considerable role in their general muscle strength and function, so that the patient can start to do the required exercises and eventually walk. The physiotherapist will then work together with the speech therapist and dietitian to meet this end goal.

"Movement is vital for encouraging mobility in stroke patients. While at times some other functions might take longer to come back and sometimes not be fully restored, rehabilitation has a far greater chance of success if we start from day one. The attitude of the patient towards treatment is also a determining factor," he says.

According to Dr Tshabalala, while many people are aware that stroke is a life-threatening healthcare event, it is not always fully understood just how devastating an impact it can have on the daily life of an individual.

“If a patient is bedridden, they can easily develop a host of other complications, some of which can be fatal further down the line. As soon as the patient is medically stable, holistic rehabilitative therapy should begin,” he says.

The need to re-establish simple daily tasks requiring fine motor skills such as brushing teeth, getting dressed, or making a cup of coffee is emphasised by Anri van Renssen and Inge de Jager, occupational therapists practising at Netcare Pretoria East Hospital.

“When a stroke occurs, a person can have real difficulty performing these tasks due to cognitive and physical deficits,” says van Renssen. “Our main aim as a team is to help that person regain their independence, which is central to a good quality of life. We include activities to stimulate healing in the brain and encourage the use of fine motor skills, such as needlework or puzzles. For this, we need physiotherapy to activate larger muscle groups and work closely with the speech therapist in the patient’s daily routine.

“The sooner we start, the better. We can see much improved outcomes in as little as seven days because our therapeutic disciplines are working collaboratively towards a common goal,” she says.

BE FAST

“Time is everything when it comes to achieving better outcomes for stroke patients,” says Dr Tshabalala. “Seeking emergency care as quickly as possible gives you a far better chance of reversing the damage as far as possible. Greater societal awareness around the symptoms of stroke is therefore key. Even primary school children should be educated about calling emergency services if they recognise the sudden onset of symptoms, which can be easily remembered with the acronym BE FAST.

B – Balance difficulties

E – Eyes lose vision or become blurry

F – Facial weakness on either side of the face

A – Arm and/or leg weakness on either side of the body

S – Speech that is slurred or difficulty in speaking or swallowing

T – Time to call emergency services

“Special treatments for stroke and established multi-disciplinary teams are available at hospitals and not primary care facilities, so it is imperative to get to the nearest hospital urgently if you suspect a stroke. It is also important to highlight that stroke can largely be prevented with healthy lifestyle choices and health screenings. We strongly encourage all South Africans to be aware of this,” concludes Dr Tshabalala.

Smart pacemaker implanted in Johannesburg hospital – A first for Africa

Fri, 10 Nov 2023 08:57:26 GMT

Meet the team behind Africa’s first implant of the world’s latest pacemaker at Netcare Milpark Hospital in Johannesburg. From skilled specialists to compassionate caregivers, this remarkable lineup is redefining cardiac innovation. From left to right are: Tasmeen Singh, radiographer; Dr Menachem Levin, cardiologist; Sr Matsiditso Mphekweni, registered nurse; Dr Aurence Nkosinathi Mdladla , anaesthetist; Sr Nolundi Notununu, registered nurse; Sr Susarah Klopper, unit manager (Cath Lab and Radial Lounge); Mo Rapulana, clinical technician and Dr Kaveshree Govender, electrophysiologist.

Reducing the burden of cardiac care, safely

Africa’s first implant of the world’s latest pacemaker, The Biotronik Amvia Sky , was recently performed by cardiologists Drs Kaveshree Govender and Menachem (Nachie) Levin and their colleagues at Netcare Milpark Hospital in Johannesburg.

The pioneering procedure followed closely on the heels of the smart pacemaker’s introduction in Europe , which took place in August, at the University Hospital Ghent in Belgium.

“My colleagues and I were privileged to gain early access to the first Amvia Sky pacemaker as it landed in South Africa – an opportunity that truly reflects our country's dynamic landscape of medical innovation,” Dr Levin says.

“This opportunity could not have come at a better time as it enabled us to assist a young man in his early thirties who was diagnosed with cardioinhibitory syncope. This rather complex condition, which results from a change in function of the interaction between blood pressure and heart rate control, profoundly impacted the patient.

“In this patient's case, when his blood pressure dipped, his heart rate steeply dropped to a range of five to ten beats per minute. This hindered his physical capabilities and overall quality of life and presented a substantial risk due to recurrent fainting episodes.

“The patient returned a week after the implantation for the system to be slightly adjusted and personalised to his needs. Less than a month later, his device settings are fully optimised, and his quality of life has markedly improved. For us as a team, seeing such a positive outcome in a relatively short timeframe is always most rewarding,” notes Dr Levin.

“Pacemakers are typically required later in life when older patients encounter difficulties initiating or controlling the electrical impulses at the upper part of their hearts, generally caused by a malfunction of the sinus node, the heart’s natural pacemaker. It can also be caused by a heart block, when there is an interruption or a complete lack of electrical flow in the top part of the heart,” he adds.

This new pacemaker is currently the only system on the market to provide a myocardial contractility sensor and physiologic heart rates through closed-loop stimulation (CLS). This allows the device to function as a conducting system in the upper region of the heart, where its algorithm identifies a drop in blood pressure and can restore the heart's natural myocardial contraction pattern.

Dr Levin says this pacing strategy is the latest approach to ensure optimal reproduction of the heart's normal conduction system. “Unlike traditional right ventricular pacing, it activates the ventricles more by utilising the heart's own electrical system below the level of the pathology, making the heart's conduction system work more efficiently. A further first and unique feature in this device is its capacity to significantly enhance safety and efficiency for patients who may periodically require access to Magnetic Resonance Imaging [MRI] scanning.”

According to Dr Levin, recognised as a stroke-ready facility, Netcare Milpark Hospital is equipped to provide advanced stroke interventions that can, in many instances, mitigate the severity of a stroke and save lives if initiated promptly after the stroke's onset.

“Many severe stroke cases are referred to Netcare Milpark Hospital for medical assistance, and several patients have pacemakers. Because MRI scanning can pose a risk to patients due to interference with the device, technologists must adjust pacemakers to a safe mode before the scan, monitor the patient closely during the procedure and reprogramme the pacemaker thereafter.

“Just as in the case of a heart attack where time is critical in unblocking arteries in the heart, when dealing with clots in the arteries supplying the brain with blood supply, every second counts. This device has the ability to automatically sense when the patient is entering an MRI environment. It then changes the pacing programming to a safe mode for the environment. Once out of the MRI, the device automatically changes back to the initial device settings. This saves valuable time, which in turn directly affects positive outcomes, he notes.

Dr Levin expressed his gratitude and that of his colleagues for the opportunity to access the very first Amvia Sky pacemaker to arrive on the African continent while recognising Netcare for supporting the use of cutting-edge technologies in the interest of patients. “I wish to acknowledge the foresight of Netcare’s management for embracing the merits of new technologies, processes and products that can improve healthcare outcomes. As clinicians, it is heartening to see how healthcare innovation can transform lives while revolutionising medical practices,” Dr Levin said.

Commenting on the introduction of the new technology, Jacques du Plessis, managing director of Netcare's Hospital Division, emphasised the essential role of patient-centric technologies within the healthcare sector and their innovative capabilities to address the needs of patients, doctors and healthcare funders.

"In the realm of healthcare, where every decision carries profound weight, our commitment to patient-centric technologies is unwavering. At Netcare, we stand as leaders in the pursuit of personalised medicine, weaving enhanced therapies and greater efficiency into the very fabric of our care. This dedication enables us to help reshape lives, shorten hospital stays, and etch stories of remarkable recovery, one patient at a time,” he concluded.

For further information on the cardiovascular treatment services offered at Netcare hospitals, please visit https://www.netcare.co.za/netcare-hospitals/specialist-services/cardiac .

The pulse of the community

Mon, 06 Nov 2023 10:56:28 GMT

(Left to right) Netcare Medicross Constantia Park clinic manager Estelle Claassen is pictured with General Practitioner Dr Nico Claassen and receptionists Algereece Damon and Christiaan de Beer.

Netcare Medicross celebrates 30 years of service

For 30 years Netcare Medicross and the healthcare professionals practising at its medical and dental centres have become part of the beating heart and rich tapestry of familiar community life, often serving multiple generations of the same family.

Dr Nico Claassen was one of the founding general practitioners when Netcare Medicross Constantia Park first opened its doors on 4 December 1994 and over this time, he has seen patients he first met as young couples become parents and then grandparents – with three generations under his care.

“Although the layout has changed so much since the beginning that it is hardly recognisable, one thing that has not changed is the wonderful team spirit and rapport between the doctors and staff, which is also reflected in the care for our patients,” Dr Claassen says.

“It is a privilege to have earned the trust of so many patients and a great responsibility. Once they have been to a specialist, many patients value our support and advice in following their treatment or management plan. It is very heart-warming, and I feel such gratitude for the relationships we have built over time.”

Mrs Tinkie Loubser has been a patient of Dr Claassen’s for 27 years, having previously worked in the dentists’ rooms at Netcare Medicross Constantia Park. “One day, 21 years ago, I consulted Dr Claassen because I started having trouble with my facial nerves,” she says.

“The following week, the doctor asked how I was feeling, and since my condition had not improved, he booked me an appointment with a neurologist. At first, I thought it was a waste of time – but the neurologist discovered I had a massive brain tumour.

“Dr Claassen was as caring and supportive as ever, he prescribed something to calm my nerves after the shock of the diagnosis and helped me to book the neurosurgeon, who saved my life by removing the brain tumour. I will always be thankful that I was diagnosed in time.”

Mrs Loubser, her husband, children and grandchildren have all been patients of Dr Claassen and the other doctors of Netcare Medicross Constantia Park in Pretoria. “He has always been good to us and supported us through so many things. Netcare Medicross has become part of our lives. Even though we live in the city, it feels more like small town care because they know you, you aren’t just a number to them.”

Mrs Sandra Fichardt has been Dr Claassen’s patient for 25 years since she was a student. “He is not your typical doctor sitting across the desk, he is also a human being. It comes naturally to him to ask about your family, and how you are feeling – apart from just asking about your clinical symptoms.

“He has seen us through so much; our children are about the same age, and we went through the ‘teenage years’ as parents at the same time, and as a medical doctor, he provided excellent support and referrals through the years.

“Dr Claassen and the other doctors we have been to at the Medicross centre have been good to us, and it is rare to be kept waiting. I also appreciate that he is mindful of our medical scheme benefits and does not prescribe unnecessarily, especially when it comes to antibiotics,” Mrs Fichardt says.

Dr Neville Wellington has been practising at Netcare Medicross Kenilworth for 29 years, and during this time he has seen patients he treated as children grow up and have their children under his care. “The beauty of being in general practice is that you have a long-term relationship with your patients,” he says.

“I started at Medicross on 7 April 1994, and so much has changed since then in terms of the building and the technology we now have. We have grown from three doctors then to 14 doctors now and from one dentist to six to match the needs of the community.”

The addition of a nursing department proved lifesaving for a patient who came in early one morning complaining of chest pains during the early stages of the COVID-19 pandemic. Nurses were performing an electrocardiogram (ECG) when Dr Wellington arrived to find the patient starting to go into cardiac arrest.

“Fortunately, we have an automatic defibrillator, and we resuscitated the man immediately and placed him on a drip while waiting for the ambulance to transfer him to hospital, and I could brief the cardiologist before the patient arrived so all would be ready to receive him. Thankfully, he was in the right place at the right time when this happened, and he survived and made a good recovery,” Dr Wellington recalls.

Dr Billyy van der Merwe, managing director of Netcare’s primary health division, thanked all healthcare professionals practising at Netcare Medicross facilities, practice management and staff members for their partnership and dedicated service to patients over the past three decades.

“Most of all, we are grateful to the individuals and families who turn to our Netcare Medicross facilities at the heart of their communities for their medical and dental needs. We will continue to invest in the services that make healthcare more convenient so you can always feel at home while looking after your health at your local Medicross,” Dr Van der Merwe concludes.

One-of-a-kind Keenan is walking tall

Wed, 18 Oct 2023 06:18:37 GMT

Keenan Petersen has never let being born with multiple deformities hold him back from anything. A lifelong friendship with orthopaedic surgeon Dr Sietse Wouters and several procedures at Netcare Garden City Hospital have enabled Keenan to walk upright. He recently attended his matric dance in style.

Knee becomes hip joint in orthopod’s quest to improve mobility

A young man with enormous tenacity and a luminous smile who was born with several bones in his limbs shortened, fused or absent is walking comfortably at last, thanks to the lifelong dedicated care and support of his mother and an innovative orthopaedic surgeon.

“I first met Keenan Petersen when he was only 15 days old, and it is wonderful to see the bright, well-adjusted and optimistic person he is today at 18 years old,” says Dr Sietse Wouters, a Dutch-born orthopaedic surgeon who has practised at Netcare Garden City Hospital since 2000.

A genetic abnormality led to Keenan being born with shortened arms, no hip joint and no femur in his right leg, which as he grew, resulted in this leg being considerably shorter than his left leg. In 2005, when Keenan was only a year old, Dr Wouters performed the first in a series of operations to develop Keenan’s capacity for mobility.

“When Keenan was born, the doctors told me he probably wouldn’t be able to walk, and so we did not try and teach him to walk – but Keenan soon figured out his own way of getting around by shuffling along on his bum,” his mother, Rowena Cohen says.

Keenan, who is now in matric with ambitions to pursue tertiary studies in Information Technology, says that from a young age, he has had to figure out his own method of doing things. “I see myself as differently-abled, and I never let it hold me back from anything. I find my own way, and this has become part of my approach to life,” Keenan says.

“In 2016, Keenan and his mother came back to see me because he was having back pain. He was growing up and developing physically, mentally and emotionally and was suffering from positional scoliosis, which is an abnormal side curvature of the spine,” Dr Wouters explains.

He had developed a way of walking with the left knee steeply bent to 110 degrees, to accommodate the straight but too short right leg. The resulting pelvic tilt and awkward gait affected his back badly.

“Keenan’s case was unique, very few doctors had seen something quite like this in South Africa. I did a lot of painstaking research and consulted highly experienced international colleagues before we decided on the most feasible approach to surgery.”

In a 7-hour procedure at Netcare Garden City Hospital, where Keenan was born, Dr Wouters and the medical team did a Steel’s Ilio-femoral fusion in which Keenan’s right knee was fused into the pelvis, which allowed his knee to function as his hip.

“Now that he had a ‘hip’ and could bear weight on the right side, we were closer to establishing a stable leg for him, but it was still 27cm shorter than the left leg. The next challenge was that Keenan’s normal right foot could not accommodate a prosthetic leg.

Dr Wouters explained to Keenan and his mother that amputating the foot on Keenan’s affected leg would finally allow him to use a prosthesis to walk upright, relieving the pressure on his spine when walking.

“For each procedure he suggested, Dr Wouters would explain the benefits, ask for Keenan’s input and give us time to think it over. The amputation was a big decision, but when we could see what Dr Wouters had in mind, we decided it was the best option,” Rowena says.

Dr Wouters performed a procedure known as a Syme amputation, whereby the foot was removed, and Keenan’s heel was stabilised in line with his hip to create a cushioned stump that would more comfortably fit a prosthesis.

“It was a hard decision, but it was worthwhile in the end. The journey with my surgeries was a scary experience, I would get nervous and feel sad sometimes. None of this would have been possible without Dr Wouters, and I cannot thank him enough,” says Keenan, who recently attended his matric dance at the Hope School in Westcliffe.

“Dr Wouters has been our guardian angel through all this, he’s shown a father’s care for Keenan. Although it was a tough road, the operations have greatly improved Keenan’s posture and mobility. We are so grateful to him and all the doctors, nurses and staff at Netcare Garden City Hospital who were there for us over the years,” Rowena adds.

“Keenan has grown into an exceptional young man, and he and his mother have shown such strength throughout. It is such an honour for me to have their trust, which has allowed us to achieve a good outcome for Keenan. South African private healthcare enables specialists to work with patients sometimes over many years to achieve a better quality of life in highly complex cases such as Keenan’s,” Dr Wouters concludes.

Young man defies the odds to overcome severe heart injury

Thu, 12 Oct 2023 12:09:49 GMT

Life-saving collaboration: Strategic multi-disciplinary approach to near-fatal pellet gun wound

Just a few millimetres of muscle – that was all that stood in the way of a fatal injury for a talented school rugby player. That and a carefully considered, multidisciplinary approach to the heart surgery that would have him back in class and training once more within a matter of weeks.

Ian Venter, an active 15-year-old from Fochville, is just like any other sporty youngster who loves the outdoors, playing team sports and spending time with friends, but after an accident with a high velocity pellet gun, Ian suddenly found himself fighting for his life.

Dr Elias Zigiriades , a cardiothoracic surgeon practising at Netcare Krugersdorp Hospital, explains that the tiny bullet from the pellet gun had gone through Ian’s breastbone, penetrating two chambers of his heart and missing his coronary artery by less than a centimetre before stopping just outside the right ventricle – the chamber responsible for pumping blood to the lungs for oxygenation.

“It was remarkably lucky that the pellet had entered Ian’s chest where it did, as the chances of saving his life could have been significantly reduced. As it was, his heart had already undergone considerable trauma, and because the pellet was so small and its location was not immediately easy to identify, we had to tread with caution,” he says.

With the operating team on standby, Dr Zigiriades worked with a radiologist and cardiologist to conduct a CT angiogram – a non-invasive scan – which allowed them to create a 3D representation of Ian’s heart to locate the tiny pellet, which had done a surprising amount of harm.

“We were astonished at just how deep an impact that little pellet had made. While we could see areas of damage that it had caused, it was difficult to ascertain whether it had stopped inside or outside the muscle wall. Ian’s treatment had already been delayed by an unfortunate series of events, with the emergency services provider taking him to a different hospital before he was ultimately referred to us. Though he was stable, by the time he arrived at Netcare Krugersdorp Hospital, it was crucial for his injury to be promptly addressed.”

Ian’s mother, Teresa, recalls the sense of dread she felt at hearing that Ian would have to undergo open heart surgery. “Accidents happen, especially with kids, but I never thought that my fit and healthy son would be going in for a procedure like this. But, as Dr Zigi explained, there was no more time to lose and I am of course so glad that he acted when he did,” she says.

According to Dr Zigiriades, only once Ian was in theatre could the two most astonishing discoveries around his injury be made.

“Firstly, once I had begun to operate, we saw that there was an enormous amount of blood surrounding Ian’s heart – about 800ml to 1 litre – that needed to be drained. Most patients are already very unstable at around the 200ml mark, so the fact that Ian had even made it this far was quite remarkable,” he points out.

“It was also at this time that we could see how close the pellet had come to Ian’s coronary artery. Ian would never have made it here if it had hit that artery. He must have had a few guardian angels watching over him.

“Given how much damage that tiny pellet had already caused, our anaesthetist also conducted a transoesophageal echocardiogram during the procedure to assess whether any damage had occurred to the heart valves. This is a special scan done with a tube via the throat that uses sound waves to assess the functioning of the heart,” he explains.

Fortunately, however, Dr Zigiriades and the team had, by this stage, uncovered the full extent of the damage. Once the pellet was removed and the tears repaired, Ian was transferred to the hospital’s cardiothoracic intensive care unit. There, he began the recovery process under the watchful eye of the unit’s experienced and skilled nurses. By the following morning, he was already sitting in a chair, and within six days, he was ready to be discharged.

“Ian immediately began rehabilitation with the physiotherapist and bounced back quickly. His age and fitness level were very much on his side,” says Dr Zigiriades.

Teresa notes that the timing of Ian’s injury meant that he only had to miss a couple of days at the start of the school term, and aside from a brief hospital visit to have some fluid drained from his lungs – a common occurrence after open heart surgery – he has been in excellent health.

“In the beginning, Ian had to take it easy, and his school was very helpful in making special arrangements to help with his recovery, such as a locker closer to his classes so that he wouldn’t have far to go with his books. He started exercising daily to rebuild his muscle strength and condition, and he is now training for the next rugby season.

“We are so glad he is back to normal life – fishing, riding his bike and enjoying his sport. What happened gave us all a huge fright, but thankfully, he got just the care he needed and is now back preparing for his future,” she concludes.

Deep inspiration: Two women share their breast cancer journeys

Thu, 05 Oct 2023 10:05:55 GMT

Dr Diana Pillay, a radiation oncologist practising at Hopelands Cancer Centre in Netcare Parklands Hospital, says breast cancer is highly treatable with the advanced techniques available today, such as Deep Inspiration Breath Hold radiotherapy.

Advanced ‘breath hold’ radiation therapy technique

A breast cancer diagnosis is no longer a death sentence, and women should not be afraid to screen for this all-too-common condition, which is now highly treatable. Two women both undergoing Deep Inspiration Breath Hold (DIBH) technique radiotherapy at Netcare Parklands Hospital, share their experiences.

“A friend of mine was diagnosed with breast cancer before me, and she encouraged me to have a mammogram in July last year, where a shadow of something was picked up in my left breast that turned out to be malignant. Since then, another two friends have also been diagnosed, one of them after hearing about my breast cancer,” says Jenny Miller.

“The four of us have become closer, and it is wonderful to have the support of other people who can truly empathise with what you are going through. We have come across so many wonderful people in our treatment journeys, and it is so encouraging to hear from breast cancer survivors.”

Mrs Miller was referred to radiation oncologist Dr Lucille Heslop and met the clinical criteria for DIBH external beam radiotherapy, a highly targeted technique that accurately delivers a dose of radiation to the cancer while sparing healthy underlying tissue.

“While chemotherapy and radiotherapy to the chest are effective for treating cancer, these can cause cardiovascular side effects. DIBH aims to reduce exposure leading to cardiac toxicity for patients with left breast cancer who have already been exposed to cardiotoxic chemotherapy and targeted antibody therapy, such as Herceptin,” Dr Heslop explains.

“DIBH radiotherapy is now a firmly established technique, which more clearly defines the coronary vessels and heart, allowing more precise planning to deliver the radiation dose safely where needed,” she says.

Dr Diana Pillay , a radiation oncologist practising at Hopelands Cancer Centre in Netcare Parklands Hospital, says that the technique requires patients to breathe in deeply and hold their breath for a few seconds, guided by the radiotherapists.

“In the past, we saw mainly older people being diagnosed with breast cancer, but nowadays, it is a wide spectrum of age groups. Breast cancer is very treatable these days, and with the more advanced techniques available, such as DIBH radiotherapy, we can do more to prevent unnecessary exposure and the side effects of treatment.”

Retired primary school teacher Monica James was diagnosed with breast cancer after she noticed a small lump on her chest. “I am generally a very healthy person, so I didn’t think much of it but went to my GP at Netcare Medicross The Bluff, and she immediately set up a mammogram appointment for me.

“At the centre, they asked me if I had been for a mammogram before, and foolishly I had not. The journey that followed was an emotional one and a steep learning curve. Still, I was so lucky to have my very supportive husband with me every step of the way and a team of amazing healthcare professionals who I have come to trust implicitly,” Mrs James, 65, says.

“At first, when you are diagnosed, it feels like a death sentence, but the more you learn, the more you realise there is hope. I first had a course of chemotherapy and then surgery to remove the tumour. My surgeon referred me to Dr Heslop for radiotherapy to treat any remaining cancer cells, and I had to go for a month of DIBH sessions.

“It’s always daunting if you don’t know what to expect, but the radiology team at Netcare Parklands are so reassuring and treated me with such dignity that they felt like my daughters, and when I was having my treatments, we became like a little family. They explain everything to you so well and are so gentle,” Mrs James says.

“The radiotherapist taught me the breathing technique, and I had to practise a little, but it became easier after the first few times. Every week, I would see Dr Heslop, and she explained how to take care of the site and prescribed medication that soothed the area, and it worked like a charm.”

Both Mrs James and Mrs Miller have now completed their DIBH radiotherapy and have responded well to the treatment. Their oncologists are continuing to manage their conditions with regular injections. “My faith has lit the way on this journey, which is still ongoing, and although I had some dark times, I am feeling so much more myself, I feel so good. I want to thank Dr Heslop and Netcare, I knew I was in good hands,” Mrs James says.

Mrs Miller adds: “When you are diagnosed with cancer, people tell you that you are brave – but really, you just get on with it. I was very grateful for Dr Heslop and the radiotherapy team at Netcare Parklands Hospital, and I could see a way forward. I am very strong in my Faith and have a lot of support from wonderful family and friends, which is crucial to overcoming fear.

“I would like to encourage women to keep going for check-ups, especially if you have dense breast tissue, making it harder to detect breast cancer. Talk to your friends and family about the need for regular screenings, it could save the life of someone dear to you,” Mrs Miller concludes.

Monica James and Jenny Miller share their journeys of breast cancer diagnosis and treatment, and based on their experience, encourage women to have regular mammograms.

Touching lives with science and tech in healthcare

Thu, 28 Sep 2023 13:53:14 GMT

Clinical Pathologist and entrepreneur, Dr Esihle Nomlomo

Clinical pathology entrepreneur honoured with SHERO Award

The power of science and technology to help people get well sooner is the driving force that motivates Dr Esihle Nomlomo, a clinical pathologist and entrepreneur who is making her mark in the South African healthcare sector.

“We congratulate Dr Nomlomo on her recent SHERO Award for women in science and technology. The award is well-deserved recognition of Dr Nomlomo’s skill and passion for bringing together clinical expertise, digital technology, and entrepreneurship to drive innovation that leads to improved access to healthcare and enhanced clinical outcomes,” says Dr Nceba Ndzwayiba, Netcare Group director of human resources and transformation.

Born in Mthatha, and raised and educated in Cape Town, Dr Nomlomo moved to Gauteng for an internship and to continue her studies specialising in clinical pathology at the University of the Witwatersrand. She worked for the National Health Laboratory Services and later launched her own pathology incorporated practice, Dr Esihle Nomlomo Inc., supported by Netcare as part of its enterprise and supplier development programme.

At just 36 years old, today her company is a crucial part of the supply chain for Netcare and is making a name for itself in healthcare.

“As a clinical pathologist I have a background in biochemistry, haematology, microbiology and virology, which allows us to review patients’ results and pathological processes holistically,” Dr Nomlomo explains.

The enterprise development partnership between Dr Nomlomo Inc. and Netcare Diagnostics as the administrator, started out with providing Point of Care services in the form of blood gas analysis for specialised units at certain Netcare hospitals.

These analysers record their data on a digitally integrated system which is able to link to the patient’s unique electronic profile. This ground breaking innovation has been expanding its services into the Netcare emergency departments (ED) and offers Point of Care services in the ED that reduce time in obtaining results, treatment and intervention.

“The Point of Care solution has revolutionised the ED space, as units are able to make rapid and reliable clinical decisions, contributing towards prompt allocation of appropriate resources towards patient care. This in turn alleviates pressure on the ED unit and improves overall effectiveness, efficiency, and clinical outcomes,” adds Jacques du Plessis, managing director of Netcare hospital division.

Point of Care is linked to and supported by central pathology laboratories in Gauteng and three regional laboratories in KwaZulu-Natal, the Eastern Cape and the Western Cape to serve patients in Netcare facilities.

“It is very rewarding to see how our technology can make a difference holistically to the healthcare journey of a patient through digitalised quality and reliable results that allow rapid diagnoses to be made, assisting patients to get back to productive life sooner – that is what really motivates me. It is the rapid impact,” Dr Nomlomo says.

The laboratory services have also extended their comprehensive services to Netcare Medicross facilities.

“The Netcare Group has been very supportive, as they have seen the advantages of the seamless continuity of care this interlinked and digital system enables for our patients. I would especially like to acknowledge Dr Richard Friedland, Group chief executive officer of Netcare, for his belief in this partnership,” she says.

Dr Nomlomo was recently honoured with a SHERO Award in the category of Science and Technology from Gagasi FM, which aims to shine a spotlight on women’s talents, abilities and direct impact on the province of KwaZulu-Natal and recognises innovation and excellence in the execution of related projects.

“It is humbling to be recognised by the people you work with at a local community level, and is one of the greatest accolades for me.”

Asked for her motivational message to other entrepreneurs or aspiring businesswomen, Dr Nomlomo shares: “Keep shining where you are and being the light for others. Everything starts with believing in what you are doing and that it is possible. Higher powers have a greater purpose for you.

“When you are a start-up, it can feel like an uphill battle but consistency is essential. Push through the fatigue, wake up tomorrow and try again or die trying. Don’t let one hard day define the rest of your year or the ultimate outcome.

“What I have learnt is the importance of having your own ‘village’, your support system to carry each other during the different phases of growth in any project or business. The refreshing power of bouncing an idea off a colleague or a team member with a different perspective and fresh eyes cannot be underestimated. The joy of knowing that a win for one is a win for all,” Dr Nomlomo says.

“The significance of what Dr Nomlomo is achieving at such a young age is powerful inspiration for the next generation, showing that hard work and perseverance are recognised and can lead to opportunities to positively touch the lives of many thousands of people into the future. As Netcare, we are privileged to partner with Dr Nomlomo on this journey and wish her every success for the future,” Dr Ndzwayiba concluded.

“How far we have come” – the enormous evolution of cardiac surgery

Tue, 19 Sep 2023 05:38:28 GMT

Reflecting on a life-altering moment: 68-year-old Joe Jordaan from East London and renowned cardiac surgeon Dr Willie Koen photographed next to a bust of Professor Christiaan Barnard at the Netcare Christiaan Barnard Memorial Hospital, which was built in tribute to the great surgeon, whose skilled hands afforded Joe a lifetime filled with personal achievements and a loving family.

More than sixty years later, the work of Chris Barnard lives on

In April 1962, a six-year-old boy with a charming gap-toothed grin embarked on a life-altering journey from East London to Groote Schuur Hospital in Cape Town, a trip that would shape his destiny in a lifetime of remarkable heart health breakthroughs.

More than six decades later, Joseph Jordaan, who is now 68 years old, recently returned to the operating theatre in the Mother City, this time at the cutting-edge Netcare Christiaan Barnard Memorial Hospital , which was built in tribute to the great surgeon whose skilled hands afforded Joe a lifetime filled with personal achievements and a loving family.

Joe was born with a congenital heart defect – a condition that saw him and his mother, Sarah, make the trip to Cape Town in search of a normal life for him at a time when advances in heart surgery were limited. Little did they know that global cardiac care was on the precipice of a quantum leap.

In the same hospital where Joe’s life would be irrevocably changed, the world's first human-to-human heart transplant would be performed less than five years later on 3 December 1967 by the visionary Dr Christiaan Barnard , the very same surgeon who performed the ventricular septal defect repair to the hole in Joe’s heart.

“It was a profoundly moving moment as my colleagues and I stood in the operating theatre at Netcare Christiaan Barnard Memorial Hospital to perform Joe’s second heart procedure,” says world-renowned cardiac and transplant surgeon Dr Willie Koen .

“There was almost no evidence of the surgery performed by Professor Barnard 61 years ago to repair the hole in Joe’s heart. The work was meticulous, and to this day, it continues to serve Joe well. This time, we were working on a different heart-related modification to replace Joe’s heart valve, close to the septum where the hole in his heart had been repaired.

“It was awe-inspiring and humbling knowing that the work of this incredible surgeon – who had operated on this very same heart using very different technology more than six decades ago – lived on 22 years after he had passed on. What an incredible legacy Professor Barnard has left, not only for his patients but for surgeons like me, who were able to follow in his footsteps,” says Dr Koen.

A few days after his procedure, Joe, a retired petrol and diesel mechanic, said he was doing “one hundred per cent” well. Talking about his recent heart scare, he said, “I got such a big fright, but fortunately I got lucky a second time. A few minutes later and I would have been gone.

“My first heart procedure lasted me a lifetime, during which I married my wife Jean, and I gained three stepchildren and a daughter of my own. I was living well, eating and drinking like everyone else. Along the way I have had a few health scares which among others, resulted in having 36 centimetres of my colon removed. I also had two hip replacements. Nowadays, I watch what I eat and I don’t drink.”

For Joe’s loving wife Jean, his most recent heart procedure – which came two days before her birthday on 1 September, was an early birthday present, valuable beyond words. “We cannot wish for better,” says Joe and Jean as they count their blessings ahead of discharge and a trip back home to East London.

According to Dr Koen, ventricular septal defect repair, even by today’s standards can be a complex and difficult procedure. Back in 1962, it would take several hours, and in Joe’s case – because of complications brought on by the complexity of the procedure – it resulted in two operations of six and eight hours, respectively, in the space of a single day. Joe spent more than a month in hospital following his procedure.

At the time, repairing a hole in the heart typically involved open-heart surgery. A large incision, often in the chest area, would be made to access the heart. In some cases, a sternotomy, which involved splitting the breastbone, was necessary to gain access to the heart. To temporarily take over the heart's circulatory function, a heart-lung machine (cardiopulmonary bypass) would be connected to the patient. This machine would oxygenate the blood and pump it throughout the body while the heart was stopped.

With the heart still and blood flow diverted through the bypass machine, the surgeon would carefully locate and repair the hole in the heart using various techniques involving sutures, patches or other materials to close the hole. Once the heart was successfully repaired, the heart-lung machine would be gradually withdrawn, allowing the heart to regain its natural pumping function. The chest incision would then be closed with sutures or staples.

“It's important to note that surgical techniques and equipment have evolved significantly since 1962. Today, most heart surgeries can be performed using minimally invasive approaches, reducing the need for large incisions and the use of a heart-lung machine in some cases. Nowadays, open-heart surgeries, which are almost a routine procedure, usually require a hospital stay of four to five days. Once you're discharged from the hospital, it can take six to eight weeks for your breastbone and chest muscles to heal as you gradually return to your normal daily routine,” Dr Koen says.

“I think we underestimate the enormous evolution of cardiac surgery and how far we have come,” says Dr Koen. “It is when you look at the life of Joe Jordaan, and how he would not have seen adulthood if not for the procedure performed by Professor Chris Barnard all those years ago, and the fact that he has now been given a second lease on life once more, that you fully understand the value and tremendous impact of cardiac surgery.”

Still inspired to make a difference

Wed, 13 Sep 2023 07:30:51 GMT

Ntsako Mathebula, a mother of three who sustained a bullet wound to her back while on duty as a police officer says that one year on, she is looking forward to going back to work in an administrative role where she can still do good and make a difference.

Tenacious mother of two embraces life after spinal damage

When 34-year-old police officer Ntsako Mathebula set out for a routine patrol with her colleagues one quiet Spring morning in 2022, it felt like any other day. Little did this fit and active mother of three know that it would be the last day she would ever have use of her legs.

While on duty, Ntsako sustained a bullet wound to her back, resulting in severe abdominal injuries, a collapsed lung and, most devastatingly, irreversible damage to her spinal cord, leaving her paralysed from the midback downwards, explains Dr Aneesa Khan, a general practitioner with special interest in physical medicine and rehabilitation who practises at Netcare Rehabilitation Hospital.

Looking back one year later, Ntsako recalls the moment her life changed when she and her colleagues pulled up to a garage in a residential area where, unbeknownst to them, a robbery was underway. They immediately came under fire without any time to respond. While Ntsako and her partner survived, tragically, their commander was critically wounded and later died in hospital.

“All the while, I was praying to God, saying, ‘I am not ready to come to you yet’. After the incident I was in a lot of pain and could not feel my legs, but I was grateful to be alive,” she says.

Ntsako was taken to Netcare Milpark Hospital and once stabilised, underwent scans to assess the extent of her injuries. Professor Maeyane Moeng, Academic Head of Trauma at the University of Witwatersrand and a trauma surgeon, along with Dr Christos Profyris, a specialist neurosurgeon, noted that the bullet had gone right through Ntsako’s spine to her small intestine.

Prof Moeng operated to remove the bullet and address the injuries to Ntsako’s abdomen, which were severe but from which she fully recovered. The damage to her spine however was irreversible and after moving to Netcare Rehabilitation Hospital, the reality of her journey began to sink in.

“At first, I was in denial – I kept thinking the feeling would return to my legs and life would go back to normal. But the first time I was pushed in a wheelchair, it felt real. I tried to keep my spirits up, smiling every day and encouraging myself, but it was very hard, knowing how easy it was before to do something as simple as sitting up. As a previously fit and active person, I now had to learn how to sit up,” says Ntsako.

Dr Khan points out that one of the primary concerns in rehabilitating paraplegic patients is sensory impairment, which prevents them from feeling pain or sensing limb position. This can lead to pressure sores, which occur when the skin and underlying tissue are subjected to ongoing pressure, such as when an individual’s legs remain in the same position for lengthy periods.

“Pressure sores can become infected and can be fatal if left untreated. After sustaining an injury like Ntsako’s, it is important to get the patient out of bed and moving as soon as possible to avoid this. The lack of muscle movement in spinal cord injury patients leads to the development of osteoporosis very early on, which also makes you far more susceptible to bone fractures – again, you may not be immediately aware of this since you cannot feel the pain if you have a fall when moving yourself from one surface to another, such as from the bed to a wheelchair.

“Lack of sensation also affects bladder and bowel control, and it is essential for patients to get onto a scheduled plan so that they can manage this. This is important for protecting the skin, digestive system and kidneys and preventing infections, as well as for feeling comfortable to participate in social situations.

“Nerve pain is another major concern and the medications for managing this pain are limited. Physical and psychological therapy are important in helping patients to manage their pain and the process of acceptance. The spinal cord injury experience is multi-faceted, and we therefore work in a multidisciplinary team with physiotherapists, occupational therapists, psychologists and social workers to give patients the strongest foundation for moving forward and having a full and happy life,” says Dr Khan.

Trinesh Baroon, a physiotherapist practising at Netcare Rehabilitation Hospital who provides Ntsako with outpatient care, notes that the mental shift for spinal cord injury patients is an enormous challenge and that Ntsako has shown herself to be a remarkably tenacious, highly motivated person.

“By the time I saw her, Ntsako had already made tremendous progress, but the move home can be challenging as it is a very different environment where you go from having round the clock care and ten physio sessions per week to being responsible for your daily needs and having just one session per week.

“In fact, she went in person to her healthcare funder to motivate her case to receive outpatient care as she is so determined to recover to the best of her ability. Her bravery and determination will influence the lives of people she will never even meet because she has helped to pave the way for others in similar circumstances,” says Baroon.

“We have worked a lot on strength and endurance and have been doing therapeutic standing to try to build up her blood pressure. Without this, there is the possibility that a patient can go into postural hypotension or low blood pressure and can have vertigo, which is a serious problem when you need to be able to safely move yourself from one surface to another. It requires continued commitment, and Ntsako has fully embraced that, asking questions when she needs to and taking ownership of her rehab – and this is when we see the most successful outcomes.”

Ntsako notes that while the adjustment to this new way of life is emotionally challenging, she feels a great sense of relief and comfort in being able to talk about it with her social worker and her loved ones.

“Talking openly about my experience is helping me to relate to my family in a new way, and I feel that I have been able to process what has happened emotionally. My goal is now to master the physical aspects of living back at home so that I can care for myself and also my family.

“I have learned from this experience that there are some things you cannot change, but you can always change your mind. It is all about attitude. I am so looking forward to going back to work in an administrative role. I am ready to start afresh, and I am still inspired to do good and to make a difference,” she concludes.

New frontiers reached in the treatment of advanced prostate cancer

Fri, 01 Sep 2023 07:31:23 GMT

The first two private sector patients with advanced prostate cancer were treated with 225-Actinium-Prostate Specific Membrane Antigen (Ac-225-PSMA) by specialist nuclear physician and Head of the Nuclear Medicine Department at Netcare uMhlanga Hospital, Dr Masha Maharaj, and her team earlier this month. Pictured here is 75-year-old Mr Graham Tayler with Dr Masha Maharaj.

New prostate cancer treatment sparks optimism for private sector patients

A treatment for the management of advanced prostate cancer, recently introduced in the private healthcare sector, is sparking a fresh wave of optimism for patients throughout Africa.

The first two private sector patients with advanced prostate cancer were treated with 225-Actinium-Prostate Specific Membrane Antigen (Ac-225-PSMA) at Netcare uMhlanga Hospital by specialist nuclear physician and Head of the Nuclear Medicine Department at uMhlanga Molecular Imaging and Therapy, Dr Masha Maharaj , and her team earlier this month.

Commenting on the breakthrough treatment, Dr Maharaj said, “Actinium-225 is a radioactive substance that we can add to a carrier called prostate-specific membrane antigen (PSMA). It is an atom that sends out radioactive particles, and PSMA joins the patient's tumour with the radioactive Actinium atom attached to it.

“The treatment is injected into the vein and once inside the body, it seeks out prostate cancer cells attaching firmly to them to deliver a precise, potent dose of radiation to destroy the cancerous cells. Known to be highly effective in the treatment of prostate cancer, any Ac-225 PSMA that is not absorbed by the tumour cells passes out of your body in your sweat, saliva, urine and stool. An average of four to six Ac-225-PSMA treatments are generally required,” explains Dr Maharaj.

Netcare uMhlanga Hospital is the only private healthcare facility in Africa to provide this highly specialised Ac-225-PSMA treatment, which is usually indicated for patients with progressive metastatic castrate-resistant prostate cancer (mCRPC) who have failed current standard lines of therapy, such as radiation, chemotherapy and hormonal therapy.

“There have been excellent outcomes reported with complete response to therapy, and for the majority of patients, there is a significant result in palliation or better pain control, delayed tumour progression (slowed tumour growth) and improvement in quality of life and overall survival. One of the remarkable characteristics of the therapy is its minimal and manageable side effects, setting it apart from various other cancer treatments.

“The patients, 75-year-old Mr Graham Tayler and 82-year-old Mr Allan Smith, presented to us late in the development of their cancers. However, within 24 hours following the procedure, they were both reported to be doing well and pain-free,” notes Dr Maharaj.

She adds that the therapy is poised to make a significant difference in the lives of prostate cancer patients who have shown resistance to alternative treatments. “For these patients, it has the potential to inspire a renewed sense of hope. Furthermore, the implementation of these targeted therapies is expected to yield cost savings within the healthcare sector. Unlike systemic therapies, which often come with a broader range of side effects, targeted therapies offer a more focused and gentler approach,” Dr Maharaj says.

There are strict international security standards regarding radiation safety, and to ensure reproducible results with uniform outcomes, such procedures can only be undertaken in a highly specialised nuclear medicine centre by specialist nuclear physicians with properly trained support staff.

Underlining the significance of specialised expertise and infrastructure in performing such intricate procedures, Dr Maharaj said it was a proud moment for her and her team of eight. “The newly upgraded laboratory at uMhlanga Molecular Imaging and Therapy has been especially equipped for preparing the Acc225-PSMA, which required imported components.”

“As a department we are proud to be part of this milestone in the private sector. The current clinical practice has shifted to precision medicine. These targeted therapies are playing a pivotal role in reducing clinical symptoms and facilitating the destruction of cancerous cells while minimising damage to healthy cells and preserving normal function.

“This therapy has great promise for men with advanced prostate cancer, in South Africa and elsewhere on the continent, improving overall survival and quality of life. We look forward to many more groundbreaking initiatives in medicine for the benefit of our patients,” concludes Dr Maharaj.

Cancer survivor completes Comrades for a good cause

Tue, 11 Jul 2023 06:16:17 GMT

Specialist physician Dr Prashant Parag and Paul Hussey

Raising funds for a lifesaving dialysis machine

When Paul Hussey was diagnosed with kidney failure and stage 4b lymphoma, few could have believed that nine years later he would return to South Africa and complete the Comrades Marathon.

“At that time in May 2014, I was only 45 years old but was little more than a skeleton with skin. With cachexia, a condition that causes extreme weight loss and muscle wasting, my face was gaunt, drawn and discoloured. Cancer was absolutely ravaging me, and I made a promise to myself, the universe, God, and humanity that one day I will return and run the Comrades Marathon,” he says.

On 11 June this year, at the age of 54, Paul fulfilled his dream of finishing the world’s oldest and largest ultramarathon in 11 hours and 48 minutes. He also embarked on a crowdfunding campaign to donate a much-needed dialysis machine to a public hospital in Durban.

“Regular running has been a massive part of my recovery and return to health and fitness, as well as learning to play the flute. I spent a lot of time in my hospital bed thinking of the Comrades and, as soon as I could, I returned to running, always with one goal in mind: the Comrades, The Ultimate Human Race.”

Specialist physician Dr Prashant Parag, who practises at Netcare St Augustine’s Hospital was Paul’s treating doctor in May 2014. “Overcoming such serious health conditions to complete the Comrades is an exceptional story of the triumph of the human spirit, and we congratulate him on this incredible achievement,” he says.

“Paul has had a transformative journey from kidney failure to malignancy and cancer treatment, to make a powerful comeback in the most inspiring way. Today he is a healthy athlete who is raising funds to help others in need of the dialysis that helped him on his journey to health.”

Paul moved to South Africa from the United Kingdom in 2014, but his health failed soon after and he was admitted to Addington Hospital in Durban. When his kidneys failed, Paul was transferred to the intensive care unit at Netcare St Augustine’s Hospital for the specialised kind of dialysis needed to improve his kidney function.

“While he was with us at Netcare St Augustine’s Hospital, a biopsy of a gland in his neck revealed Paul had non-Hodgkin’s lymphoma, a cancer of the blood. This is difficult news for anyone to hear, but he was relieved to have a diagnosis. Paul made the brave decision to go back to England for cancer treatment, which highlights his determination although he had a long battle ahead of him,” Dr Parag says.

When Paul’s condition was stable enough, his mother accompanied him on the flight back to England, which happened to be the day after the Comrades Marathon 2014. “I was in a wheelchair at the airport travelling back to the UK for medical treatment surrounded by hundreds of athletes all wearing their Comrades medals, looking super fit, and excited with that amazing sense of achievement having run 89kms in the hot African sun. In that fateful moment I could not have felt further away from where they were,” Paul recalls.

Today, Paul is among the distinguished group of runners recorded in the celebrated annals of Comrades finishers, and he has never forgotten the two hospitals in Durban that assisted him in his time of need. He recently returned to visit Netcare St Augustine’s Hospital and Dr Parag to share his message of hope and appreciation for the care he received all those years ago.

“In 2014 I was so ill, I was bedridden and I could barely stand unaided. Through the window of my hospital room, I caught a glimpse of the tranquil garden and imagined myself sitting in it, healthy and without a care in the world. For me to go back there, sit in that garden and play my flute felt like I was completing a circle and honouring my past sick self,” Paul says.

“For people who are going through cancer diagnosis or treatment, my message would be: don’t give up, no matter what, don’t give up because you never truly know what lies ahead. It helps to hold onto a goal and a vision of yourself healthy in the future.”

“With the resilience of the human spirit, Paul has demonstrated the profound impact compassionate care and comprehensive healthcare, including the entire treating team, nursing and support staff, can have on a person’s life. Paul has taken this a step further through his fundraising initiative in an attempt to touch the lives of many more South Africans,” Dr Parag says.

Paul is collecting funds to donate a portable reverse osmosis dialysis machine and other essentials to Addington Hospital, and Netcare’s corporate social investment arm, the Netcare Foundation is donating a significant contribution. Through their CSI fundraising drive, the staff at the Comrades Marathon Association also decided to come on board and match the donation, resulting in Paul now having sufficient funds to purchase the reverse osmosis dialysis machine.

“Netcare helped me a lot when I was so ill, and I am so grateful that they are making this donation to touch the lives of others suffering kidney failure. I am so grateful to them, the Comrades Marathon Association and all the donors so far. The dialysis machine will make a great lasting difference to people requiring this type of therapy at Addington Hospital,” Paul says.

If you would like to contribute to Paul Hussey’s ongoing fundraising initiative for Addington Hospital, please visit https://www.justgiving.com/crowdfunding/paul-hussey-5?utm_term=xNB46Ed43 .

Coming together to change a life

Tue, 31 May 2022 09:15:36 GMT

Stephen Terry, pictured here with wife Desiré, eldest son Xavier (back left), son Damion (right) and daughter Zanél (front), is recovering well from a life changing procedure performed at Netcare Montana Hospital.

Combined efforts of healthcare professionals give father of three hope for the future

As a young man of just sixteen, Stephen Terry was the victim of a near fatal electrical accident that dramatically affected his mobility. Now, 29 years and one complex procedure later, he has been given a new lease on life thanks to a combined effort to set this dedicated father of three on a path to recovery.

According to Dr Etienne Maritz , an orthopaedic surgeon practising at Netcare Montana Hospital, Stephen had been living with a severe injury to his left foot, including nerve damage, resulting in acute ankle pain and the inability to walk normally.

“Stephen had been unable to walk properly and as a result his day to day work and home life had been badly impacted. It seems that through all the years he did his best to live productively, trying to provide for his family but his quality of life had certainly been impacted and he was experiencing a great deal of unnecessary ongoing pain and discomfort,” he notes.

Stephen had sustained the injury from an accident that he describes as having radically changed his reality from one moment to the next. “At the time I was just a teenager, out playing with friends on our street one evening when the ball got stuck up in a tree. Without thinking twice, I climbed up to fetch it and unknowingly touched an exposed electrical cable that was hanging down.

“I woke up three days later to the news that 93 000 volts of electricity had passed through me in that moment. I was thrown backwards and landed against a large rock. I was lucky to be alive but my back had been broken and I was paralysed for six months. I had to learn how to walk again, which fortunately I could do. However, the injury to my left foot got worse and worse, until eventually I could only walk on the side of my foot,” he says.

Dr Maritz was made aware of Stephen’s case via the community outreach initiative of local radio station Groot FM, and took an interest in trying to help Terry receive the medical attention he needed.

“When I heard about Stephen’s case I contacted my colleague Dr Pieter Coertze, who is also an orthopaedic surgeon practising at the hospital, to see if we could assist him. We conducted a preliminary examination, during which we did an assessment and took some X-rays. It was clear that with a little assistance from all the necessary parties involved, we would be able to help Stephen.

“While the operation was fairly complex as it effectively involved three procedures, we were able to do these at the same time and on a day patient basis, with another colleague of ours practising at the hospital, anaesthetist Dr Gideon Haasbroek, also volunteering his time and expertise for the operation.

“It was very much a team effort, with Netcare Montana Hospital supporting us by waiving the hospital fees while SA Biomedical sponsored the specialised suturing and anchoring materials required,” says Dr Maritz.

“The three procedures we performed during the operation were the lengthening of one of the tendons, a tendon transfer from one part of the foot to another, and the reconstruction of an ankle ligament. All this was done in an effort to rebalance Stephen’s foot.”

According to Dr Maritz the procedure, which was performed in March, will result in a much improved gait for Stephen, which will have a positive impact on his daily life and ability to work, and may even make it possible for him to participate in certain recreational sports.

While a three month healing period is necessary before the true success of the operation can be assessed, Stephen says that he is already experiencing some encouraging signs. “My foot is starting to straighten and for the first time in 29 years I can feel all of my toes.

“I will start to do physiotherapy soon and am enjoying the sense of possibility for the future that this experience has given me. What I am looking forward to most is taking care of my wife and our three children, who are all still in school. I have been working as a truck driver and have been getting more and more used to it. And in my spare time, I will be enjoying fishing at the dam.

“I cannot thank everyone enough for this priceless gift – the doctors for their time and efforts, Netcare Montana Hospital where I was so well looked after by the amazing staff, SA Biomedical for assisting with the materials for the operation, and of course Groot FM for connecting me with this wonderfully supportive network of people and companies. I would also like to say a big thank you to my boss André Olivier Snr and everyone else at Tshwane Fire Spinklers for their support during this time, and to my sister in law Chantelle Terry who contacted Groot FM and put this all into motion. The experience has changed my life,” says Stephen.

Ben Rood, general manager at Netcare Montana Hospital, said that the hospital and its staff members were delighted to hear of Stephen’s progress and are most glad to have played a part in this initiative. “It is a privilege to serve our community and truly heart warming when such a significant difference can be made in the life of an individual. We thank the doctors whom we are honoured to have practising here at our facility for their generosity and we wish Stephen all the best for a brighter future ahead,” he concluded.

Blessed with a chance for a normal life

Fri, 27 May 2022 13:15:36 GMT

Blessing with the theatre team at Netcare Pretoria East Hospital. From left to right are orthopaedic surgeon, Dr Mart-Mari Visser; registered nurse, Sr Jarinda Greyling; anaesthetist, Dr Monica Julyan; and registered nurse, Mr Joseph Moshoeshoe.

Corrective surgery to help eight year old Blessing walk normally again

The challenges brought about by being unable to walk properly for the first eight years of his life have not stopped a little boy from Middelburg from dreaming big. Now, with the help of some dedicated healthcare professionals, young Blessing Sithole, who hopes to become a pilot one day, is firmly on the road to recovery and to leading a normal life.

Born with congenital clubfoot, Blessing’s family were unable to obtain the medical assistance he required before now due to financial constraints. Dr Mart-Mari Visser, an orthopaedic surgeon practising at Netcare Pretoria East Hospital, says that Blessing had been walking entirely on the side of his feet, where a new walking pad had developed.

“Clubfoot is a common congenital foot deformity, which presents in one out of every 1 000 babies. With this condition, the shape of a newborn’s foot is similar to that of a golf club, meaning it is stuck in a position where the heel is facing inwards and backwards, while the arch of the foot is twisted with the toes facing backwards and towards the ankle.

“The cause is largely unknown. If addressed at birth, clubfoot can be treated easily with the Ponseti method, which avoids the need for invasive surgery.

“A person with the severity of Blessing’s condition should be wearing specially adjusted shoes, but his feet were unamenable to custom shoes. They were totally rigid and after conducting an examination it was clear that he needed reconstructive surgery, in the form of a posteromedial lateral release. This entails a complete release and readjustment of most of the skin, joints, ligaments and muscles of the foot,” she explains.

Dr Visser says that after undergoing several hours of surgery, Blessing will now need to go through six weeks of cast treatment, followed by the use of splints after his casts are removed. Thereafter he will start with intensive rehabilitation, including gait training, which he will undergo at a facility closer to his home in Mpumalanga.

“It is early days in the recovery process, however the current results are good and he will at the very least have fully functional feet, which will make a considerable difference to his daily life. He is a very brave little boy and we are looking forward to hearing how he progresses,” says Dr Visser.

According to Pieter Louw, general manager at Netcare Pretoria East Hospital, Blessing’s case was brought to the hospital’s attention by Dr Visser, who has a special interest in foot and ankle surgery, particularly in paediatric patients.

“Blessing’s family have limited medical cover and financial constraints meant that additional assistance was required to make this highly specialised operation possible. We are fortunate enough to work with such passionate and dedicated specialists as Dr Visser, who had offered her time and expertise free of charge to help this young boy, after he was referred to her from a facility in Middelburg. We were only too glad to play our part in making this life changing procedure a reality, alongside a contribution from the Netcare Foundation, by writing off the shortfall on the hospital fees,” he notes.

Blessing’s father, George Mtshweni, says that it has come as a huge relief that Blessing has now finally had the treatment he so badly needed all these years. “In every other way, Blessing was a normal eight year old boy who just wanted to run around and play with his friends but life was a struggle because of his clubfeet.

“Now thanks to the work of Dr Visser and the team here at Netcare Pretoria East Hospital, my son has a better chance of a fulfilling life, and I am very grateful for that. I hope that one day he too could become a doctor or a physiotherapist and help others like he has been helped,” he says.

Louw concluded by thanking Dr Visser, the Netcare Foundation and the staff at Netcare Pretoria East Hospital. “It is heart warming to see the compassion and care that they demonstrated by making a difference in this child’s life. We wish Blessing all the best for what promises to be a bright future.”

Dress Up Your Tekkies to Save Lives with CANSA

Thu, 26 May 2022 06:11:53 GMT

One of the ways you can help the Cancer Association of South Africa (CANSA ) to continue to effectively educate communities about cancer, lowering personal risk and accessing affordable cancer screening, is to ‘pay’ your Tekkie Tax. CANSA invites all to brighten up their shoes or Tekkies on Friday 27 May 2022 and support this easy and enjoyable fundraiser.

Anita Snyders, CANSA’s National Sustainability Manager says: “We’re ‘Better Together, because with your help CANSA’s reach can be so much wider, and more people educated regarding the impact of cancer. Funds raised go towards our health programmes educating communities about the importance of cancer screening and lowering cancer risk. Education is key to detect cancer early and improve treatment outcomes”.

Participating is easy: Order the ‘Better Together Tekkie Tax’ sticker at R10 from the nearest CANSA Care Centre. Make your Tekkies proud and lace them up with a set of the uniquely branded Tekkie Tax shoelaces – R35 and get a ‘Better Together Tekkie Tax’ sticker included.

Snyders concludes, “Make sure you are ready to celebrate Tekkie Tax with CANSA on Friday, 27 May 2022, and show that you care about educating to save lives. And please share your participation on your social media platforms using the hashtag #TekkieTax #CANSAeducation.”

Tekkie Tax orders can be placed with your local CANSA Care Centre or forms may be requested from Anita Snyders asnyders@cansa.org.za

CANSA Says Choose Smoke-Free Lives

Fri, 20 May 2022 04:00:36 GMT

The Cancer Association of South Africa (CANSA) aligns itself to the theme, ‘Tobacco - Threat to our Environment’ for World No Tobacco Day (31 May 2022). Together with the National Council Against Smoking (NCAS), Heart and Stroke Foundation of South Africa and the South African Medical Research Council, it continues campaigning for the new Control of Tobacco Products and Electronic Delivery Systems Bill to be passed by Parliament, to make it easier for South Africans to choose smoke-free lives and put an end to the threat tobacco-use poses to the environment.

Lorraine Govender, CANSA’s National Manager: Health Promotion explains, “Tobacco kills over eight million people worldwide every year. It also destroys our environment adding unnecessary pressure to our planet's already scarce resources and fragile ecosystems, through cultivation, production, distribution, consumption, and post-consumer waste. The new bill will soon be presented to Parliament to be passed to amend the existing Tobacco Control Law focussing on 100% smoke-free indoor areas; plain packaging and pictorial health warnings; banning adverts at tills in retail outlets and the sale of tobacco and related products in vending machines; and regulation of e-cigarettes. The new bill will further help decrease the impact of second-hand smoke on those not smoking and discourage youth from starting to smoke.”

Tobacco use is considered the single most important man-made cause of cancer that can be avoided. Both tobacco smoke and tobacco products for oral use, contain several cancer-causing substances contributing to tobacco related cancer. These include tobacco-specific N-nitrosamines which may be formed from nicotine in the body. It’s important to consider in the evaluation of possible long-term effects from sources of nicotine, such as e-cigarettes and products for nicotine replacement therapy, which both have a potential for life-long use. Infographic ’10 Reasons Why Electronic Cigarettes Need to be Regulated in SA’

Nicotine is the major chemical component responsible for addiction in tobacco products. A person smoking 25 cigarettes / day will absorb about 0.43 mg nicotine / kg bodyweight. Recent studies have shown that nicotine can affect several important steps in the development of cancer and suggest that it may cause aggravation and recurrence of the disease. Both cigarette smoking and smoking other forms of tobacco can cause cancers in multiple organs.

Govender adds, “Although one billion people worldwide already smoke and more will start, individuals who stop smoking lower their smoking related cancer risks effectively, with almost immediate health benefits. CANSA encourages smokers to quit and put their health and the health of others first.”

How CANSA Helps

CANSA’s awareness campaigns rolled out at schools and universities are aimed at creating messaging to effectively prevent the start of tobacco use, especially for youth and young adults.

Govender states, “We’re currently working with the University of KwaZulu-Natal on the Multi-National Lung Cancer Project to create awareness in targeted underserviced communities about lung cancer through door-to- door visits. Our aim is to showcase that early detection of lung cancer can save lives and improve the long-term quality of life.”

Another initiative is offering support to help people quit smoking via the CANSA online eKickbutt support programme giving helpful tools to quit. CANSA further works together with like-minded stakeholders in South Africa, South African Medical Research Council, The National Council Against Smoking and international partners, Campaign for Tobacco Free Kids, to provide the scientific evidence to drive the development of effective tobacco control policies to assist in dramatically reducing tobacco use, lower cancer risk and health-related disparities.

“We recently funded a qualitative research study on electronic cigarettes in collaboration with the UCT Knowledge Co-op which focussed on the knowledge, perceptions, and attitudes among university students,” added Govender.

CANSA also plays an important watchdog role to ensure compliance to the current tobacco legislation by addressing concerns from the public on issues of non-compliance via info@cansa.org.za .

Triplets born in time for Mother’s Day 2022

Tue, 17 May 2022 05:24:03 GMT

First time parents Amrish Surujballie and Sarika Srikissoon celebratated Mother’s Day with their newborn triplets, who were born at Netcare St Augustine's Hospital on 4 May 2022. From left to right are Sr Sushie Odayar (maternity unit manager) holding the newborn baby girl, Amrish holding one of the newborn baby boys, Sarika holding the other newborn baby boy, with paediatrician Dr Jonathan Grey Egner who assisted in the birth of the babies looking on.

First time mom welcomes triplets on her birthday

First time parents Amrish Surujballie and Sarika Srikissoon are elated to be celebrating Mother’s Day with their newborn triplets, who were born at Netcare St Augustine's Hospital on 4 May this year.

Born on the day of their 31 year old mother, Sarika’s birthday, the two healthy little boys and girl made sure that 4 May would from now onwards be one giant birthday celebration within their family.

For Amrish and Sarika the jubilation does not end there, as they also celebrated their fourth wedding anniversary recently, on 28 April.

“Our hearts are overflowing with joy. When we found out about my pregnancy both my husband and I were so excited. From early on in the pregnancy I was aware that I was expecting twins but when our obstetrician, Dr Sagie Naidu, confirmed that it was in fact triplets it was a surprise bonus for us,” said a delighted Sarika.

Sarika is totally at home at Netcare St Augustine’s Hospital, having worked as a clinical nurse in the catheterisation laboratory at the hospital since 2013.

“Sarika and I have been trying for a baby for four years. The nurses and doctors at Netcare St Augustine’s Hospital have been incredible. They have made my wife and I feel so comfortable throughout the process,” said Amrish.

The triplets were born at 35 weeks through a caesarean section, with each baby weighing between 2.35 and 1.71 kilograms at birth.

Commenting on the birth, renowned fertility specialist Dr Sagie Naidu, who has helped many couples fulfil their dream of parenthood, said that the delivery of the triplets went very well. “This is largely thanks to great teamwork and the fact that their mother has been such a model patient throughout her pregnancy journey.”

Dr Naidu has been practising as a gynaecologist, obstetrician and fertility specialist at the Durban Fertility Clinic based at Netcare St Augustine’s Hospital for more than 25 years, and Sarika has been his patient for more than seven years.

Dr Naidu and Netcare St Augustine’s Hospital are delighted to have welcomed the triplets and look forward to waving them safely home.

From left to right: Dr Sagie Naidu, Sr Sushie Odayar (maternity unit manager), Sarika, Amrish and obstetrician Dr Mahesh Bhana, who is Dr Sagie Naidu’s colleague.

Brand new mental health facility opening in Richards Bay

Fri, 13 May 2022 05:48:40 GMT

Zinhle Mbata, unit manager at Netcare Akeso Richards Bay.

Professional support available to strained residents and businesses to aid mental health

The community of Richards Bay is soon to have access to a comprehensive private mental health service with the imminent opening of Netcare Akeso Richards Bay. The brand new specialised facility, the first of its kind on the KwaZulu-Natal North Coast, is set to bring mental wellness closer to the people of the industrious city.

According to Zinhle Mbata, unit manager of Netcare Akeso Richards Bay, events over the past two years have resulted in an increased number of residents seeking mental healthcare. “The people of KwaZulu-Natal have experienced considerable difficulties in recent times, in addition to the already devastating impact of COVID-19 on South Africans.

“For residents and business owners in Richards Bay, which is an economic hub of our province, the financial knock-on effect from wave after wave of challenging circumstances has resulted in a very real toll on the mental health of our community. We are therefore pleased that we will be able to render much needed support to those in need of professional help,” she says.

Mbata notes that the facility will offer treatment for mental health conditions ranging from anxiety, depression and bipolar mood disorders, among others. “We will also be reaching out to establish relationships with local businesses and employer groups to address the impact of burnout in the workplace, which is not only affecting the wellbeing of employees but also productivity levels and absenteeism rates across commerce and industry.

“The well-established Netcare Akeso burnout management programme makes use of evidence based psycho emotional tools shown to be effective in building resilience and addressing common stressors identified over a wide range of work environments,” says Mbata.

Both inpatient and outpatient treatment and therapies will be offered at the new facility by a multidisciplinary team of psychiatrists, psychologists, occupational therapists and a social worker as well as experienced mental health nurses, to best support the individual needs of each patient and their families.

“Furthermore,” says Mbata “the therapists operate under the aegis of the Centre for Psychotherapy Excellence (COPE), offering face to face individual, group and family therapy sessions to ensure the continuity of care on a patient’s evolving journey of mental wellness.”

Conveniently situated in the heart of Richards Bay, on the eighth floor of the Netcare Richards Bay Medical Centre and directly opposite Netcare The Bay Hospital, Netcare Akeso has created a welcoming and therapeutic environment, with a breathtaking 180 degree view of the bay.

“A tranquil patient rooftop garden balcony provides a safe outdoor space while the inhouse gym allows patients to maintain physical fitness. We also have a quiet room for meditation and silent contemplation. We encourage our patients to engage with the healing properties of nature and make planned weekly visits to the beach with inpatients for just this purpose.

“Netcare Akeso Richards Bay has been specifically designed to instil a sense of peace in those who seek our help and to act as a blank canvas, allowing patients to visualise themselves beyond where they currently find themselves, while they go through a therapeutic based healing process.

Mbata says that the facility plans to expand its service offering in response to the needs of the community over time and will be conducting outreach sessions through corporate wellness events in the area as well as awareness days at local learning institutions to assess the need for mental healthcare among the city’s young adults.

“The people of this city are strong and have withstood a great deal in recent times, but it is also important for us all to be aware that it’s okay not to be okay. At Netcare Akeso Richards Bay we will provide a safe and supportive space, with treatment offered by healthcare professionals who can understand the struggles of the community.

“We are pleased to be providing access to the highest level of mental health and care right here in Richards Bay, so that those who live and work in the area and who are seeking help do not have far to go. We look forward to making a meaningful impact here and assisting our fellow residents in making their mental wellbeing a priority,” concludes Mbata.

Robotic assisted knee and hip replacements established in Pretoria

Mon, 09 May 2022 11:43:00 GMT

(Left to right) Dr Wian van der Merwe, an orthopaedic surgeon practising at Netcare Pretoria East Hospital, is pictured performing knee replacement surgery with the advanced Mako SmartRobotics system, assisted by registered nurse Madri van der Sandt and enrolled nurse Dineo Mokone. Dr Van der Merwe is one of three orthopaedic surgeons practising at the hospital who are accredited to do robotic assisted hip and knee replacements. By June, three more orthopaedic surgeons will complete the final leg of their accreditation to perform robotic assisted hip and knee surgery.

Orthopaedic surgeons trained in high tech precision option

A team of orthopaedic surgeons at Netcare Pretoria East Hospital, using a state of the art robotic surgical system, are expanding the options in hip and knee replacements for patients from northern Gauteng and surrounding provinces.

“We congratulate orthopaedic surgeons Dr Wian van der Merwe and Dr Tiaan Stoffberg on achieving full accreditation last year in the use of this advanced technology, for the benefit of those in need of such surgery,” says Pieter Louw, general manager of Netcare Pretoria East Hospital.

To achieve accreditation, the specialists completed comprehensive training in Istanbul, Turkey, with the new SmartRobotics™ surgical system.

The Mako robotic system at Netcare Pretoria East Hospital is the first in Tshwane and one of only a handful of these advanced systems in South Africa. Dr Van der Merwe performed the first robotic assisted hip and knee surgeries at the hospital in late November 2021, and many more patients have since chosen to have this option for their surgery.

“By the end of June, a further two orthopaedic surgeons practising at our hospital will complete the final leg of their accreditation in the use of the robotic assisted system. This will result in a total of four experienced orthopaedic surgeons offering this option to people requiring knee and hip replacements at our facility,” Louw says.

Surgical expertise meets robotic technology

Dr Van der Merwe explains that the Mako robotic system is designed to further improve surgical precision. The technology assists the surgeon in the planning of the procedure beforehand, and provides additional checks in real-time at each stage during the operation.

“Based on a CT scan of the patient’s knee, the system’s sophisticated software develops a three-dimensional digital map of the knee, and calculates the optimal implant size, placement and alignment of the prosthetic knee joint to fit the patient’s specific anatomy. This data is then translated into a preoperative surgical plan,” Dr Van der Merwe says.

The system combines three key components – 3D CT scan based planning, AccuStop technology and insightful data analytics – into one platform for more predictable and personalised orthopaedic procedures.

Precision and extra safeguards

“This offers an extra level of precision, adding to the surgeon’s own technique and experience. On the day of the procedure, the digital 3D map of the knee is carefully aligned to the patient’s actual knee in theatre, and the surgical plan is validated,” he explains.

“The dimensions needed for the procedure are set, and at these boundaries cutting automatically stops, serving as an additional safeguard to preserve the surrounding soft tissues and healthy bone. The resections achieved are extremely accurate to the surgical plan, being within a fraction of a millimetre,” Dr Van der Merwe says.

As the surgeon guides the robotic arm system, it provides detailed visual, auditory, and tactile feedback. “The robotic system cannot do anything without the surgeon. Rather, it helps keep the surgeon within the optimal dimensions to match the patient’s individual anatomy through the defined surgical plan.”

Why accuracy matters

The stability of the knee joint, as well as the range of motion and comfort a person enjoys after a knee or hip replacement can be greatly influenced by the accuracy of the fit of the prosthetic joint for the specific patient.

“In addition, where there is minimal interference with the surrounding soft tissues, the post-operative recovery can often be quicker. This technological advance is a further tool we can use to help deliver advantages such as these for our patients,” Dr Van der Merwe says.

“We are pleased that the introduction of this Mako robotic system now offers this world class option to more patients in need of knee or hip replacement surgery. Netcare Pretoria East Hospital is only the fourth facility within the Netcare Group where robotic assisted knee and hip replacement surgery is available, answering to the demand already seen at Netcare Linksfield, Netcare Pinehaven and Netcare Blaauwberg hospitals,” Louw concludes.

How Nhlelo beat the odds in recovering from a severe brain injury

Wed, 04 May 2022 08:44:23 GMT

Three-year-old Nhlelo Chauke made rapid strides in recovery at Netcare Rehabilitation Hospital following a car accident in which she sustained a severe brain injury. On the right, little Nhlelo is enjoying the Valentine’s Day celebrations at her creche.

Early intervention in paediatric brain complications key to improved development in later years

A little girl who astonished healthcare professionals with her remarkable progress following a severe brain injury has, one year later, become a shining example of just what a difference rehabilitation can make to the developing brain.

Three year old Nhlelo Chauke was travelling home from a family visit in Limpopo in January last year when her mother’s vehicle was involved in a terrible car accident that left Nhlelo totally unresponsive, with paramedics having to resuscitate her at the scene. After three weeks spent fighting for her life at Netcare Montana Hospital, Nhlelo was transferred to Netcare Rehabilitation Hospital in Johannesburg.

According to Prof Andre Mochan, a neurologist practising at the paediatric unit of the rehabilitation facility, it was clear that Nhlelo had a long way to go in regaining brain functionality. “She had suffered a diffuse brain injury, where due to the impact of the accident the nerves and cells had been badly shaken, resulting in bleeding in multiple parts of the brain. On arrival, she was completely non-communicative, had difficulty responding to visual stimuli and her movements were totally uncoordinated. She was not able to sit up or hold up her head.”

Prof Mochan, along with the other members of the dedicated multi-disciplinary paediatric team in the unit, spent the first three days assessing Nhlelo using internationally recognised scoring systems. “Nhlelo’s scores were very low but there were some hopeful signs, such as her ability to move her limbs and open her eyes,” says Prof Mochan.

Charne Cox, Nhlelo’s physiotherapist at the rehabilitation hospital, explains that although she was three years old, Nhlelo’s brain injury was so severe that the team needed to go right back to the basics of baby movements – doing tummy time, learning to roll, learning to sit and so on.

Nhlelo’s father, Mzamani Steven Chauke, recalls the relief that he and his family felt as Nhlelo began to improve. “At the time of the accident, I was still in Limpopo, as I was going to drive back home a couple of days after my wife who needed to return to work. I am a paramedic and when I received the call I did not even know if my little girl would make it through resuscitation.

“Upon arriving at Netcare Montana Hospital’s emergency department, I was informed that Nhlelo had a very slim chance of survival. There was nothing we could do but pray, and our prayers were truly answered. Nhlelo survived and by her second week at Netcare Rehabilitation Hospital she started to recognise me again. That’s when I knew something positive was happening.”

Chauke says that the team at the hospital included him and his wife throughout Nhlelo’s rehabilitation, providing encouragement and sharing information as to how she was improving at regular family meetings with the entire treatment team.

“We know that children coming to our facility have already been through a lot and that being hospitalised is difficult for a child and their family under any circumstances,” says Cox. “Our brightly coloured paediatric unit at Netcare Rehabilitation Hospital is specially geared towards making the children who stay with us feel comfortable and we use elements of play in almost all therapies,” she says.

“Our small multi-disciplinary team includes an occupational therapist, speech therapist, social worker, psychologist as well as skilled nurses and together we develop the best possible treatment plan for each one of our patients, whilst engaging the family every step of the way. Successful treatment of children depends heavily on the involvement of their parents who really do become a part of the treating team, as they get to know us all and receive ongoing emotional support from the social worker and psychologist.

“As therapists, we almost always work together through all treatments, so that our patients have the benefit of not only therapies by a multi-disciplinary team but also interdisciplinary involvement. For example, when the speech therapist was working on feeding strategies to build oral strength for Nhlelo, I as the physiotherapist would also be present to ensure that she was correctly positioned for swallowing her food and ensuring that the lungs are clear once the feeding has finished. Ultimately, all team members have the same goals of development, and it is most effective if we work together in achieving these.”

Cox explains that many different types of therapy were involved in Nhlelo’s treatment, such as the use of a tilt table to familiarise her with the sensation of standing once more. Neural optometrists from Eyetek, who assist in all cases involving visual concerns, did visual stimulation exercises in the darkroom to strengthen her eye muscles.

“Our speech therapist worked on imitating gestures to encourage Nhlelo to communicate, such as waving, reaching, smiling and so on. Within the first week, we began to see improvements in her scores and as she progressed she became increasingly engaged and enthusiastic.

“Nhlelo really enjoyed the hydrotherapy in the heated pool where we have floating toys. This is always a joyful experience for children as the weightlessness in the water gives them a great sense of freedom. She also loved the visits to the hospital by TOP Dogs – these are clean, highly trained therapy dogs. Patients can brush, feed and, if possible, walk them. Nhlelo also enjoyed the baking groups which provide a sense of community fun and cognitive stimulation.

Originally Nhlelo had been booked into Netcare Rehabilitation Hospital for 12 weeks, but her progress was so exceptional that she was able to go home after just eight weeks. “By the end of her stay, when I would walk into the ward in the morning, she would smile and run to hug me. It was truly heart-warming to see her recover so well.

While Nhlelo’s progress was far beyond our expectations, we find that all children have amazing mental strength and can adapt more quickly and easily than an adult, provided they have the appropriate support,” notes Cox.

Looking back, Chauke recalls that before the accident he had not realised the significance of Nhlelo’s second name, Confidence. “At the time it was just a name that I chose but it came to have great meaning as our little Nhlelo has all the confidence she needs to take on and overcome life’s challenges,” he says.

Nhlelo was discharged in April 2021 and now, one year later, her father says he sees her recovery as a miracle. “She attends creche every day and while she still has some difficulties with her balance due to an ongoing issue with her ear, she is improving all the time. She’s very smart and loves counting, reciting the days of the week and the months of the year, and is fascinated by colour.

“Nhlelo has become very attached to the photographs we have of her at Netcare Rehabilitation Hospital. She keeps them on the dressing table and gets quite upset if anyone moves them. The people at the hospital really do things with all their hearts. The way they support the family and look after the kids goes above and beyond the call of duty,” says Chauke.

Prof Mochan explains that each brain injury patient is different, and it is almost impossible to predict what the outcome may be in the rehabilitation process. “We cannot force the brain to do things that it is not capable of doing but it shows us what it can do during the treatment process. As that is revealed we can adjust our strategy and work with the brain. It is from this that we can start to see a trajectory of improvement.

“When a human brain has been damaged by injury or a tumour for example, the rehabilitation process is a bit like rebooting a computer after crashing, opening program after program with the team closely observing to assess where problems may lie. This is a delicate process and you do not want to overstimulate the brain as that will risk ‘crashing the computer’ again. This is important for both healthcare professionals and family members to understand. We have to go step by step, at the pace at which the brain is able to recover.”

Prof Mochan further points out that when it comes to children’s brains the rehabilitation process is particularly complex compared to that of the adult brain, which is already fully developed. In a child, injury disturbs normal development, which needs to be addressed in addition to the recovery from the injury itself.

“Sometimes a child may seem to recover quickly following a brain trauma and it is understandable that the parents want to take their little one home as soon as possible, however skipping the rehabilitation process would be doing the child a great disservice. This is because it is hard to know what damage has been done to longer term development processes. It is therefore imperative that kids with brain complications, no matter how small, are referred to a rehabilitation facility so that an in-depth evaluation can be conducted, and a rehabilitation plan can be developed accordingly,” concludes Prof Mochan.

Growing your power of choice in healthcare

Fri, 29 Apr 2022 07:47:38 GMT

Say hello to more options and goodbye to shortfalls in medical cover

When it comes to your family’s health, selecting a specialist or hospital of your choice for your medical treatment can lead to unexpected out of pocket expenses, even if you are a member of a medical aid.

“Families often face costs over and above what their medical scheme covers on admission to hospital for a medical procedure or for consulting their preferred specialist. Now, this doesn’t need to be a limiting factor when it comes to making decisions about what is best for you and your health,” says Teshlin Akaloo, managing director of NetcarePlus.

“In many cases, unless people are willing to cover the costs above their medical scheme’s limits, they are restricted to the use of their scheme’s network of hospitals and doctors.”

Financial shock absorber

“Co-payments often can come as a shock at a time when a person should be focusing on their health. This points to the need for solutions that function as an extension to the cover medical schemes offer, providing security and the power of more choice in healthcare.”

Akaloo points out that medical specialists’ bills often exceed the amount medical schemes will cover. “It is important to understand that when medical aid benefit options refer to covering 100% of scheme rates for specialist consultations, this tends to be significantly lower than what the doctors’ services actually cost”.

“Cancer treatment can also become costly for families when medical scheme oncology benefit limits are reached or shortfalls occur when a patient chooses an oncologist who is not on their medical schemes network.”

To help fill these gaps NetcarePlus, which is part of the Netcare Group, has launched a gap cover product called NetcarePlus GapCare which provides access to a much wider choice of healthcare providers. The product is underwritten by the Hollard Insurance Company Limited.

Akaloo adds: “As NetcarePlus, we have created a solution that in addition to traditional gap cover benefits, enables full access to Netcare’s facilities regardless of the medical scheme plan you are on.”

More choice, more affordably

When medical care is required, this innovative gap cover range goes beyond the limits of a typical medical scheme, offering extensive shortfall cover such as for consulting in and out of hospital specialists, emergency medical treatment in an emergency department, extended day to day costs when medical savings have run out or benefit limits are reached.

“Furthermore, medical schemes may apply sub-limits for certain in-hospital medical procedures, prosthetic devices, and extended stays in a mental health, rehabilitation, step down or sub-acute facility. Once the sub-limit is reached, NetcarePlus GapCare takes care of shortfalls” Akaloo adds.

This holistic gap cover offering leads the market in terms of the breadth of services covered. “For example, witnessing or surviving a violent crime or accident or experiencing a trauma, such as yourself or a loved one being diagnosed with a life threatening illness, can happen to anyone at any time and can have lasting consequences for mental health if the person does not have sufficient professional support early on,” Akaloo says.

“We have therefore made sure that a trauma counselling benefit is included on all NetcarePlus GapCare options to ensure counselling with a registered counsellor or psychologist is provided for over and above medical savings and medical scheme sub-limits.”

More gap benefits, more widely available

These benefits are not restricted to the use of Netcare hospitals, as shortfalls in any hospital will be covered.

For those looking to start or grow their family, the NetcarePlus GapCare 300+ and 500+ options provide cover against shortfalls for both prenatal and postnatal costs, including in the case of high risk pregnancies. “If your medical scheme only covers a stay in the general maternity ward, we cover the ‘gap’ for mothers to stay in a private room where availability permits, offering more privacy for the new parents,” Akaloo adds.

Now available directly to medical scheme members

Introduced late last year, the NetcarePlus GapCare range was previously available through intermediaries and is now also being made available directly to individuals via an e-commerce platform on the Netcare website, where the sign up process can be concluded within minutes.

Securing private healthcare affordably

Commenting on the introduction of NetcarePlus GapCare, Besa Ruele, chief executive officer of Hollard Life Solutions, said: “We are pleased to be a part of this innovative answer to reducing the medical funding challenges many South Africans grapple with. NetcarePlus products offer a practical and affordable solution, providing reassurance that access to private healthcare is secured in advance – before it is needed.”

“Access to quality healthcare is important for all of us. As a company at the forefront of developing solutions that mitigate against life’s unexpected eventualities, we are acutely conscious of the importance of preparing for the challenges that life throws our way,” Ruele says.

“Life can be unpredictable, but healthcare costs don’t have to be. Taking care of your family’s medical needs in world class hospitals and with the specialists of your choice can be achieved without threatening household budgets. This is the new, affordable way to be assured of private healthcare cover for your family well beyond the limits of your medical scheme,” Akaloo concluded.

For more details visit https://www.netcare.co.za/NetcarePlus/Gap-Cover .

Note: The NetcarePlus GapCare product is underwritten by The Hollard Insurance Company Limited (Hollard), a licensed non-life insurer and an authorised financial services provider. NetcarePlus is an authorised financial service provider. This cover is not a medical scheme, and the cover is not the same as that of a medical scheme. This insurance product is not a substitute for medical scheme membership.

Is your Colon Healthy?

Fri, 22 Apr 2022 06:27:06 GMT

The Cancer Association of South Africa (CANSA) promotes living an active balanced lifestyle and promotes that certain lifestyle changes can lower the risk of cancer.* It further advocates cutting out lifestyle factors that can put one at risk for cancer, especially colorectal cancer which is among the top three cancers** among men and women in South Africa. Poor lifestyle choices can play a significant part, in increasing risk for this type of cancer.

Lorraine Govender, CANSA’s National Manager: Health Promotion, talks about CANSA’s Colorectal Awareness Campaign, now in its second year: “We aim to educate with the facts in a fun, interactive way. In partnership with Medtronic, CANSA released a colorectal awareness video featuring ‘Sizwe and Crystal’ who discover how their lifestyle choices have affected their colorectal health, and what symptoms they should not ignore.”

Govender adds, “The ‘Colin the Colon’ Tunnel , was further created to give the public a chance to learn about colorectal cancer in a visual and tactile manner. The public can walk through a 2x3m inflatable tunnel representing the colorectal tract and get educated about colorectal cancer. Colin may be viewed inside and out at various CANSA events and may even be requested to be on display at employee wellness events by the public, just email us on info@cansa.org.za.”

Colorectal or colon cancer is among the top three cancers for both men and women in South Africa with 1 in 77 males and 1 in 132 females diagnosed according to the National Cancer Register (2019)**. There is evidence of many more younger individuals being diagnosed with colorectal cancer. It’s the second most common cancer in men (following prostate cancer) and the third most common cancer in women (following breast and cervical cancer). Unfortunately, there aren’t always symptoms in the very early stages of this cancer, and when symptoms occur, they are often dismissed as unrelated or misdiagnosed. Many people are diagnosed only when the disease has progressed to an advanced stage.

“Sizwe, Crystal and Colin help create awareness of risk factors that should be cut out to lower risk of colorectal cancer, and of symptoms of the disease, potentially saving many lives through early detection, when the cancer is still treatable. CANSA recommends regular cancer screening, awareness of your body and family history, as well as leading an active balanced lifestyle,” Govender concludes.

Factors increasing risk for colorectal cancer include lifestyle factors such as lack of regular exercise; low fruit / vegetable intake; low fibre and high fat diet; obesity; alcohol abuse; tobacco use and poor oral hygiene. Hereditary syndromes (Lynch Syndrome); a personal or family history of polyps or colorectal cancer; inflammatory bowel disease; type 2 Diabetes and old age are other risk factors.***

CANSA offers an online Lifestyle Risk Assessment Tool , that helps identify lifestyle factors which could increase cancer risk, and then provides recommendations on how to change behaviour to lower cancer risk. This can also be done at CANSA Care Centres .

Screening

It’s important to be aware of a family history of colorectal cancer and to take advantage of screening, before symptoms are experienced, and not to wait until experiencing discomfort, as there are no symptoms at the onset of this cancer. Early detection is particularly important.

A colonoscopy, performed by a Gastroenterologist, in symptomatic patients or patients over the age of 50 can detect precancerous polyps in the colon. If these polyps are removed, the chance of developing colorectal cancer can be dramatically reduced. If abnormal symptoms are experienced, or if there is a family history of colorectal cancer, a colonoscopy may be requested at a younger age.

Identifying the presence of blood in the stool, can help detect colorectal cancer early. Faecal Occult at home stool tests (R100), which can be done at home, are available at certain CANSA Care Centres – email info@cansa.org.za for details. If the test is positive (visible red line on test strip) for the presence of blood in the stool, CANSA will provide a referral letter to request a colonoscopy.

Stoma Service

Many colorectal cancer patients have a portion of their bowel and / or colon removed and end up with a permanent stoma. A stoma is an opening on the abdomen that connects to the digestive or urinary system to allow waste to be diverted from the body. It can take a while for a patient to adapt to living with a stoma, so it’s important to seek support from CANSA.

CANSA’s stoma service has an excellent offering of stoma products, accessories and provides patient support. The CANSA Tele Stoma Support Service offers online consultations for stoma patients and their families to assist with challenges or stoma queries. Make an appointment on 0800 22 66 22.

* https://www.wcrf-uk.org/uk/health-advice-and-support/resources-cancer-prevention/10-ways-protect-yourself-against-cancer

** National Cancer Registry 2019

*** https://cansa.org.za/files/2021/03/Fact-Sheet-on-Colorectal-Cancer-NCR-2017-web-March-2021.pdf

Celebrating Atang’s first birthday and successful heart repair

Thu, 21 Apr 2022 08:20:53 GMT

Baby Atang with her father, Ernest Matshoga, and mother, Tintswalo Baloyi, after her operation.

Photo courtesy of Debbie Yazbek Photography.

Lifesaving procedure for baby girl who ‘knows what she wants’

“When we learned that our baby girl had a hole in her heart, I think I had a nervous breakdown. The heart is not something you can live without, like an arm or a leg. The heart is so vulnerable and central to life,” says Tintswalo Baloyi, mother of baby Atang who celebrated her first birthday this month, just two weeks after undergoing a specialised procedure to correct the life threatening heart defect with which she was born.

“Since the heart operation, Atang is recovering very well. She’s enjoying lots of attention from us and her grandmother, and we were so happy to celebrate her first birthday. She is still too young to talk, but even at such a young age our little girl knows what she wants, and she has no difficulty making it very clear to us,” laughs the relieved mother.

“Knowing our baby’s heart has been repaired is the best birthday present we could have wished for,” adds Atang’s father, Ernest Matshoga.

Teaming up for Atang

Atang, who turned one on 14 April, is the most recent beneficiary of the Heart to Heart Campaign, a corporate social investment match funding initiative of Medipost Holdings and the Netcare Foundation to help children who need urgent life saving heart operations. The Maboneng Foundation, a non-profit organisation, co-ordinates the sponsorship of surgeries for South African children with congenital heart defects.

Specialists of the renowned Maboneng Heart and Lung Institute provided their time and expertise pro bono for the baby girl’s heart operation, which was performed at Netcare Sunninghill Hospital in Johannesburg.

“The team at Steve Biko Academic Hospital brought Atang’s situation to our attention, as the ventricular septal defect [VSD], or hole in the wall of his heart between the two chambers, was likely to become debilitating, potentially life threatening, if it was not corrected soon,” says cardiothoracic surgeon and co-founder of the Maboneng Heart Institute, Dr Erich Schürmann.

A race against time

“As the surgery to correct the defect is highly resource intensive and there is sadly such a great need for such procedures, there is a considerable waiting list. It is a race against time, however, because as the child grows the heart defect causes damage to the arteries of the lungs. We were determined to find a way to help Atang to have the operation sooner with private sector support to cover the theatre and hospitalisation costs,” he says.

Cardiothoracic surgeons Dr Martin Myburgh and Dr Hendrick Mamorare of the Maboneng Heart and Lung Institute, paediatric cardiologist Dr Janine Meares, anaesthetist Prof Nathi Mdladla and cardiac perfusionist Mr Thulas Dladla, who all practise at Netcare Sunninghill Hospital, performed the procedure to close the hole in Atang’s small heart. “It was very emotional for us parents waiting for our baby to come out of theatre. We are truly grateful for the opportunity, and we appreciate what this operation means for our daughter’s future,” Ernest says.

Pharmacist of the future?

When Atang’s mother was asked what career she could imagine for her baby when she grows up, Tintswalo said she would not be surprised if their little girl becomes a pharmacist one day. “She knows her medication so well, and she was so good when I gave her medicine for the heart condition, that I think she might have a future as a pharmacist. Her personality already shows she is caring, so perhaps that would be a good match for her – time will tell.”

“Whichever path Atang chooses, we are so pleased that this brave little girl has come through the operation so well and is ready to take on the future and the opportunities it will bring,” adds Rentia Myburgh, group sales and marketing director for Medipost Holdings, comprising Medipost Pharmacy, MediLogistics, Kawari Wholesaler and Distributor, and the MediTraining Academy.

“Our sincere thanks to the Netcare Foundation for matching our CSI donation, which has enabled twice as much to be achieved for children like Atang in need of life saving procedures,” she says.

“We wish Atang a very happy first birthday, and we are absolutely delighted that she now has the chance of living a full and healthy life,” adds Mande Toubkin, general manager emergency, trauma, transplant and CSI at Netcare, and a trustee of the Netcare Foundation.

“God bless all the doctors and nurses who looked after our little girl – You are not just doing your jobs, you are making miracles. We are so grateful to Medipost , the Netcare Foundation and Maboneng Institute for making this possible. We can never forget what you have done for Atang,” Tintswalo concluded.

For more information about the Maboneng Foundation, which coordinates sponsorship of the procedures, or to make a donation please visit www.mabonengfoundation.co.za .

Are outdated health claims systems causing unnecessary friction?

Mon, 11 Apr 2022 06:30:56 GMT

Agility Health CEO Dr Tebogo Phaleng

Real time approvals protect smaller practices and members

Outdated claims processes are causing unnecessary friction at the expense of medical scheme members and healthcare practitioners relying on legacy systems, placing unheeded financial pressure on smaller practices and potentially delaying treatment.

“Fraud, waste and abuse [FWA] are essentially symptoms of outdated coding structures and obsolete claims systems that are in themselves wasteful in their inefficiency and abusive in their delayed, and all too often detrimental, financial impact on small healthcare practices in particular,” says Chantal Viljoen, chief executive officer of Knowledge Objects (KO).

KO is a South African-born global technology company specialising in advanced administration and risk management systems through the application of artificial intelligence to manage claims risk for healthcare funders globally.

“Indeed, medical schemes have a duty to protect their members’ funds, and a responsibility to defend the integrity and sustainability of the broader healthcare system through, among others, the mitigation of FWA,” adds Agility Health chief executive officer Dr Tebogo Phaleng.

“Effective claims management processes should be able to ensure payment of claims for appropriate care. Members of medical schemes and their healthcare providers appreciate and expect the certainty of immediate approval of claims upfront.

“Where a medical scheme’s administrator does not apply the full benefits of technology to streamline this process, it unnecessarily creates the sort of friction between schemes and healthcare providers that can potentially impede members’ access to much-needed care.”

“Instead, the advanced rule-based technology we employ to manage clinical and business risks allows us to proactively check that the treatment is both clinically sound and that it falls within the member’s benefit entitlement,” Viljoen adds.

“In a complex environment where more than 70 medical schemes have their own rules and exclusions, real-time claims approval helps remove the administrative burden for the healthcare provider and assists with a sound relationship between consumers and their treating providers.”

Machine learning puts health needs first

Powered by big data and constant self-refinement through machine learning, new patterns and trends are identified to improve clinical risk management continually, putting members’ healthcare needs first. “Simultaneously and instantaneously, each line item is assessed on its own merit and any fraudulent or wasteful claims are detected at this granular level, and are flagged as inappropriate before payment is granted,” Viljoen explains.

Any queries on claims or pre-authorisations are automatically sent to the healthcare provider for clarification without the need for time-consuming email or telephone exchanges, allowing for immediate resolution and approval.

The artificial intelligence rules engine system developed by Knowledge Objects processes claims in real-time, proactively checking against individual members’ clinical risks to ensure funding of appropriate care, protecting their health by preventing contra-indicated treatments.

“This ensures that scheme funds are efficiently used only for clinically valid claims and significantly reduces the potential for human error interference, consequently reducing inappropriate healthcare costs, operational expenses and the administrative burden on both the medical scheme and healthcare providers,” Dr Phaleng notes.

“This protects medical scheme members’ funds and ensures that resources are optimally used to fund legitimate claims for the sustainability of the medical scheme.

“The primary focus is on confirming that quality, appropriate care is provided at all times, and to support healthcare practitioners to ensure better clinical outcomes for their patients,” Dr Phaleng concludes.

Innovative CPR via video call could save your life

Tue, 05 Apr 2022 06:22:59 GMT

Netcare 911’s national emergency operations centre [EOC] is putting life-saving skills into the hands of the public with a new telehealth video call service to help callers at the scene of a medical emergency to correctly perform CPR, where needed, until paramedics arrive. Netcare 911 critical care coordinator, Tshepo Ramookho (left) demonstrates CPR on a mannequin representing the patient, while Netcare 911 critical care operations manager, Zita van Zyl (right) coaches the caller on how to replicate the actions on the patient to keep the patient’s blood circulating to their vital organs until paramedics arrive on scene.

Mouth-to-mouth no longer the only way to administer CPR

In a first for Africa, a new digitally enabled life-saving service puts callers phoning from the scene of a medical emergency face-to-face with trained Netcare 911 emergency healthcare providers to demonstrate and guide them through the cardiopulmonary resuscitation (CPR) technique until paramedics arrive.

Particularly since the start of the COVID-19 pandemic, members of the public may be hesitant to perform mouth-to-mouth resuscitation on anyone other than an immediate family member in an emergency – however this aspect is no longer considered necessary.

“Few people are aware that CPR does not require mouth-to-mouth resuscitation, as recent findings show ‘hands only’ CPR can be as effective as the traditional technique involving giving the patient rescue breaths,” says Shalen Ramduth, Netcare 911’s operations director.

The American Heart Association now recommends that members of the public perform ‘hands only’ CPR using chest compressions alone if an adult collapses and they are not in a healthcare setting.

Life-saving skills in the caller’s hands

“Even if you have never done CPR before, Netcare 911’s national emergency operations centre [EOC] is putting life-saving skills into the hands of the public with this new, innovative application of telehealth video call technology,” says Zita van Zyl, Netcare 911’s critical care operations manager.

When a caller reports an emergency requiring CPR to Netcare 911’s EOC on 082 911 , the coordinator immediately initiates the video calling process by sending the caller a link via SMS which connects to a live secure video platform. The caller clicks on the link to connect with the Netcare 911 emergency care providers, enabling them to see and hear each other.

“A second qualified health provider, a registered nurse or paramedic, then demonstrates the relevant CPR technique for an adult, child or an infant on an appropriately sized mannequin representing the patient at our designated and specially equipped Telehealth CPR station at our EOC. All the while, a case manager coaches the caller to copy their actions to perform CPR correctly on the patient at the scene.”

“Thanks to the visual element of the two-way video link, the caller can more accurately follow the CPR technique required, while our ‘CPR coach’ provides informed and detailed feedback to the caller to guide their CPR efforts.

“In this way, it is possible for the caller to replicate the CPR actions, with the necessary depth and rate of chest compressions to keep the patient’s blood circulating to their vital organs until professional help arrives on scene,” she says.

The video link furthermore makes it possible for the EOC coordinators and healthcare practitioners to do a more detailed immediate assessment of the patient remotely, which can be significant for clinical decision making and help in the co-ordination of resources to evacuate the patient using the most effective transport modality available.

The confidence to save a life

“Through this easy-to-use service, we hope more South Africans will gain the confidence to get involved to assist a person in need of life-saving resuscitation. It is less daunting to attempt CPR if you can copy a professional’s actions, and all the time the caller is being encouraged and coached through every step to help ensure they are doing it correctly, even if the caller has had no prior training,” Ramduth adds.

“This can buy precious time to save the heart and brain by keeping the blood supply moving around the patient’s body until paramedics are on scene to take over, which can improve outcomes exponentially.”

The Netcare 911 live video link telehealth service is provided through the secure Netcare VirtualCare platform, with all data encrypted to protect the caller, ensure patient privacy and protect confidential information. Using the platform does not require an App to be downloaded and is very user friendly, yet secure.

“In emergency medical situations, applying technology in this innovative way can help to save many more lives and inspire more South Africans with the knowledge to lend a hand with ‘hands only’ CPR if the need arises,” Ramduth concludes.

Confronting cancer with comprehensive service

Thu, 31 Mar 2022 08:29:32 GMT

One of the radiation oncologists practising at Netcare St Anne’s Hospital, Dr Jeethendra Sithlu of Hopelands Cancer Centre, is pictured with general manager of the hospital, Louis Joubert, at the radiotherapy unit. The hospital now offers in-house radiotherapy in addition to other cancer care services.

In-house radiation therapy now available at Netcare St Anne’s Hospital

The recent installation of a state-of-the-art linear accelerator at Netcare St Anne’s Hospital is bringing the benefits of a comprehensive cancer care service underpinned by multi-disciplinary expertise to the communities of Pietermaritzburg and surrounding areas.

“With the introduction of the advanced Varian linear accelerator here at the hospital, offering a range of specialised radiation therapies to cancer patients, we are now able to provide comprehensive and integrated in-house cancer care for the convenience and comfort of patients diagnosed with cancer,” says Louis Joubert, general manager of Netcare St Anne’s Hospital.

Specialist collaboration in cancer care

Multi-disciplinary collaboration by medical professionals has been a feature of cancer care at Netcare St Anne’s Hospital, enabling them to provide integrated and holistic care centred around the individual person’s unique circumstances and needs.

For many years, Hopelands Cancer Centre has offered chemotherapy treatment at Netcare St Anne’s Hospital in Pietermaritzburg. However, patients who in the past required radiation therapy had to receive this aspect of their treatment at an off-site facility.

“Clinical and radiation oncologists, surgeons in various disciplines, and other healthcare professionals work closely together to custom develop and review the best and safest treatment options and plan for each individual patient, taking into consideration their type of cancer and the stage thereof, as well as their personal circumstances. Treatment may involve radiation, chemotherapy, surgery, or a combination of these modalities,” adds Dr Ziad Seedat, managing director of Hopelands Cancer Centre.

“With the opening of the in-house radiotherapy facility, we are now able to offer patients convenient and integrated care in the familiar surroundings of the hospital,” says Dr Seedat.

To complement the cancer treatments, Netcare St Anne’s Hospital’s also provides patients with holistic, compassionate support including patient navigation by a specially trained oncology nurse who guides and assists each patient throughout their cancer treatment journey. Other support services include dietary advice, prosthetic devices, wigs, a wound care clinic, physiotherapy for lymphoedema treatment as well as patient and family counselling if needed.

“This versatile radiotherapy system offers highly accurate image guided intensity modulated therapy, and has applications for many different types of cancer. This non-invasive radiation therapy involves the use of ionising radiation to deliver a powerful dose of energy to the tumour,” says Dr Seedat.

“In this type of radiotherapy, the linear accelerator directs multiple beams of radiation to within the confines of the tumour or lesion. Each of these beams is made up of ‘sub-beams’ allowing for varying degrees of intensity as needed within the precisely defined treatment area,” he adds.

Prea Naidoo, Netcare's regional radiation manager in KwaZulu-Natal, says that the integrated approach with each major treatment modality now under one roof is convenient for people in the province diagnosed with cancer.

“Particularly for the treatment of irregularly shaped tumours, or where the lesion cannot be surgically accessed, the radiation technology offered at the hospital can precisely administer the prescribed dose of radiotherapy, while sparing the normal structures and tissue around the tumour.

“The system has applications for cancers in various parts of the body, including the head, brain, neck, lungs, stomach and prostate. This treatment is provided on either an outpatient or inpatient basis, with the support of Netcare’s cancer care team who are experienced in supporting each patient through their treatment,” she says.

“This advanced technology means that both the shape of the radiation field as well as the dose to each part of the tumour can be carefully controlled. Treatment times are also often shorter with sophisticated technology such as this, which many patients prefer to more traditional radiation therapy systems,” she says.

Dr Seedat and fellow radiation oncologists Dr JD Sithlu and Dr H Asmal, who also practise at Netcare St Anne’s Hospital at Hopelands’ Pietermaritzburg branch, are among the specialists now offering radiation therapy.

“Together, we can confront and fight cancer with the extensive cancer care services available. There is more hope than ever for improving outcomes for cancer patients and saving lives, particularly with early detection through regular screening, technological advances and our holistic, collaborative approach to each person’s individual journey with cancer,” Naidoo concludes.

Is social anxiety holding you back in life?

Thu, 24 Mar 2022 07:39:12 GMT

Overcome fear and share the ‘music of your individuality’

Up to three-quarters of us experience some degree of social anxiety, ranging from mild shyness to debilitating social phobia. In more severe cases, social anxiety can hold a person back from pursuing opportunities and relationships, as well as potentially affecting academic and career progress.

“Many of us have some level of discomfort expressing ourselves to other people, as we are social animals who are sensitive to approval or rejection from others,” says Mark de la Rey, a clinical psychologist practising at Akeso Kenilworth.

Imagine someone who has a gift, a great pianist who can make beautiful music but only when they are all alone in their own home. No one gets to enjoy that person’s talent if social anxiety keeps it locked up, and the person will never reach their full potential as a pianist.

“We all have valuable contributions to share, and we make our own ‘music’ through expressing our unique individual thoughts and feelings. We have the power to uplift people, enhance understanding and create happiness in the world – if only we can open up and share a part of ourselves with others,” De la Rey says.

Degrees of social discomfort

“Being a little shy or anxious about making new friends, asking someone out on a date, or giving a presentation, for example, is fairly common. While we may not find it comfortable, in most cases it should be possible for a person to overcome their anxiety to carry out these things.

“A big part of the anxiety is often around communicating one’s inner thoughts to others. Social anxiety becomes more concerning if the individual has great difficulty making their voice heard. If you find anxiety is preventing you from participating fully in some area of your life, this may suggest a social anxiety disorder,” De la Rey explains.

“In the more severe cases, where the person can’t even conceive of expressing themselves, for example with their colleagues, peers, or potential romantic interest specifically, or interacting with others more generally, this could be described as bordering on social phobia. In such cases, professional assistance can help to identify what the anxiety is stemming from, and with the appropriate therapy or skills the person is often able to move past their fears.”

“Social anxiety can be life limiting, robbing the individual of opportunities for new experiences and personal development, as well as the ripple effects it can have on their families, who often find it heartbreakingly frustrating to see their loved one unable to make the most of their life and abilities.”

Skills can help move past social anxiety

“Fortunately, there are practical skills one can learn that are often extremely helpful for overcoming anxiety. Dialectical behavioural therapy (DBT) skills, for instance, may be used alone or in combination with other types of therapy according to the kind of assistance the individual client requires,” he says.

Learning DBT skills offers a way to manage anxiety and emotional responses, which can offer a practical process to work through the sometimes-crippling effects of social anxiety in a person’s daily life.

“These skills are a non-apologetic way of observing and identifying what the person is feeling in those times, describing it, and deciding how to respond and participate – even though we might feel vulnerable or anxious about it.

“The skillset involves learning what a person needs to do to manage anxiety and move past it, and skills relating to how we apply these in real life situations. It really is possible to break through the grip of social anxiety and, once learnt, apply these skills at work, school, university, and in your social relationships, including family, friendship circle and your partner,” says De la Rey.

“These skills can be effective for young and old alike, eight to 80 years old and beyond, as an effective way to help gain the confidence to engage more with other people. There are also a number of other tools that may be helpful for individuals looking to cope with social anxiety, including crisis survival skills, distress tolerance skills, interpersonal skills, as well as more specific therapies for any related or underlying disorders.”

For information about mental health and services such as these, and accessing care, Netcare Akeso is here to help. In the event of a psychological crisis, individuals can phone the Netcare Akeso crisis helpline on 0861 435 787, 24 hours a day, to talk to an experienced counsellor.

“The pandemic has been a major setback for many young people, in particular for those who previously were on the verge of significant social anxiety. Those who were struggling then were often still coping in the school environment because they had social group support and interaction, and outlets such as sport.

“As these were withdrawn, some have regressed and are now finding their anxiety overwhelming. This often means they are battling with the full return to school, and it can have a real impact on their mental health and wellbeing. There is a solution to address whatever may be making daily life untenable; the tools to get past it are within reach,” De la Rey concludes.

What everyone should know about kidney disease

Tue, 22 Mar 2022 07:21:06 GMT

‘It’s far more common than people think’ – nephrologist

Undiagnosed or poorly controlled diabetes, high blood pressure or HIV significantly increase the risk of kidney disease. As these conditions may not initially have any noticeable symptoms, many people are living with deteriorating kidney health, unaware of this serious long-term threat to their wellbeing. This points to the need for greater awareness of the importance of regular screening and reliable access to chronic medication.

“If a person’s system is under pressure from an underlying health condition that is poorly controlled, this may cause irreversible damage to the kidneys, potentially leading to chronic kidney disease or even kidney failure,” says pharmacist Marizette Weldhagen of Medipost Pharmacy , South Africa’s largest national courier pharmacy.

“Kidney disease is unfortunately far more common than people think, and kidney failure is the ninth most common cause of death in South Africa. However, it often doesn’t present with any symptoms until it has reached a more advanced stage,” adds Dr Kagiso Motse , a nephrologist practising at Netcare Ferncrest Hospital.

What is the kidneys’ role in the body?

The kidneys have a vital role in purifying the blood and maintaining the necessary balance in our body.

“When kidneys are functioning properly, they remove toxins from the blood and keep the body from becoming too acidic. The kidneys help to maintain the body’s fluid levels, salts and electrolytes in balance,” Dr Motse explains.

“Possible symptoms of kidney disease may include feeling tired and generally unwell, changes in the colour or volume of the urine and swelling. If you notice these signs, you should seek medical attention sooner rather than later.”

When a person’s kidneys are damaged to the point where they are no longer able to perform these functions, this is known as kidney failure and the person will need to have special renal therapy known as dialysis several times a week where a special machine is used to artificially purify the blood.

Risk factors

People who are at increased risk should screen for kidney disease each year, as kidney function can often be preserved if it is detected earlier.

Dr Motse points out that the risks for kidney disease fall into two categories: those we can do something about, and the risks that are unmodifiable or beyond our control. “The unmodifiable risks include age, as older people are more likely to get kidney disease, genetic factors with certain ethnic groups tending to be more genetically predisposed to kidney disease, and previous physical damage to the structure of the kidneys,” Dr Motse says.

“It is never easy to be diagnosed with a chronic condition, however the good news is that if we are aware of our risks, there are modifiable risks we can do something about to support remaining kidney function. If you are overweight, talk to your treating doctor about how you can safely lose weight to help alleviate strain on your kidneys,” she advises.

“Chronic high blood sugar in poorly controlled diabetics can cause serious damage to the kidneys, as well as other organs. Hypertension, or high blood pressure, and high cholesterol are also detrimental to kidney health over time. Undiagnosed or untreated HIV also places a person at higher risk for kidney disease,” she says.

“Always consult your doctor before taking any medication, including non-prescription medicines. Non-steroidal anti-inflammatory drugs [NSAIDs] are common pain relievers available without prescription, and are only intended for occasional, short-term relief of pain and inflammation,” Weldhagen says.

“NSAIDs, such as ibuprofen, are among the medicines that may be harmful to the kidneys and should be avoided by people who have impaired renal function. It is always important for patients to check medicine package inserts for contraindications relating to kidney problems.”

Preventing further kidney damage

“The hallmark of prevention for kidney failure is about controlling the risk factors. Know your status for these common conditions, and if you have diabetes, hypertension, HIV or other conditions associated with a higher chance of kidney damage, you can reduce your risk by ensuring your condition is well managed and regularly screening the kidneys using blood and urine tests to look for signs of dysfunction,” Dr Motse says.

Medipost Pharmacy offers free delivery of prescribed chronic medication, including treatment for diabetes, hypertension and HIV among many other conditions, anywhere in South Africa. This service ensures patients can access their medicines easily and confidentially from their home or workplace.

“It is not easy for some of my patients living in rural areas to go to a physical pharmacy to get their monthly medicine. The convenience of having their medicine reliably delivered to their door, even if they live on an unnamed road far from an urban centre, helps patients to keep on track with their prescribed treatment for chronic conditions. This improved treatment adherence helps prevent further kidney damage.”

“Another aspect of Medipost Pharmacy’s service includes supplying renal practices with injectable iron supplements and erythropoietin (EPO) that dialysis patients require to stimulate the development of red blood cells and help prevent anaemia, which is very common among people living with kidney failure,” Weldhagen adds.

“Many patients are on the kidney transplant list. Some of our patients have received kidney transplants, and we supported them by dispensing the required special medicines related to this procedure. Although there are many patients waiting for a transplant, a successful kidney transplant usually means the person is no longer reliant on dialysis,” she concludes.

Sunshine on a cloudy day

Thu, 17 Mar 2022 10:19:36 GMT

Action shots featuring a fun-filled day at the long-awaited Netcare Rehabilitation Sports Day which took place recently.

Gauteng’s ‘Hospital of Hope’ celebrates patient determination at annual sports day

Strict COVID-19 protocols and limitations on participant numbers did not dampen the mood at Netcare Rehabilitation Hospital when patients and staff of the remarkable hospital on the hill in Auckland Park recently got to celebrate its 21st annual sports day.

The day has become an all important event for patients and staff of the hospital that has throughout the years witnessed the struggles, tears and moments of enormous accomplishment of those on their way to recovery.

According to the hospital’s general manager, Gugulethu Setati, the theme for this year’s event, ‘Sunshine on a cloudy day’ is a reflection of the courage that patients have shown throughout their recovery.

“These words really rang true for us this year as we all anxiously waited for the sunshine to break through when our big day finally dawned. The annual sports day was initially scheduled to take place on 3 December last year, to coincide with World Disability Day. But because of the onset of the fourth COVID-19 surge, we unfortunately had to postpone the event.

“This annual sports day we took a moment to acknowledge the difficulties that have been overcome by the sheer determination of our brave patients and to express our gratitude for the many blessings that, together, we have experienced,” said Setati.

Precious memories and words of hope were shared by Netcare Rehabilitation Hospital stalwarts on the day. General practitioner, Dr Virginia Wilson, who has been an integral part of the hospital through the years, recounted some incredible moments in its history, leaving the audience with a profound quote by Jason Ross that sums up the essence of rehabilitation. “Rehabilitation is not about broken people but about people breaking through that which we never imagined possible. It is not about coming to terms with being less than what you were before but about the need to have more strength and courage than ever before. Every rehabilitation journey is a heroic one.”

Rita Henn, founder of Rita Henn and Partners, the main therapy practice that provides physiotherapy, speech therapy and occupational therapy services at the hospital, recalled how the sports days have evolved over the years. “The event started out with just a few participants and grew to a day that is attended by various stakeholders from many other private and public rehabilitation centres. And here we are today, celebrating a COVID-19 friendly event with everyone wearing masks and maintaining social distancing while having loads of fun,” she said.

In line with this year’s theme, everyone who participated in the event donned a bright sunshine yellow t-shirt to brighten up the day which saw participants in various stages of recovery walking, rolling, or strolling on crutches to compete, bringing with them the very special kind of energy that always surrounds this event.

“It was an incredible day of activity, competition and fun, through which the message of hope, courage and teamwork resounded. The programme for the day saw patients engaging in various activities ranging from wheelchair basketball, bowls and volleyball to obstacle courses and adapted scuba diving, among others,” notes a delighted Setati.

“We always round off the day with some special Netcare Rehabilitation Hospital sports day traditions, including an invitation volleyball match between our hospital’s team and representatives from the trauma centres at Netcare Milpark and Netcare Union hospitals. This is jokingly referred to this as the ‘grudge match’. The trauma centres were yet again no match for the Netcare Rehabilitation team who walked away with the trophy.

“The final challenge of the day was the tug of war between the multidisciplinary team from Netcare Rehabilitation Hospital and the team from the Netcare trauma centres. This year, the trauma centres reigned supreme,” recounts Setati.

“While the ultimate aim of the hospital’s sport’s day is to encourage patients to have fun while participating in physical activity, teamwork and competition, as a healthcare facility, our first priority was the implementation of strict COVID-19 protocols to safeguard all those who were present on the day.

“The 2021 event may have been postponed by a few months, but the great thing is that having it so early in 2022 means that we get to do it all over again towards the end of the year – something which we all can look forward to and work towards,” she added.

Commenting on the event Netcare South West regional director, Nolan Daniels thanked all the sponsors that collaborated with Netcare Rehabilitation Hospital for their generosity to make the event possible. They were Servest, Empact, Rita Henn and Partners, Rehab First Lokomat, Heinrich Grimsehl Orthotists (ARC), Charlene Grimsehl Dietician, Arjo, Coloplast and Activo Health.

“Life as we know it, is a journey to be appreciated with each trial, each tribulation and each challenge being an opportunity to reflect, to learn, to grow, to build your character. Even after all the adversities faced, the opportunity for a new lease on life remains.”

“We at Netcare are, as always, honoured to play our part in this journey and so very happy to once again witness the hope and joy that this meaningful day inspires,” said Daniels in closing.

“There’s always a place where a teddy is needed”

Tue, 15 Mar 2022 08:19:04 GMT

(Left to right) Netcare Linmed Hospital general manager Linda Bossert is pictured with talented knitting pensioner Mrs Theda Swanepoel and emergency department clinical nurse specialist Nicole Jansen, holding some of the beautifully handcrafted teddy bears donated by Mrs Swanepoel.

Hospital grateful for knitting retiree’s teddy bears for little patients

“Mrs Theda Swanepoel seems to have an almost telepathic sense for when our teddy stocks are running low, and she appears like a fairy godmother with a new consignment of her beautiful hand knitted teddies, which she donates for us to give to children coming to the emergency department,” says Alan Stroud, unit manager of the emergency department at Netcare Linmed Hospital in Benoni.

“When I retired in 2015, I didn’t know what to do with myself. I joined a knitting club at the Rynpark Old Age Home, and that’s where I began knitting teddies,” the talented Mrs Swanepoel says.

“A friend introduced me to Alan in 2018, and I wanted to donate some of my teddies for children who may be hurt or ill and need treatment in the emergency department. Alan saw the first four teddy bears and his reaction was ‘Wow’,” she recalls.

Since then, Mrs Swanepoel has generously donated close on 500 of the nearly 700 teddies she has made to date, to the emergency department at Netcare Linmed Hospital.

“I make approximately 10 a month, and last year donated 120. Alan kindly contributes towards my wool to help cover the costs, and I am so thankful to him for helping to bring cheer to the children by treating them to a teddy,” she says.

“These handmade teddies help to make a visit to the emergency department much less intimidating for children, and we couldn’t be more grateful to Mrs Swanepoel,” Stroud says.

“It is such a joyous and wonderful gesture, Mrs Swanepoel is incredibly kind and thoughtful to make these beautiful teddy bears with such love for our young emergency patients,” adds Linda Bossert, general manager of Netcare Linmed Hospital.

“Each teddy she makes is unique and reflects the time and effort Mrs Swanepoel dedicates to this labour of love and caring. The children really appreciate being given their very own teddy to cuddle while they are at the hospital, which they can take home to cherish afterwards.”

The talented pensioner is steadily working towards her 1 000th teddy. “It is so rewarding to know that my teddies are bringing comfort to children. There is always a place where a teddy is needed,” Mrs Swanepoel concludes.

Since 2018 Mrs Theda Swanepoel has generously donated just on 500 of her handmade knitted teddies to the emergency department at Netcare Linmed Hospital to help comfort children coming in for treatment.

Dr Tebogo Phaleng appointed Agility Health CEO

Fri, 11 Mar 2022 11:42:26 GMT

Dr Tebogo Phaleng has been appointed the new Chief Executive Officer (CEO) of Agility Health

Strategic health risk management company welcomes new leader

Health strategy specialist Dr Tebogo Phaleng has been appointed the new Chief Executive Officer (CEO) of Agility Health, the medical scheme administrator and managed care provider with a footprint throughout the continent of Africa, the Board of Agility Health announced.

“We are pleased to welcome Dr Tebogo Phaleng to the Agility Health family as he takes the helm of our uniquely positioned boutique health risk management company,” says Dr Namane Magau, chairman of Agility Health.

Dr Phaleng joins Agility Health from his most recent role as Chief Strategy Officer at Discovery Health, where he was responsible for strategic risk management, health policy, regulatory and industry affairs. As a former Director of the Health Funders Association (HFA) and with more than 21 years of experience within the healthcare industry, spanning continents and the public and private sectors, Dr Phaleng brings a wealth of technical knowledge and unique insight to his new role.

“I am excited and look forward to taking up this leadership role at Agility Health. The globally renowned technology-driven approach to health risk management emphasises improving people’s health, and this resonates strongly with me. I foresee opportunities to apply these principles and to leverage Agility Health’s assets in enabling sustainable access to quality healthcare,” Dr Phaleng adds.

Dr Phaleng serves on the Council for Medical Schemes’ advisory committee on Fraud, Waste and Abuse, is also a former member of Business Unity South Africa’s (BUSA) health task team and the World Economic Forum’s global health strategy officers’ community.

“As Agility Health, we are looking forward to working with Dr Phaleng and learning from him as he forges the next era of leadership for Agility Health and our valued clients,” says Dr Magau.

Outgoing CEO Mr Patrick Masobe will be relocating to be closer to his family, after leading Agility Health for a period of six years.

“On behalf of the Board, we express our appreciation to Patrick for his invaluable contribution and leadership these past years. He has played an integral role in Agility Health’s success, and we wish him the very best in his future ventures.” Dr Magau concludes.

Saved by a wasp

Thu, 24 Feb 2022 08:33:24 GMT

It is almost a year since a wasp changed the course of Kahmiela August’s life and her 47th birthday is fast approaching. Her last batch of cancer tests recently come back clear and in celebration she tried to ride down a mountain in Franschhoek on a two-wheel scooter together with her family – something she had never done before.

Please note: The family briefly removed their masks for this photograph.

I’m whole, I’m happy, I survived… and I am grateful

It was March 2021 and 45-year-old Kahmiela August from Monte Vista in the Western Cape was feeling blessed. Her family had moved to the perfect home, she had a new job and her weight-loss journey had yielded fruit – she had lost a whopping 65 kilogrammes.

Kahmiela vividly recalls what appeared to be one of the best times of her life: “I was exercising regularly, which I hadn’t done in years. I was in the best health ever. Could it get any better?

“That was until the day I got stung by a wasp in my car, which was annoying as the car had been locked and unused in the garage while I was working from home during COVID-19. I don’t know how that wasp survived for weeks in a closed car. But this, it turned out, was no ordinary wasp.”

Soon after Kahmiela was stung several bumps appeared on her chest. After a week of waiting for them to disappear she finally found the time to see the doctor for an antihistamine. Much to her shock and horror the doctor felt it necessary to have a closer look at one of the seemingly innocent little bumps. Suddenly the possibility of breast cancer loomed large. If it had not been for the wasp sting, Kahmiela would not have thought of visiting her doctor as the thought of a possible cancer diagnosis had never crossed her mind.

The cancer diagnosis

“First there was the overwhelming agony of waiting, of watching my kids and husband, while desperately trying not to fall apart worrying that I would not be able to raise them. I recall the doctor talking and me hearing nothing except the word cancer and how my husband, my rock, remained strong for me while holding everything together.

“Finally, on 6 April 2021 – the day I turned 46 – a diagnosis of stage II to III breast cancer was confirmed. This meant that the cancer had grown deeply into nearby tissue while spreading into my lymph nodes, but fortunately not to any other parts of my body. Six months of treatment stretched ahead of me – first there was the chemotherapy followed by surgery and finally radiation therapy. Happy birthday to me!

“The world went silent until I walked into the office of my treating oncologist Dr John Sauer at Netcare N1 City Hospital. Aloma at his reception was there and they were all so kind. I walked in feeling overwhelmed, tearful, alone and terrified ¬ – I left feeling they’ve got this. You’re going to be okay. It wasn’t because of their medical words. It was because they reached my soul and consoled me somehow. The compassion from the first moment made this journey bearable.

“My choice from the start was that I would not play ‘Dr Google’. The doctors were medical professionals, and I was not. I still believe that this was the best decision I could have made in surviving my cancer journey mentally.

“The first chemotherapy session was rough and afterwards I ended up in Netcare N1 City hospital for five days with sepsis. COVID-19 was still rife and because of visitor restrictions, I was all alone. I had taken some work along to my chemotherapy session and insisted that my husband brought my laptop to the hospital. However, the panic in the voices of my children, my family, my friends and the fear in my husband’s eyes made me sit up and think.

“It was a lightbulb moment – I could not deal with this and work at full pace. I could not go on as though cancer was just a little inconvenience that I could humour and swat away in irritation. For the sake of my loved ones I needed to totally devote myself to fighting this battle.”

A journey of survival

And so Kahmiela’s journey of survival began. She was determined to not let anyone, including herself, live in fear and was adamant to keep her family life as normal as possible for the sake of her husband and the children.

“It didn’t matter how bad I felt, I got up every morning, smiled, packed lunches, made breakfast. I helped with homework, made supper and sometimes bought it. I tried to sleep when everyone was at school or working and I made sure that I was awake when they were home.”

She says staying in the routine was good for everyone psychologically and that it kept her busy so that her mind only wandered to ‘what if’ in the middle of the night.

Kahmiela started making a list of silver linings and whenever she thought of something new, she laughed. “For example, I could now legally try dagga as I would be using it for ‘medicinal’ purposes. Also, I would lose weight quicker – so, goal weight, here I come. I got to park in the oncology bays at Netcare N1 City Hospital while others had to search for parking. And that is just some of it,” laughs Kahmiela.

Tough days as mental anguish tries to take control

“When finding yourself in a situation like this you instinctively want to argue with the doctors because you’re scared. You want to cry with the humiliation of having so many people handle your ‘treacherous boobs’ – you want to give up when your arms are blue from needles and when the drips simply aren’t working anymore. When you are so nauseous you just want to sleep – when your hair starts falling out. There were so many gut-wrenching moments when reality really set in. But I pulled through by repeating ‘The treatment is working because the lump is slowly shrinking, so it is worth it’ to myself.

“As terrified as I was, I survived with the mantra ‘You are not in control – trust’. I would disengage my soul from my body and let the doctors and staff treat me while I trusted in them, totally at peace with myself. Sometimes in my darkest moments I would silently sing favourite songs in my head or count to 300 so I could get through just five minutes at a time. I would try to smile and thank the staff, because treating and caring for sick people every day cannot be easy for them either. I was so blessed by not only having a competent, but also a deeply compassionate treatment team at Netcare N1 City’s cancer care centre. I will forever be grateful for that compassion, given in moments when I had never felt more alone.

Remission – too good to be true?

“After six months, my doctor finally said the words… ‘We cannot guarantee a minute particle hasn’t spread, but you are in remission.’ My husband was overjoyed. But I was devastated. I wouldn’t tell anyone the good news. It was one of my lowest moments, and I didn’t want to get out of bed. All I heard was ‘minute particle’ which I erroneously interpreted as ‘this nightmare will never be over’.

“My husband on the other hand heard ‘remission”. I didn’t want my silent devastation to take away his joy at us making it through our greatest nightmare. Eventually I reached out to a Facebook CANSA group where I could speak my truth to others going through this journey. They heard me and helped me see. This was another great lesson – ask for help from those who have walked the journey, when you need it.

The patient’s advocate

Marilyn Lameyer, regional radiation therapy manager for Netcare Western Cape, says a cancer diagnosis is a life-changing experience and it is common to feel overwhelmed – even when, as in the case of Kahmiela, the end of the journey is in sight. “Supporting and assisting patients fighting cancer every step of the way through their individual treatment process therefore forms an integral part of the holistic care we provide.

“The comprehensive range of cancer treatments offered under one roof at the dedicated Netcare N1 City Hospital cancer care centre is supported by a multi-disciplinary team comprising a surgeon, oncologist, pathologist, radiologist, patient navigator as well as a social worker who are involved in the diagnosis, clinical assessment, counselling, treatment including breast reconstruction, and patient support.

“Our patient navigators – experienced cancer care nurses who are specially trained in supporting, guiding and assisting each individual patient from diagnosis through treatment to recovery – play a key role in smoothing the transition from one phase of treatment to the next for each patient. They also serve as the point of communication between the patient and the various medical professionals who are involved in their treatment so that the different aspects of a patient’s care are not dealt with in silos but in a holistic and compassionate way.

A perfect day

It is almost a year since the wasp changed the course of Kahmiela’s life and her 47th birthday is fast approaching. Her last batch of tests recently come back clear and she has much to celebrate.

“Clear, Clear! Cancer, you lose – I win! Whoop, whoop! As I’m now the invincible Supergirl I recently tried to ride down a mountain in Franschhoek on a two-wheel scooter together with my family – something I had never done before. Needless to say, it really did not go well, but my family and I laughed hysterically. For us it was simply a perfect day.

“I’m back, working at full pace, I’m exercising again. Sadly, I’m picking up weight again, but we’ll blame this on the festive season, not the extra slice of cake I had for lunch… God bless that little wasp for saving my life,” concludes a jubilant Kahmiela.

Talk to help save precious young lives

Wed, 23 Feb 2022 10:01:45 GMT

Adolescents and teens most at risk of suicide in SA

The transition from childhood to adulthood comes with many pressures that may not always be easy for children and young adults to discuss with their parents, family or teachers. Adults may also find it difficult to broach concerns about a teenager’s mental health. These conversations may take courage to initiate but could make the difference between life and death.

Psychiatrist Dr Marshinee Naidoo , who practises at Netcare Akeso Parktown and Netcare Akeso Alberton, says that the stigma around mental health can prevent troubled teenagers from seeking support from those closest to them.

“Teenagers will not always know how to express what they are going through, especially to authority figures such as parents and teachers. If any person is feeling suicidal, they do not necessarily spell it out or draw attention to their state of mind directly in words. There are, however, some potential warning signs that may come across in the person’s behaviour, in some instances.”

What depression or trauma looks like in teens

Over 10% of 12 to 17-year-olds go through at least one episode of major depression, defined as a period of at least two weeks where they are depressed to the point where they are unable to function, often with persistent feelings of apathy, sadness or anxiety, and disinterest in activities they usually enjoy. Sleeping significantly more or experiencing insomnia may also be associated with depression.

“There may be noticeable changes in their behaviour, such as acting out or withdrawing. This can be a source of tension between the teen and their parents but should be regarded as a signal that something is not right. It is important to recognise at times like these that understanding and open communication without judgement are needed more than ever,” Dr Naidoo adds.

Trauma can also take its toll on the mental health and wellbeing of teenagers, which could in severe cases lead to suicidal thoughts, if not properly addressed. “Teenagers may be so traumatised by an event that they feel unable to open the subject, or they may worry about how their caregivers will react,” she says.

The following signs may suggest a child or teenager has experienced trauma:

Worrying and fretting constantly
Avoiding a particular activity, person, or place
Vague or unspecified fear and anxiety
Deterioration in schoolwork
Social withdrawal or less communicative behaviour
Emotional reactions that seem out of character

“People who are suicidal do not always signal their intentions. If there is any cause for concern, however, it is always better to reach out to the person and try to assist them to find professional mental health support.”

In the event of a psychological crisis, the Netcare Akeso crisis helpline is available on 0861 435 787, 24 hours a day, to talk to an experienced counsellor. The Netcare Akeso mental health facilities provide caring professional support to persons of all ages, on either an inpatient or outpatient basis.

Breaking the isolation takes courage and sensitivity

“The loneliness and isolation associated with depression and the effects of trauma can deepen a person’s sense of despair. If you notice any person, and in particular a teenager, who is displaying signs of major depression or trauma, be sensitive to the fact that they may not feel able to proactively ask for your support – this does not mean it is not needed,” Dr Naidoo advises.

“Suicide is reportedly the fourth leading cause of death for teenagers aged 15 to 19 globally and constitutes a serious public health risk. It takes courage to help someone take the first steps towards healing.

“Tragically, too many precious young lives are lost every year to suicide. Greater awareness in society is needed to break down the stigma around mental health issues and ensure families and caregivers are better equipped to recognise and assist suicidal individuals before it is too late.”

Be Uniquely You and Colourful at CANSA Shavathon

Mon, 21 Feb 2022 07:12:07 GMT

The Cancer Association of South Africa (CANSA) is hosting its annual CANSA Shavathon fundraising event at shopping centres across the country on Saturday, 26 February 2022. CANSA invites everyone to come and celebrate by bringing family members, friends or colleagues to shave or spray in solidarity with those facing a cancer diagnosis. Certain venues may also host an event on Sunday, 27 February 2022. All venues will follow COVID-19 safety regulations.

Maria Scholtz, CANSA’s Head Sustainability, says “We’re so excited to launch our ‘Be Uniquely You – Be Colourful’ campaign. To shave or spray in a multitude of colours, costs only R50 per adult and R25 for children under 12 years. We know times are tough, and we’ve kept the price the same since Shavathon started. Many South Africans take part on behalf of a loved one who is living with cancer or who has been lost to cancer. Volunteers and staff are delighted to be able to host events and are ready.”

All funds raised go directly towards providing CANSA’s care and support service to cancer patients and loved ones. Stencils are again available to add flair when spraying hair and donations of hair can be made towards making a wig for cancer survivors. The spray is safe to use, being made of vegetable dye and comes out after one wash. A limited-edition badge of honour will be given to those who make hair donations of 25 cm or longer and limited edition CANSA Headwear will be sold for R50 per item (while stock lasts).

Host an Event

Anyone can host a Shavathon event, it’s not limited to workplaces, organisations or schools. Those wishing to host their own event to raise funds for CANSA, will be hosting events from 28th February to 4 March 2022. To host an event, please register and order Shavathon products through the CANSA Online Shop.

Raise Funds Online

Participants are also invited to open an online fundraising page before participating in a Shavathon event and to invite their contacts to support the action they will take on behalf of cancer Survivors on the day, whether they shave, or spray, by making an online donation to the participant’s fundraising page.

Scholtz adds, “Be sure to share your online fundraising efforts on your social media platforms using the hashtag #CANSAShavathon in the weeks leading up to your participation. We’re really thrilled to bring the public another opportunity to honour cancer survivors and raise vital funds for our care and support programmes. If you can’t make it, don’t forget that you can pay a ‘Bail Out Fee’ online.”

Find out more on Shavathon FAQ’s (find out all you need to know about this popular event) and Participating Shopping Centres (events will be added here weekly leading up to Shavathon).

Diagnosing and treating epilepsy is not always simple

Wed, 16 Feb 2022 05:59:33 GMT

Seizures and epilepsy: understanding the distinction and specialised treatment options available

Specialists from three epilepsy monitoring units at Netcare hospitals have shed light on common misperceptions about this neurological condition, explaining the importance of accurate diagnosis in order to optimise treatment of persons with epilepsy.

"When people think of epilepsy, a person experiencing convulsive seizures may immediately spring to mind. As doctors we know, however, that seizures may be attributable to other causes and that epilepsy takes various forms – some of which do involve convulsive seizures, but also others that do not," explains Dr Shaheed Gora, a neurologist practising at the specialised epilepsy monitoring unit (EMU) at Netcare Milpark Hospital in Johannesburg.

What is epilepsy?

"Official estimates vary, but epilepsy in its various forms is believed to affect around 55 million people worldwide, and approximately one percent of South Africans. This neurological disease is not contagious and certainly is no indication that a person is mentally deficient," Dr Gora observes.

"From critically acclaimed novelists Fyodor Dostoyevsky and Laurie Lee, to musicians Lil Wayne and Prince, and sport legends such as Jonty Rhodes, many epileptics have distinguished themselves in their chosen fields. It is even believed that the ancient Greek philosopher Socrates, and historical figures including Roman emperor Julius Caesar and French emperor Napoleon Bonaparte – both revered for their political and military strategies ¬– were epileptic."

Dr Vanmala Naidoo, a neurologist who practises at the Netcare Mulbarton and Netcare Vaalpark hospitals’ EMUs, says that there are many different types of both epilepsy and seizures, and they may present in many different ways. "While some epileptics experience convulsive or grand mal seizures, characterised by the body stiffening and uncontrolled muscle jerking, other types of epilepsy may involve atonic seizures, where the person briefly loses control of their muscles and collapses, or absence seizures, where the person may simply just stare into the distance for up to 10 seconds."

What are seizures?

A seizure is defined as a surge in the electrical impulses of the brain, causing a number of possible symptoms depending on which area of the brain is affected. Seizures can be caused by epilepsy, but there are numerous other factors that they may be attributable to.

Dr Raksha Sitharam, a neurologist practising at the EMU at Netcare Waterfall City Hospital in Midrand, says that not everyone who experiences a seizure is necessarily epileptic. "Other causes of seizures can for example be due to metabolic derangements such as low glucose. Withdrawal from illegal drugs or alcohol has also been associated with seizures," Dr Sitharam notes.

Diagnosing epilepsy

"As epilepsy is a complex group of conditions, diagnosis is not always simple. There are other conditions that may present in ways similar to certain types of epilepsy, and in order to effectively treat the patient these would need to either be ruled out or confirmed," Dr Sitharam adds.

Typically, the patient's medical and family history will be taken into consideration, and a clinical examination performed. An electroencephalogram (EEG) test will be performed to record electrical activity in the brain. The doctor may also ask for eyewitness accounts of someone who saw the patient having a seizure to help determine what type of seizure it was. MRI or CT scans are also commonly used to help identify the cause of seizures.

Diagnosing epilepsy by video and EEG monitoring in specialised EMUs

"Even with the aid of front-line diagnostic tools, further testing may be required to distinguish epileptic seizures from other conditions that may present similarly, such as syncope [fainting spells], heart rhythm disorders, sleep disturbances or behavioural disorders," Dr Sitharam explains.

Dr Gora explains the process: "Video-EEG involves continuous simultaneous EEG and video monitoring over a period of between 24 hours and five days, which enables doctors to see the patient's physical response on video footage and compare it with simultaneous information recorded on the EEG.

"Through this process, we are able to identify the type of seizures being experienced, and in which part of the brain the seizures originate. We can determine how often the patient has seizures, even those types of seizures that might otherwise be difficult to notice. This helps to determine the best possible treatment option for the individual," Dr Naidoo adds.

Dr Sitharam says that video-EEG monitoring also has applications for assessing whether the type and dosage of medication a patient has been prescribed is the most appropriate for their particular condition.

When being admitted to an EMU, patients are encouraged to bring along a close friend or family member who is familiar with their seizures, both to assist in alerting the neurodiagnostic technician to the seizure and for personal support. During their stay at an EMU, patients may bring a laptop, books or craft materials to help them pass the time. They may be required to stay awake for some time, as sleep deprivation testing may be necessary.

The EMUs at Netcare Mulbarton, Netcare Milpark and Netcare Waterfall City hospitals are equipped with state-of-the-art technology and designed with patient comfort in mind. The aim is to make a patient’s stay as pleasant as possible, and the en-suite bedrooms also have television sets for patients to while away the hours.

What to do if you see someone having a grand mal seizure

"There are a number of misperceptions surrounding the neurological condition of epilepsy, some of which are potentially harmful. As we mark National Epilepsy Week, we wish to raise awareness about what to do if you witness someone having a convulsive seizure because well meaning but misinformed seizure interventions may actually cause injury to the person having a seizure," says neurologist, Dr Shaheed Gora of the epilepsy monitoring unit at Netcare Milpark Hospital.

What to do:

Loosen constrictive clothing around the person's throat
Remove any sharp or hard objects including furniture near the person that might cause them injury
If the person is wearing spectacles, remove them
If bystanders have gathered around, reassure them if they are upset by what they're witnessing and ask them to give the person space while you keep an eye on them
If possible, position the person so that they are laying on their side so that any vomit or excess saliva can drain from their mouth
If the person having a seizure is pregnant call an emergency medical services provider, such as Netcare 911 on 082 911
If the seizure lasts longer than three minutes, call an emergency medical services provider

What not to do:

Do not panic
Do not try to put your fingers or any object into the person's mouth during the seizure
Do not hold the person down or restrain them

Once the seizure is over:

Check that the person is breathing normally. At this stage you may need to clear any obstruction from the mouth with your finger, and put the person in the recovery position (i.e. laying the person on their side, with their mouth angled downwards so that any fluid or vomit will drain out of the mouth instead of blocking the airway).
Allow the person to rest
Persons who have suffered a seizure are frequently confused or drowsy thereafter or have a severe headache. Reassure them and stay with them until they are fully alert and recovered
Do not offer them food or drink until they are fully alert
Check that the person has not sustained any injury during the seizure

NETCARE EPILEPSY MONITORING UNITS

Durban metabolic surgery centre joins ranks of the few in SA accredited to perform specialised procedure

Fri, 11 Feb 2022 05:27:54 GMT

Morbidly obese patients can now receive help close to home in KZN

The Durban Metabolic Surgery Centre , run by well-known surgeons Dr Gert du Toit and Dr Ivor Funnell , has been accredited by the South African Society for Surgery, Obesity and Metabolism (SASSO) to perform the highly advanced Biliopancreatic Diversion with Duodenal Switch (BPD-DS) surgery.

Performing procedures at Netcare St Augustine’s and Netcare uMhlanga hospitals, Drs Du Toit and Funnell started performing laparoscopic gastric bypass surgery – the preferred procedure for morbid obesity and associated illnesses including type 2 diabetes – in 2006. Since then the team has completed approximately 660 procedures, which have achieved some life-changing results for patients.

Why BPD-DS surgery?

“The gastric bypass procedure has been the gold standard for weight loss, or metabolic surgery, for around 30 years. However, ongoing research and audits have demonstrated that super obese patients, especially those with BMIs of around 55 to 60 and higher and with long term diabetes, do better with more drastic malabsorptive procedures such as BPD-DS surgery,” comments Dr Du Toit.

“With patients requiring comprehensive post-operative management from a multi-disciplinary team, as well as support from family and loved ones, this was not always an easy option for those in KwaZulu-Natal to have BPD-DS surgery as it was not offered locally. We are delighted that we are now able to perform this much needed, tailormade procedure here in KwaZulu-Natal at Netcare St Augustine’s Hospital,” he says.

BPD-DS surgery explained

Dr Du Toit explains that BPD-DS surgery offers a very specific set of benefits but takes quite a bit longer to perform when compared to a gastric bypass. “In the hands of practised surgeons a gastric bypass can take approximately one hour 30 minutes, whereas the BPD-DS procedure is about four hours long. In addition, more comprehensive, multi-disciplinary post-operative care as well as ongoing monitoring of vitamin levels and supportive infusions are required.

According to the International Society for Weight Loss Surgery (IFSO), the most authoritative society in the field of metabolic surgery internationally, less than one percent of all bariatric procedures undertaken throughout the world are performed as a BPD-DS because of its complexity.

“The BPD-DS procedure is not suitable for everyone. Patients who stand to benefit most from it are morbidly obese individuals with comorbidities and longstanding diabetes. The uncommon, complex procedure involves the surgical removal of about 60 to 70 percent of the stomach, leaving the patient with a smaller, tube-shaped stomach. Thereafter, the end portion of the small intestine is divided much lower down than in the case of a gastric bypass. In this way, two thirds or more of the intestine is bypassed so that the end portion of the intestine can be connected to the duodenum near the stomach. The BPD-DS controls how much can be eaten and lowers the absorption of proteins, fats as well as nutrients,” notes Dr Du Toit.

The Durban Metabolic Surgery Centre, based at Netcare St Augustine’s and Netcare uMhlanga hospitals, has recently joined the ranks of few specialised centres in South Africa, when it was accredited by the South African Society for Surgery, Obesity and Metabolism (SASSO) to perform the highly advanced Biliopancreatic Diversion with Duodenal Switch surgery. The centre is run by Dr Ivor Funnel (left) and Dr Gert du Toit (right) who started performing laparoscopic gastric bypass surgery as the preferred procedure for morbid obesity and associated illnesses, including type 2 diabetes, in 2006. Since then the team has performed approximately 660 procedures, which have achieved some life-changing results for patients.

Stringent requirements

SASSO, which is affiliated with IFSO, requires surgeons to perform around 300 gastric bypass operations and only thereafter do they become eligible to be proctored and accredited to perform the BPD-DS procedure. This requires that the surgeon attend at least two cases performed by the proctoring surgeon. Thereafter the proctor has to be in attendance at the candidate surgeon’s facility while the surgeon performs three cases on their own.

According to Dr Du Toit, he and his colleague Dr Funnell were privileged to have the highly skilled and experienced Dr Gary Fetter, who has the unique accomplishment of having performed around 1 200 of these procedures at Netcare Waterfall City Hospital, proctoring the team at Netcare St Augustine’s Hospital.

“I was assisted by Dr Funnell and Dr Bruce Yelland and we successfully performed five BPD-DS procedures over a period of two days. These were all interesting yet complex procedures with the potential to change the lives of a number of relatively young patients. To date the results which were tracked over a period of three months have been heartening, with the patients losing an incredible 164 kilos between them by 10 January 2022. More importantly, each of the patients have had an uncomplicated recovery.

“The weight of the first 35-year-old female patient has to date dropped from 223kg to 182kg while a second 38- year-old-female, who initially weighed 131 kg, reflected a loss of some 20 kg. A 27-year-old female patient was able to start 2022 with a drop in weight from 175 kg to 118 kg while our two male patients aged 30 and 39 respectively were able to reduce their weight from 164 kg to 139 kg and from 254 kg to 233 kg over the past three months.

“We have subsequently done a number of these procedures and are delighted with the results obtained to date. Obtaining this level of accreditation required a tremendous team effort from a number of departments at Netcare St Augustine’s Hospital as well as by local pharmaceutical suppliers. This achievement and the work that got us to this point was truly a team effort by the administrative staff, specialists, other healthcare professionals, combined with the support of the hospital management, the world-class surgical facilities and equipment provided by Netcare, and the quality care provided by the hospital’s nursing staff. The accreditation is an acknowledgement of the contributions each has made towards providing our patients with hope for the future and a new lease on life,” Dr Du Toit asserts.

“It is extremely gratifying for us that the Durban Metabolic Surgery Centre has received this all-important accreditation from SASSO, a highly-esteemed national authority,” says Heinrich Venter, general manager of Netcare St Augustine’s Hospital

“The work that the multi-disciplinary team, led by Dr Du Toit, has done at the hospital has been nothing short of life-changing for so many individuals. This accreditation is testimony to the hard work and exceptional expertise of the team,” he adds.

“On behalf of Netcare St Augustine’s Hospital we congratulate Dr Du Toit, Dr Funnell and everyone who has contributed towards this important milestone, which firmly places Netcare St Augustine’s Hospital on the map for BPD-DS and other forms of metabolic surgery,” concluded Venter.

New year, new you? Tips for staying motivated to reach your goals

Tue, 08 Feb 2022 04:27:41 GMT

“Set realistic milestones and celebrate progress”: Occupational therapist

New Year’s resolutions are notoriously difficult to stick to but with the right perspective and self-acceptance, it is possible to stay motivated and make progress towards our goals. Remaining on track requires perseverance, a healthy dose of adaptability, and the courage to accept oneself, an occupational therapist advises.

“Many of us make New Year’s resolutions, and often within a month or so the initial enthusiasm for self-improvement wears off and motivation begins to flag, particularly when the end goal still seems far out of our reach,” says Alice Gelderblom Waddilove, an occupational therapist practising at Netcare Akeso Kenilworth mental health facility.

“Too often, people become discouraged when they feel they are not making sufficient progress towards their goals, and this can affect one’s confidence. To keep going, we need to be kind to ourselves while finding workable ways that will help us remain on track without holding ourselves to unrealistic goals. For example, if you are not sporty by nature and set yourself the goal of running a marathon, accept that this may not be achievable all at once.”

Goals should not be seen as a measure of self-worth

Gelderblom Waddilove points out that goals should be regarded as things one hopes to achieve, rather than a rigid measure of achievement that supposedly reflects one’s self-worth.

“You may find it necessary to adapt your goals due to circumstances beyond your control. Rather than abandoning your plans, remain flexible within your goals and find what is workable for you,” she advises.

“Here the concept of radical acceptance, an aspect of dialectical behavioural therapy [DBT] which involves reflecting on a situation as objectively as possible, can be helpful. DBT may be used alone or in combination with other treatments, either in an inpatient or outpatient setting.

“There is a tendency to be particularly self-critical when we are feeling low. Rather than becoming discouraged, take stock of the situation and reflect on where you find yourself now without judgement,” she suggests.

“Although self-acceptance can be challenging, particularly for those experiencing certain kinds of mental health disorders, try to be fair and compassionate with yourself, focusing on the progress you have made so far towards your resolutions.

Small steps and marking progress

“Taking better care of your physical and emotional wellbeing should always be a priority, and the key is to keep making incremental progress, focusing on what the next step is and what is within your control.”

Gelderblom Waddilove says it can be helpful to set smaller, more realistic steps that are more manageable as a series of milestones towards your ultimate goal. “Give yourself credit for completing each of these steps and celebrate the little victories you achieve along the way. If you are coping fairly well with the demands of work within your work-life balance, that in itself is no small feat.”

“Even if we experience setbacks in pursuing our goals, remember that all is not lost. Part of life is to find meaning and a sense of purpose in the journey. The late photojournalist Dan Eldon aptly summed this up: ‘The journey is the destination’. While achieving one’s goals is wonderful, it is also important to have something to strive for, so keep setting new stimulating challenges for yourself,” Gelderblom Waddilove says.

“If we persevere, and rather than throw in the towel, continue with the building blocks towards our ultimate goal, we may find that we end up in a totally different place to the one we initially imagined, which may provide us with a deeper meaning and purpose.”

For support in coping with mental health issues and accessing care, and for professional help in a mental health crisis, Netcare Akeso is here to help. In the event of a psychological crisis, emergency support can be reached on 0861 435 787, 24 hours a day.

Non-surgical micro procedures making strides

Mon, 31 Jan 2022 10:58:46 GMT

Fallopian tube recanalisation now performed in South Africa - a first in Sub-Saharan Africa

The pioneering field of interventional radiology is opening up new treatment possibilities, precisely targeting health problems that often lie deep within the body – without the need for invasive traditional surgery. Recently, the scope of what is being achieved with these micro procedures has extended even further to include procedures for highly targeted treatment of liver cancer, and for identifying and remedying a relatively common cause of infertility in women.

“Today micro-invasive treatments are helpful for a wide range of conditions from fibroids, prostatic enlargement, advanced pelvic cancers, and delivering cancer treatments, to a diverse array of interventional radiology procedures in the chest and abdomen,” says diagnostic and interventional radiologist and founder of The Microsurgery, Dr Gary Sudwarts, who practises at a number of Netcare hospitals.

What is interventional radiology?

Using imaging equipment including specialised x-rays, a thin catheter wire is inserted into an artery through a tiny puncture in the patient’s skin and carefully directed to the relevant site within the body for treatment.

In the case of artery embolisation procedures, tiny particles are released at the site to starve the lesion of blood supply, causing it to wither and become harmless. Chemoembolisation procedures deliver a dose of chemotherapy right to the blood vessels supplying the tumour. These micro procedures are performed while the person remains conscious, or with only minor sedation where needed.

A distinct advantage of interventional radiology approaches is that procedures are non-surgical, and therefore less physically traumatic than traditional open surgery. Micro procedures do not incur many of the risks associated with open surgery and do not require general anaesthetic. Often the recovery is quicker and the hospital stay reduced, compared with traditional open surgeries.

“In the past, such options were usually reserved for inoperable conditions and for patients who could not tolerate anaesthetic well or had other risk factors that otherwise precluded them from surgery. Developments in the field in recent years have opened many new applications for these least invasive interventions. Now, interventional radiology is increasingly recommended as a first line treatment for patients in appropriate instances, with a growing list of applications,” he says.

Dr Sudwarts is well known for his work in raising awareness of uterine fibroids, which include symptoms of heavy menstrual bleeding, abdominal pain and bloating, among others, and can cause infertility.

“Previously, women would have had to undergo open surgery, often a hysterectomy, to find relief from uterine fibroids. Now, the minimally invasive uterine fibroid embolisation procedures that are available allow for the condition to be treated without sacrificing fertility in the childbearing years.”

Non-surgical treatment for blocked fallopian tubes – a first in Sub-Saharan Africa

There are many possible causes of infertility. Following a gynaecologist or fertility specialist’s comprehensive assessment and diagnosis, women who are unable to conceive due to a blockage in their fallopian tubes now have an advanced non-surgical option available.

Dr Sudwarts and Dr Maja Wojno recently became the first interventional radiologists to offer fallopian tube recanalisation in Sub-Saharan Africa in a procedure performed at Netcare Park Lane Hospital in Johannesburg, and so far more than 20 women have undergone the procedure successfully.

“The fallopian tubes are crucial to fertility and if they become blocked, commonly due to clusters or casts of cells, fertilisation cannot take place. This micro procedure to reopen the fallopian tubes is painless and does not require the woman to stay over in hospital or take additional recovery time off work.”

The procedure is available to women through The Microsurgery at Netcare Christiaan Barnard Memorial, Netcare UCT Private Academic, Netcare uMhlanga Hospital, and Netcare Park Lane hospitals.

TACE for cancer of the liver

In a first for Cape Town, Dr Sudwarts and Dr Wojno recently performed a highly specialised transarterial chemoembolisation (TACE) with Lipiodol; a micro-invasive procedure for multifocal hepatocellular carcinoma, the most common type of primary liver cancer, at UCT Private Academic Hospital.

“The aim of the TACE procedure is to deliver a very high dose chemotherapy directly to the cancer cells in the liver. Usually this kind of cancer is inoperable, and unfortunately patients tend to be diagnosed once it has already started to progress.”

Following the South African Health Regulatory Authority’s (SAHPRA’s) recent approval of an advanced combined contrast agent, chemotherapy vehicle and embolic agent known as Lipiodol Ultra Fluid, Dr Sudwarts and Dr Wojno used this triple-action fluid in the procedure to precisely target the cancerous cells in the liver.

“The micro-invasive TACE is extremely safe and not painful, and it can be effective in decreasing the size of the tumour or extent of metastases, improving patients’ quality of life and survival prospects. This treatment is available through The Microsurgery at Netcare UCT Private Academic and Netcare Christiaan Barnard Memorial hospitals.”

Jacques du Plessis, managing director of Netcare’s hospital division, congratulated Dr Sudwarts, Dr Wojno and the team for continually seeking new and effective treatments for the benefit of patients.

“The world-class micro-invasive options made possible through interventional radiology have revolutionised treatments for a wide range of conditions, and we are grateful for the specialists’ dedication to bringing the advantages of these treatment modalities to patients in Netcare hospitals,” Du Plessis concluded.

Would you know if you had a ‘silent killer’?

Mon, 17 Jan 2022 16:17:40 GMT

Untreated conditions can cause long-term damage

Many people are unaware that chronic health conditions such as type 2 diabetes, high cholesterol or hypertension can cause damage to the body, often without the person experiencing noticeable symptoms. Although they can occur individually, these three conditions are often interlinked and can significantly increase the chances of stroke, heart attack and premature death.

“At the beginning of a new year, many of us think about improving our health through taking up a fitness regimen or eating more healthily. A crucial but often overlooked aspect of taking care of our wellbeing is having routine health screenings,” says Joy Steenkamp, a pharmacist at Medipost Pharmacy, South Africa’s largest national courier pharmacy.

“Even if you feel healthy and well, be aware that you could be living with one or more of these underlying conditions without knowing it. With non-communicable diseases on the rise in South Africa, it really is advisable for adults to screen for these common health threats each year so that any risks can be detected and managed early to ward off more serious complications from developing in future.”

Diabetes – chronic high blood sugar

Diabetes is a chronic long-term condition that affects how your body breaks down sugar from the food that you eat. While type 1 diabetes is usually diagnosed in childhood, type 2 diabetes develops over time and is more often diagnosed in adulthood.

“Insulin is a hormone that helps control your body’s blood sugar levels. If your body doesn’t produce enough insulin or cells stop responding to insulin, too much sugar remains in your bloodstream and this can lead to serious health problems over time, including potentially irreversible damage to the eyes, kidneys and other organ systems. It is therefore critical to be aware of your blood sugar levels and get tested regularly to know if you are at risk of developing type 2 diabetes,” Steenkamp says.

“With the medicines available these days, along with regular exercise and a healthy diet as advised by your treating doctor, diabetes can be very well controlled with many new oral or injectable medicines to help keep blood sugar levels stable.”

Hyperlipidaemia – high cholesterol

“High cholesterol, or elevated levels of fat in the bloodstream, is another common non-communicable disease that is all too common in South Africa. Although people with high cholesterol usually do not have any symptoms, if it remains undiagnosed and therefore untreated it significantly increases the risk of heart disease, heart attack and stroke,” Steenkamp adds.

“A simple blood test reveals cholesterol levels, and if these are outside of the healthy range your treating doctor will prescribe the right kind of chronic medicine to help maintain cholesterol at healthier levels. A diet that is low in saturated fat and regular cardio exercise are generally recommended as part of the treatment plan.”

Hypertension – high blood pressure

“The World Health Organization estimates that almost half of people living with high blood pressure globally remain undiagnosed and therefore untreated, and only one in five have their hypertension under control,” Steenkamp says.

When hypertension is not well controlled it places additional pressure on the cardiovascular system, potentially leading to heart attack, heart failure and stroke, as well as kidney damage among other risks.

“Unmanaged, these conditions are associated with significantly higher risk of hospitalisation and premature death, but these outcomes can be avoided with the right treatment. Once a person has been tested, they have the power to improve their long-term health and can often avoid complications with the necessary treatment and lifestyle adjustments.

“When your doctor has prescribed the right medication specifically for you, this is only the first step to effective treatment, and it is of critical importance that you continue to take your medicine exactly as prescribed – even when you feel better.”

Supporting better health outcomes

“Being diagnosed with a chronic condition and starting new medication can be daunting, and to help make it as easy as possible to adhere to prescribed treatment Medipost Pharmacy offers telephonic assistance from the pharmacy team in all official languages, as well as free delivery of chronic medicines to any address in South Africa. If you have any questions or concerns about your treatment, reach out to your pharmacist who can give you advice, such as how to overcome potential side effects,” Steenkamp says.

“To be effective, chronic medicine must be taken at the right dosage continuously, even when you’re on holiday or out of your usual routine.”

As part of its free delivery service for chronic medicines, with advanced notice those registered with the courier pharmacy can have their confidential medicine parcels delivered to another address while they are away from their usual delivery address. As well as dispensing medicines to individuals privately, the service also includes assistance with registering PMB conditions, including diabetes, hypertension and hyperlipidaemia, to help conserve medical scheme members’ day-to-day benefits.

“Medipost Pharmacy aims to improve access to quality and affordable medicines for all South Africans, making it simple and convenient to adhere to chronic treatment and improve your health and quality of life,” Steenkamp concludes.

For more information, please visit www.medipost.co.za

‘The biggest blessing is just being alive’

Thu, 30 Dec 2021 05:50:45 GMT

Mbusi Ndlovu

Young accountant urges people to get vaccinated after year-long battle with COVID

“If the story of my ordeal with COVID-19 can convince at least one person to get vaccinated, it might just save a life,” says Johannesburg’s Mbusi Ndlovu, who has been locked in a life-or-death battle with the coronavirus for more than a year.

“The severity with which I had been affected by COVID-19 makes no sense at all,” says Mbusi. He was only 29 years old, went to gym, had no pre-existing conditions and had no lung problems – he didn’t even smoke. Yet this time last year he landed in hospital and now, a year later, he is still battling the virus.

He cannot understand how people can refuse to get vaccinated after spending months in a hospital bed and having to learn to walk again. “Vaccination should be our priority. It gives us the opportunity to fight this virus. COVID-19 is real – I know exactly how bad it is. I am proof that it can also kill young people,” he says.

Dr Paul Williams, the Netcare Milpark Hospital-based critical care specialist and pulmonologist, whose team was responsible for Mbusi’s care, says the young accountant was extremely ill. “He had COVID-19 as bad as we’ve seen in anyone who survived. We thought he may have to be considered for a lung transplant. He still had to be on a ventilator for about three weeks after having three months of Extracorporeal Membrane Oxygenation (ECMO) treatment.”

But according to him, Mbusi has made a remarkable recovery. He credits Mbusi’s positive outlook on life in general, “which made it much easier to look after him.” Dr Williams says they suspect that Mbusi had the Delta variant of the virus, which can explain the severity of his illness.

According to Mbusi, his ordeal with COVID-19 has become the worst experience of his life. “On 11 December 2020, I went to a GP with flu-like symptoms, and she diagnosed me immediately: ‘you have COVID-19!’. She referred me to the Netcare Waterfall Hospital for a COVID-19 test, which confirmed her diagnosis.

“A couple of days later, it became difficult to breathe, and we had to call an ambulance to come pick me up. At the Netcare Sunninghill hospital, they told me I have mild symptoms.

“I went home to self-isolate, but a couple of days later, things got much worse. I was sweating and struggling to breathe. My body was giving up. On 18 December I was rushed to Netcare Milpark Hospital, where fortunately a bed happened to be available.

“I remember when I got there, I was immediately taken to ICU. Within a couple of days of being in hospital, the medical team decided to put me on ECMO. Luckily, the team at Netcare Milpark Hospital had this technology available and as the largest ECMO unit in the country they also have the expertise to assist patients who need this kind of specialised treatment. Large tubes attached to the machine were inserted through the large vessels in my neck.”

ECMO is a state-of-the-art process where a machine artificially performs the functions of the lungs, 24 hours a day. It pumps and oxygenates a patient's blood outside the body, allowing the heart and lungs to rest. “The biggest issue was that this virus had started to damage my lungs to the extent where they were not functioning and responding.

“This entire time the medical team was buying some time for my lungs to recover so that they could function again. This piece of technology played a key role in giving me a chance to survive. Initially things were not looking good, but the team soldiered on and kept monitoring my progress but for some reason, I was not getting any better.

“While ECMO was buying my lungs some recovery time, my liver started to become a problem. They now had to bring on board a liver specialist. With multiple key organs failing at the same time, you can just imagine how slim the chances of survival were. I was in ICU, heavily sedated from December 2020 until I regained consciousness in March just after the ECMO was removed in February.

“Yes, I was on ECMO for that long. At some point, the medical team had started having conversations about having a lung transplant performed because I had been on ECMO for so long. The team decided to take a chance and remove the ECMO. Luckily, my lungs responded and could function,” says Mbusi.

Obviously, his lungs were significantly damaged and had to be monitored carefully. Mbusi then went on a ventilator in the beginning of March this year, which is when he woke up, intubated in an ICU isolation ward.

“I remember one of the physiotherapists came to see me. She told me I was going to recover. I couldn’t answer her because I had a tube in my throat and couldn’t speak at all.

Mbusi says he became incredibly frustrated because he thought he wouldn’t be able to ever walk again. “How could I possibly walk when I couldn’t even move a leg?” he asks.

The physiotherapist explained that the human body loses muscles by just being in bed for a couple of weeks if not days. Mbusi had been in a hospital bed for three months, not moving at all, being fed through a tube running through his nose.

He says his biggest victory was when he could lift his right arm. “In my mind, I kept wanting to move my legs. I tried and tried until they started moving. I was slowly gaining the muscles back.”

He remembers how emotional he felt when a physio told him that as part of his exercise for the day they were going to try and make him stand. “I wanted to walk, but I couldn’t stand for even 10 seconds.”

Eventually he managed to stand, and later started walking again. His rehabilitation was a slow process with occupational therapy, speech therapy and physiotherapy.

He remembers getting daily injections to prevent blood clots. One day, the physiotherapist put him in a wheelchair and took him outside so that he could see the sun after not being outside for months.

He says he will forever be grateful to the team at Netcare Milpark Hospital. He believes they saved his life. “I wish I had more time to talk about each of the different specialists, the speech therapist, the dietitian, the nurses, doctors, the psychologists, even the cleaning ladies… But it is such a long story.”

According to Mbusi, his severe illness was particularly traumatic for his family. His brother passed away early in 2020, and they also lost his grandmother that year which was the year he was hospitalised. His family flew from KwaZulu-Natal a few times to see him but was confronted by the frustration of having to return not knowing if he would survive. All of this resulted in many sleepless nights and a great deal of stress for his father, who as a parent, had to deal with having a child in hospital in a different province, without daily access. His father was also the first point of contact throughout Mbusi’s hospitalisation.

After being discharged in April, he still had to go to rehabilitation to work on his severely diminished lung capacity. “It’s been quite a journey. I’m much better now. I have made significant progress and things look good. I still have to see an occupational therapist every two weeks, but the greatest blessing is that I’m alive. I’ve lost so much weight and muscle. It was unbelievable to find myself in that state.”

He has made a graded return to work in June and is almost working at full capacity again.

And he loves to tell people the story of his year of severe COVID-19. “The point of sharing this story is to try and convince people to get vaccinated and protect themselves against this deadly virus. Some did not buy it, but I managed to convince quite a few people to take the vaccine.”

When he became ill, the vaccines were not available yet, but as soon as his age group qualified, he got vaccinated.

He wrote his story on social media a couple of weeks ago, which quickly created a Twitter frenzy. Several of his followers suggested that he consider a career in writing. “This is a great story to tell,” he says. “But there are other great stories too, I’ll definitely try my hand at it. Who knows what the future holds?”

“I would like to thank everyone who was part of this journey with me. From the entire Netcare team to my whole family, friends, colleagues, church members – everyone who was there to support me throughout this difficult journey. Thank you very much for allowing me to share my story – I hope it saves someone’s life,” concludes Mbusi.

Psychologist’s advice for coping with festive triggers

Thu, 23 Dec 2021 05:29:19 GMT

Make the best of this special time of year

The festive season, particularly during another COVID-19 wave, can present triggering situations for many people. A counselling psychologist offers advice for building tolerance and coping mechanisms for the interpersonal conflicts, distressing or uncomfortable situations that may arise at this time of year, and which could be compounded by the pandemic.

“Many of us may find it difficult to regulate our emotions when faced with distressing situations, such as family tensions, financial pressures, dealing with loss or worry about the future,” explains Zain Julies, a psychologist practising at Netcare Akeso Milnerton.

“Looking for ways to deal with distress, we may find ourselves reaching for the old familiar ‘crutches’ such as alcohol, food, over-the-counter medication, reliance on social media and technology, or unhealthy relationships with certain people, when facing uncomfortable situations,” she says.

“At this time of year, which is so often associated with indulgence, it may be easier to fall into unhealthy patterns with short-term fixes. It can be helpful to remember that such choices often don’t make us feel better in the long run and can frequently make things worse than before.”

Don’t waste precious time on things beyond your control

Zain suggests taking a moment to reflect on ‘What is in my control, and what is not?’ in times of stress, to provide a reality check on what falls within one’s circle of influence.

“The things that I have direct control over include my thoughts, my words, my actions, my decisions, my attitude and my mood. Secondly, there are aspects of life that we may be able to influence, such as other people’s actions, where we work, and who follows us on social media,” she adds.

“Thirdly, there are things we may be concerned about that are simply not within our control, such as lockdown restrictions, the weather, media, a sports match, traffic, or our past decisions, choices and behaviour.

“While we may not be able to control these factors, what we can control is our reactions to them. Accept that worrying will not change the situation and will not make you feel any better. Instead, one can choose to refocus on being mindfully present, making the most of this time of year and our loved ones.”

Building tolerance and coping skills

Zain points out there are techniques one can learn to manage unpleasant situations without losing control and acting destructively. “One of the approaches that has proved effective for many people in dealing with interpersonal conflict is dialectical behaviour therapy [DBT], which is an evidence based form of therapy that can also be helpful in treating personality disorders and certain mental health conditions,” she says.

DBT is one of many approaches that mental health professionals at Netcare Akeso facilities can offer to assist clients, either as part of an inpatient treatment programmes or on an outpatient basis.

A particularly useful tool within the DBT framework is distress tolerance, defined as ‘the ability to tolerate distress without acting on it’. “These skills empower you to survive an immediate crisis without making it worse, as it can be tempting to react impulsively in times when we may be overwhelmed by emotions,” Zain says.

Five things you can see, and a partridge in a pear tree

“Distress tolerance equips the person with the skills to temporarily distract and distance themselves from emotional pain, creating a pause that enables them to act more effectively in the situation.”

“One of the easiest ways to deal with distressing situations or emotions is to focus on your five senses to ground yourself. If you are feeling overwhelmed, find five things that you can see, four things that you can hear, three things that you can touch, two things that you can smell and one thing that you can taste. This simple exercise in mindfulness can help prevent you doing or saying something you may later regret.”

Another skill that Julies suggests may prove helpful in times of frustration or when festive cheer wears thin is known as the STOP skill, which stands for:

S is for S top, don’t say or do anything.
T is for T ake a step back.
O is for O bserve and evaluate what is happening, both inside yourself and in the external situation.
P is for P roceed mindfully.

“This puts a pause between your feelings and the urge to do anything. In addition to these skills, self-care is important to get through the year-end break, whatever challenges it may present,” Julies says.

Get enough good quality sleep
Eat a well-balanced diet
Exercise on a regular basis
Take brief rest periods during the day to relax
Take vacations away from home and work
Engage in pleasurable or fun activities such as yoga, prayer, meditation, or progressive muscle relaxation
Avoid overindulging in caffeine and alcohol

“Take care of yourself and your mental health all year round. For information about mental health issues and services, accessing care, and for professional help in a mental health crisis, Netcare Akeso is here to help. In the event of a psychological crisis, emergency support can be reached on 0861 435 787, 24 hours a day, 365 days a year,” she concludes.

Miracle baby gets a baby sister for Christmas

Wed, 15 Dec 2021 08:20:50 GMT

From left to right, registered midwife Sister Tracy Van Niekerk is photographed with a clearly delighted Mihle Biyela who is being held by his father Mr Phiwayinkosi Biyela while his mother, Mrs Ntombenhle Biyela is cradling his new baby sister, Asimdumise.

Mihle visits baby sister at Netcare St Augustine’s Hospital two years after his birth

When Mihle Biyela was born on 12 February 2019 he was hailed a miracle baby by the medical team who safely brought him into the world. On 12 November, two years and nine months to the day, the healthy, happy little toddler was given an early Christmas present – a baby sister.

Recounting the happy event, the delighted father, Mr Phiwayinkosi Biyela says that the family is overjoyed. “We have called our little daughter, Asimdumise, which means ‘Let us praise the Lord’ in isiZulu. Along with our first born, a 10-year-old girl named Ayabonga, our family is now complete.”

Gynaecologist and obstetrician, Dr Bongani Mazibuko who practises at Netcare St Augustine’s Hospital, says the birth of the new addition to the Biyela family was, thankfully, uneventful. “There were some concerns during Mrs Biyela’s two most recent pregnancies, however both children are in perfect health. Best of all, Mihle has not had to undergo any of the many procedures that the medical teams believed he would need at the time of his birth and thereafter.

On top of it he is a bright, happy little boy who can count without any difficulties. His treatment has been conservative and effective, and we are happy that everything has fallen into place beautifully for this young fellow who is now also a proud big brother.”

Saved from a life-threating condition by an advanced in-utero keyhole blood transfusion procedure at 25 weeks while still in his mother’s womb, baby Mihle’s parents could not be happier with the way everything has turned out.

“We were extremely cautious with both Mrs Biyela’s pregnancies and the interventions that we have implemented for the two babies have yielded excellent results. With her most recent pregnancy we were monitoring the pregnancy from the outset and unfortunately Mrs Biyela had to be hospitalised two weeks prior to the delivery of baby Asimdumise, as she had gone into early labour. On delivery day, however, everything went well and Mr and Mrs Biyela now have a bouncing baby girl to complete their family,” recounts Dr Mazibuko.

Mihle’s mother, Mrs Ntombenhle Biyela, says she will always regard her little boy as a “miracle baby” as she had been warned that the foetus suffered from a life-threatening condition known as hydrops fetalis, which was characterised by a fluid build-up around the heart, lungs and other organs, and was unlikely to survive.

“It has been a difficult and painful journey with Mihle, as we were originally warned that the foetus had very little chance of surviving,” remembers Mrs Biyela. “The problems with my pregnancy started only at 24 weeks and fortunately, after it was recommended that my pregnancy be terminated, we sought a second opinion from Dr Mazibuko. He in turn contacted foetal specialist, Dr Ismail Bhorat for assistance.

“We will always be grateful to Dr Bhorat, Dr Mazibuko and their teams at Netcare St Augustine’s and Netcare uMhlanga hospitals. They kept us informed and reassured us every step of the way throughout the treatment and the pregnancy. From thinking that I was sure to lose my baby, to being able to take Mihle home, and seeing him

grow into a bright little boy he has become is the greatest gift I have ever been given.”

According to Mr Biyela, thinking of their experience with Mihle’s healthcare journey brings so many emotions to the fore. “It makes me think of other prospective parents out there who might currently be having a similar challenge and may already have lost hope of welcoming their little ones into the world because of a life-threating condition.”

“I want these parents to know that there is always hope when we have well equipped hospitals with experienced, believing and brave medical specialists like Dr Mazibuko, Dr Bhorat and their teams. If God managed to use Dr Mazibuko and Dr Bhorat to help me and my wife, I do believe that he can also use them to bring hope to other parents and families who might have the same challenge. It is not too late for those parents and families – I would highly recommend that they arrange consultation with these doctors,” he adds.

“Mihle is a very clever little boy,” says his proud mother. “He notices everything, wants to try everything and does not want to fail at anything. He knows all the advertisements and cartoons on television and right now he is applying his mind to speaking English, and he already speaks it well. He also knows the alphabet. I will always thank God for this happy outcome and for the way Mihle has developed.

“During my pregnancy with Asimdumise I became a little worried at 36 weeks, as I was having abdominal pains. The doctor started treatment immediately and I tried not to stress too much. Once again, my husband and I put our faith in God. We also knew that Dr Mazibuko was a good doctor and that we could put our trust in him,” says Mrs Biyela, who originally hails from Nkandla in northern KwaZulu-Natal, and now lives in KwaNdengezi in Durban.

Netcare St Augustine’s Hospital general manager, Heinrich Venter, says that the staff and management of the facility were pleased to welcome the Biyela’s back for the birth of their baby daughter.

“The Biyela’s have become part of the Netcare St Augustine’s extended family. We are deeply thankful that Mihle is doing so well and that he now has a second little sister, who – just like him – was also born here at our maternity unit. We are delighted at the positive outcome and to have played a role in Mihle and baby Asimdumise’s care. We wish the Biyela family all the very best for the future,” concludes Venter.

A brief recap of Baby Mihle’s healthcare journey

Hydrops fetalis can be caused by a variety of underlying conditions, which can result in several potential complications. The prognosis for the foetus is dependent on establishing the exact cause and then treating it early and appropriately. Without this, the condition is almost invariably fatal for the foetus.

The diagnosis of the foetal anaemia was made using advanced sonographic and Doppler techniques investigating the peak flow velocity in an artery in the brain. Baby Mihle was suffering heart failure due to severe anaemia since his heart had to pump harder to get blood to the cells and the heart eventually started to fail.

The medical team performed a life-saving in-utero keyhole blood transfusion procedure called an IUT (intrauterine blood transfusion), when the foetus was only 25 weeks. At the time it was established that the hydrops was not because of immune system problems but was likely caused by a viral infection that had attacked the foetus’ red blood cells, resulting in severe foetal anaemia. Under such circumstances, the in-utero blood transfusion procedure is indicated. Before performing the procedure 1-2 ml of foetal blood is extracted, in a procedure called a cordocentesis, to determine the haemoglobin level of the foetus.

This information is needed to determine the exact volume of blood to be transfused. The foetus immediately started to recover after just a single IUT procedure and suffered no further complications because of the hydrops and continued to develop strongly. Working closely with Dr Mazibuko, the medical team was able to get baby Mihle to a healthy 36 weeks when he could be safely delivered.

The minimally invasive IUT procedure is only indicated in rare cases such as that of Baby Mihle. Hydrops can so easily result in complications and has a mortality rate of some 90%. The procedure itself is intricate, requiring blood to be carefully replaced in the correct volume. A needle has to be guided through ultrasound control into the umbilical cord so that the blood can be sampled for testing, and the blood transfusion can then be undertaken. Complications that can occur are slowing of the heart rate, leakage of blood from the insertion site or clot (haematoma) formation in the cord.

Gynaecologist and obstetrician, Dr Bongani Mazibuko who practices at Netcare St Augustine’s Hospital.

Gender-based violence increases mental health strain in the shadow of Covid-19

Wed, 08 Dec 2021 15:26:25 GMT

A “shadow pandemic” of increased violence against women and girls has followed in the footsteps of the Covid-19 pandemic, with heightened mental health impacts on victims of gender-based violence that will outlast the physical health sequelae of the pandemic.

While the economic, social and physical health impacts of Covid-19 take up the spotlight, the pandemic has also worsened South Africa’s already high rates of mental illness and gender-based violence, says specialist psychiatrist Dr Yumna Minty, of the South African Society of Psychiatrists (SASOP).

Studies have shown that women who are victims of physical or sexual violence at the hands of their intimate partners are twice as likely to experience clinical depression as women not exposed to interpersonal violence, and are at greater risk of attempting suicide, she said.

During the annual 16 Days of Activism against Gender-Based Violence campaign [25 November-10 December], SASOP has called for firmer policy interventions and improving multi-stakeholder collaboration between government agencies (police, justice, health, education and social development sectors), civil society and NGOs for an integrated and coordinated response to the problem.

“With a new variant of the coronavirus recently identified and the prospect of a fourth wave of infections and renewed restrictions on the cards, we also need to ensure that both government and civil service such as helplines, victim support centres and shelters are able to remain operational regardless of lockdown level and can extend their capacity for online and telephonic advice and counselling.

“Given that remote working under pandemic conditions means that women may be stuck in their home environment with an abuser and be unable to leave or make a phone call to seek support, alternatives such as SMS and WhatsApp helplines have provided these women with a lifeline and should be continued even beyond the pandemic,” Dr Minty said.

Globally, one in three women experience physical violence, mostly by an intimate partner. UN Women reports that all types of violence against women and girls, especially domestic violence, have increased around the world since the outbreak of Covid-19.[i]

In South Africa, one in five women who have ever been in a relationship have experienced physical violence at the hands of a partner, and one in 16 have experienced sexual violence by an intimate partner.[ii]

South African women are murdered at a rate that is four to five times the global average,[iii] at least half of them by their intimate partner.[iv] Women make up two-thirds of the victims of sexual offences, including rape, and South Africa’s prevalence of rape is among the highest in the world, standing at five to six times the global average.[v]

Similar to other countries, domestic violence reports to the police and calls to helplines increased in South Africa with the onset of lockdowns to curb the spread of the Covid-19 pandemic.

“It has been widely reported that more than 2 000 gender-based violence cases were reported to police in the first week of lockdown in March 2020, a 37% increase over the weekly average in 2019. An Oxfam study[vi] on the worldwide increase in gender-based violence during the pandemic states that calls to domestic violence hotlines in South Africa increased by 69% during the first month of lockdown.

“This is a clear indication of the scale of what President Cyril Ramaphosa has called the ‘second pandemic’ of gender-based violence in South Africa. Conditions such as remote working and isolation with abusers, restrictions on movement, school closures and having to adapt to remote and home schooling, financial worries due to feared or actual job losses, and generally struggling to cope with drastic life changes brought about by the pandemic have all contributed to both increased mental stress and worsening levels of domestic and interpersonal violence against women,” Dr Minty said.

She said that even before the pandemic, worries about personal safety and becoming a victim of crime affected South African women more than men.

Women in South Africa are more fearful of walking alone in their neighbourhoods in daylight or at night, walking to work or shops, taking public transport, and allowing their children to play freely in public open spaces or walk alone to school.[vii]

“All of these fears in turn contribute to heightened levels of stress and anxiety, which impacts on women’s mental health. Women live in constant fear of violence and threats to their wellbeing and that of their children - from strangers, family members and, worst of all, their intimate partners.

“Women exposed to violence and trauma are more likely to develop post-traumatic stress disorder (PTSD), depression, anxiety and substance abuse problems. They are also more likely to cope poorly with the general stresses of life, have low self-esteem and disordered eating patterns,” she said.

One in three South Africans suffer from common mental disorders such as anxiety and depression in their lifetimes,[viii] with more than half the respondents in a recent study reporting higher levels of psychological distress since the outbreak of Covid-19, and many turning to drugs and alcohol to cope.[ix]

These ongoing fears and the mental health impacts thereof have a knock-on effect in how women are able to function in society in their multiple chosen or designated roles as mothers, wives, caregivers, educators, employees, professionals or business owners.

“Women play such an integral role in both formal and informal social and economic structures – it is imperative to consider their needs and support them,” Dr Minty said.

“Prevention and change starts with education and empowerment of both men and women. We need to move away from a patriarchal social structure and improve the economic status of women, along with better access to healthcare and education that empowers women rather than promoting submissiveness.

“For both women and men, we need to improve access to public mental healthcare and do better in combatting substance abuse that fuels violence,” Dr Minty said.

REFERENCES

[i] UN Women. The Shadow Pandemic: Violence against women during Covid-19. https://www.unwomen.org/en/news/in-focus/in-focus-gender-equality-in-covid-19-response/violence-against-women-during-covid-19

See also https://www.one.org/africa/blog/invisible-pandemic-gender-based-violence/ for statistics from various countries on increases in violence against women during the Covid-19 pandemic.

[ii] Stats SA. 2016. South Africa Demographic and Health Survey 2016: Key Indicator Report. http://www.statssa.gov.za/?page_id=1854&PPN=Report%2003-00-09&SCH=7015

[iii] Stats SA. 2018. Crime against women in South Africa, An in-depth analysis of the Victims of Crime Survey data 2018. Report 03-40-05. http://www.statssa.gov.za/?page_id=1854&PPN=Report-03-40-05

[iv] Abrahams N, et al. 2013. Intimate Partner Femicide in South Africa in 1999 and 2009. PLoS Med (10)4: e1001412. Download at https://doi.org/10.1371/journal.pmed.1001412

[v] World Population Review. 2021. Rape Statistics by Country. https://worldpopulationreview.com/country-rankings/rape-statistics-by-country

[vi] Oxfam. 25 November 2021. Action against gender-based violence being pushed to the outlying margins of the global COVID-19 response. https://www.oxfam.org/en/press-releases/action-against-gender-based-violence-being-pushed-outlying-margins-global-covid-19

[vii] See note iii.

[viii] Lifetime prevalence of common mental disorders in South Africa is 30.3%. Herman AA, et al. The South African Stress and Health (SASH) Study: 12-month and lifetime prevalence of common mental disorders. SA Medical Journal, Vol 99, No. 5. 2009. http://www.samj.org.za/index.php/samj/article/view/3374

[ix] PharmaDynamics. October 2020. South Africans’ stress levels have shot up by 56% since start of pandemic according to survey. https://pharmadynamics.co.za/south-africans-stress-levels-have-shot-up-by-56-since-start-of-pandemic-according-to-survey/

Wish upon a star

Wed, 08 Dec 2021 08:21:33 GMT

Dr Marienus Trouw, a gynaecologist sub-specialist in reproductive medicine, who practises at Netcare Pretoria East Hospital, checking on a newborn baby in the neonatal ICU at the hospital.

Courageous 20-year journey ends with the birth of baby Esther

In a remarkable tale of human fortitude supported by advanced fertility treatment, one lucky couple was finally blessed with a baby after trying for 20 years to conceive.

The joy was “indescribable” for Alex Dandadzi and Eleanor Mukura, when Eleanor at the age of 52 gave birth to a healthy baby girl at Netcare Pretoria East Hospital, after undergoing a number of fertility treatments at the Pretoria Fertility Centre based at the hospital. The decades long ‘journey’ to this incredible moment however had been nothing short of a rough ride at every possible turn.

“I first became aware of my fertility problems when it was discovered that I have fibroids, or growths in my uterus that were preventing me from falling pregnant. Twice I had them removed and twice they grew back. I was on the verge of making a final decision to have my uterus removed when one Sunday morning I received an unexpected phone call from an old childhood friend who had had a similar experience of fibroids removal treatment at Netcare Park Lane Hospital in Johannesburg,” says Eleanor.

Hailing from Harare in Zimbabwe, the couple travelled to South Africa where the next chapters of their story began to unfold. Filled with renewed optimism, Eleanor for the third time underwent a lengthy operation to remove the fibroids that had grown back, after which she began her journey with in vitro fertilisation (IVF).

Dr Marienus Trouw, a gynaecologist sub-specialist in reproductive medicine, who practises at Netcare Pretoria East Hospital explains that IVF involves hormonal injections to encourage the woman to produce more than one egg – these eggs are then retrieved from the uterus and fertilised in a laboratory to create embryos. They are then allowed to grow for around five days before being placed back into the uterus.

“The first procedure was unsuccessful and the doctor who treated me passed away before we could try again. After some time we were referred to Dr Trouw, however by this stage the fibroids had once more grown back, so I then had to undergo my fourth fibroid removal before we could continue with IVF treatment,” says Eleanor.

“This time it was a success and we were filled with an incredible sense of hope. However, no sooner had I reached the end of the first trimester when devastatingly, I had a miscarriage. We had come so far and decided to keep on trying. The following two attempts resulted in failure. It was only some years later, on our fifth and final IVF attempt that I finally fell pregnant with our baby girl who is now here with us.”

All told, Eleanor and Alex’s 20 year journey to this point involved four fibroid removal operations for Eleanor, five rounds of IVF and one miscarriage, not to mention the many emotional ups and downs along the way. But every single step has been worth it, confirms Eleanor.

“The result is our beautiful baby who we have called Esther, a biblical name which carries the meaning of a star and a woman of courage. Her Shona name is Nyashadzashe, which means grace from God. We had almost given up on having a baby of our own but by God's grace, when we least expected it at our older age, it happened,” she says.

According to Dr Trouw, this particular case in fertility treatment is an exceptional one. “There are many factors that can influence fertility and the outcomes of fertility treatment. Age of the mother is one of the key determiners in the rate of success. When it comes to IVF there is an average success rate of about 50%, and while this can be higher, up to 65% for women younger than 35, it can also drop to as low as 10% after the age of 42,” he explains.

“Physiological factors in the female, such as fibroids, can be the initial cause for difficulty in conceiving. This can also include ovulation problems, blocked fallopian tubes and endometriosis – when the tissue that normally only grows on the inside of the uterus also grows on the outside and attaches to other parts of the body, which can cause scarring that makes it difficult to conceive.

“We also see physiological problems in the male, such as poor sperm motility, low sperm count and in some cases no sperm at all. Around a third of cases involve a combination of factors within the female, the male or both, while about 10% of cases cannot be explained, as we simply do not have all the knowledge yet,” he notes.

While the complexity of fertility issues can seem overwhelming for individuals trying to conceive, Dr Trouw points out that there are a number of solutions available to those who are struggling, as well as steps that can be taken to avoid problems worsening over time.

“Firstly, for people who have diagnosed difficulties with fertility, there are multiple treatments available and it could be as simple as stimulating ovulation with tablets or injections. For women suffering from endometriosis, fibroids or blocked fallopian tubes, surgery may be the answer. Sometimes we might do insemination with an intracytoplasmic sperm injection (ICSI), where the sperm is injected into the egg in cases where it cannot naturally penetrate the outer layer for whatever reason,” says Dr Trouw.

“Secondly, thinking and planning ahead can be hugely helpful for people who know they would like to have children but who are not yet at that stage in their life. We live in a time where many people are choosing to start a family later than has traditionally been the case. It is important for them to be mindful of the impact that age can have on fertility, particularly in women where older eggs are generally not only fewer in quantity but also lower in quality, which can lead to complications such as miscarriage or chromosomal abnormalities in the foetus.

“If one is able to do so, freezing eggs before or around the age of 35 can be a good option in case fertility problems are diagnosed later down the line when the time does come when a couple would like to start a family. It is also important for both men and women to consider their own state of health, as lifestyle factors such as obesity and smoking can negatively impact fertility in both sexes.

“If you do find you are struggling to conceive, your general gynaecologist will be able to refer you accordingly. However, it is important to be aware that the fertility treatment journey is different for everyone. It can therefore help to have a step-wise plan in place, created in conjunction with your treating doctor, so that you know what to expect, as timelines can become quite drawn out and there are often high costs involved, particularly when it comes to more advanced technologies,” Dr Trouw suggests.

For Eleanor and Alex, the road to finally bringing their little bundle of joy home was far longer and more arduous than they could ever have expected. “Even once I had successfully fallen pregnant the second time, it was not a smooth ride – I had elevated blood pressure and had to go on maternity leave six weeks before the estimated delivery date. This involved me travelling to South Africa from Zimbabwe, where I live and work. I also developed kidney complications that meant I had to remain hospitalised after the birth for much longer than would usually be the case.

“I would never wish for anyone to have to endure such hardship and I would advise couples not to leave family planning too late, as you never know what complications may arise. Thanks to the support of Dr Trouw, Sr Lizette White and the rest of the amazing team at Netcare Pretoria East Hospital, our greatest wish came true. Our message to anyone out there who is struggling to conceive is to keep your hope alive – miracles do happen.”

Pieter Louw, general manager of Netcare Pretoria East Hospital, says that the facility and its staff are honoured to have played a part in this extraordinary success story. “Each and every couple and individual who visits the fertility centre at our hospital for treatment has a different story to tell. It is our privilege to support them, alongside the world class specialists who practise here, as they navigate what can be a very challenging experience and to share in their joy when treatment results in special moments such as the birth of baby Esther,” he concludes.

Alberton’s new hospital of the future is taking shape

Tue, 07 Dec 2021 04:15:50 GMT

Netcare Alberton Hospital, which is currently under construction on the grounds of the former Newmarket racecourse, south of Johannesburg

Building a future fit facility for advanced, holistic healthcare

The new purpose designed Netcare Alberton Hospital, which is currently under construction on the grounds of the former Newmarket racecourse, south of Johannesburg, is taking good shape. Construction of the state of the art facility is at an advanced stage and the hospital is expected to open its doors to patients in April 2022.

Earthworks to prepare the site for construction of the eagerly awaited facility began in April 2019, and approximately 117 000 cubic meters of soil was removed from the site over some seven months. More than six million bricks have been laid to date, and the new building will include at least 183 tons of steel and 38 600 square metres of flooring by the time it is completed.

Netcare Alberton Hospital will ultimately comprise some 60 349 square metres gross building area (GBA). The building will be four storeys high in some areas, and three storeys in others, providing ample space to house the disciplines and services currently offered at Netcare Union and Netcare Clinton hospitals much more comfortably,” says Jacques du Plessis, managing director of Netcare’s hospital division.

The hospital is being developed in conjunction with local businessman, Riaan Jonker, and Nedbank through a joint venture, namely the Rejem-Linton (Nedbank) – Netcare Property Holdings Joint Venture. The main contractor appointed for the construction is Trencon Construction (Pty) LTD, supported by a multitude of local, national and international sub-contractors and suppliers.

Design and management of the project is undertaken by a multi-disciplinary professional team consisting of Profica Project Managers, A3 Architects, O’Mahony Peel Rowney Quantity Surveyors, Green Consulting Structural Engineers, WSP Civil Engineers, Spoormaker & Partners Mechanical Engineers, BFBA Johannesburg Lifts, Electrical and Electronic Engineers, IX Engineers Wet Services Consultants, Chimera Fire Protection Consultants, Insite Landscaping Architects, Saftek Health & Safety Consultant, EMKE Consultancy Health Care Consultants, and Sivest Environmental Consultants

Focus on substantial local investment

Du Plessis explains that a key focus of the project implementation was to ensure substantial investment in local labour and businesses. To this end, and at the peak of construction, the project offered employment to more than 800 local people, more than 90 local companies were utilised, and in excess of R200m has been spent on local businesses and suppliers.

“The Alberton community has been steadily growing, and so too has the demand for quality private healthcare services by communities in the area. Given the number of highly specialised medical treatments provided at Netcare Union and Netcare Clinton hospitals, patients from as far afield as Mpumalanga and other neighbouring provinces, as well as from neighbouring countries, are also regularly referred to the hospitals for treatment.

“For over a decade, we have been planning towards relocating Netcare Union and Netcare Clinton hospitals to a single, ultra-modern healthcare facility that will integrate the range of services currently available at the two existing hospitals.

“The decision to merge the two hospitals into one flagship facility and relocate it to a better positioned site was taken after extensive studies to explore possible solutions for the fact that the existing hospitals lacked the necessary space and capacity to cater for the growing demand and the need for necessary upgrades. Expanding and upgrading the current facilities was not a viable option,” he added.

The 427-bed hospital in the Newmarket development precinct is conveniently located for residents of the greater Alberton area and is also easily accessible for patients from further afield.

Customised design and layout to enhance patient experience

“Numerous technologically advanced and environmentally sustainable features form an integral part of the new facility’s design. Valuable input has been obtained from dozens of building professionals, as well as the specialist physicians practising at the existing two hospitals, to ensure that all of the daily operations within the facility will be optimally streamlined,” Du Plessis notes.

“Considerable planning has also gone into incorporating patient comfort and convenience in the design. The layout of the new facility will ensure minimal disruption to patients when they require tests, scans or procedures, as these services will be easily accessible from the wards.”

The modern maternity unit with a dedicated caesarean theatre, neonatal and paediatric intensive care units (ICUs), which are currently based at Netcare Clinton Hospital, will be housed in a secure, spacious and self-contained area on the third floor.

Netcare Union Hospital’s specialised cardiac unit including cardiac theatre, ICU and catheterisation laboratory, dedicated hybrid, vascular and laminar flow theatres and sleep laboratory will also have their own purpose designed and digitally enabled facilities within Netcare Alberton Hospital.

The radiology unit will be expanded to serve more patients promptly. The facility will be easily accessible from the hospital wards for additional patient convenience.

“Communities in the region will be reassured to know that the emergency department based at Netcare Union Hospital, which houses one of only three private Level I accredited trauma centres in the country, will be expanded in the new hospital and continue to provide life-saving care to patients from across the region,” Du Plessis says.

“The new hospital design provides for ease of access for emergency vehicles and emergency helicopters, enabling emergency and inter-hospital air ambulance transfers from a larger geographical area. The Netcare 911 base to be established on the premises will work seamlessly with the emergency department to provide pre-hospital emergency care at the scene of accidents or medical emergencies and en route to the emergency department.”

New specialist physicians and those currently practising at Netcare Union and Netcare Clinton hospitals will be accommodated in comfortable consulting rooms towards the front of the hospital, adjacent to the wards and intensive care units. Ancillary healthcare services will be based close to the consulting rooms for the added convenience of doctors and patients alike.

“We are very grateful to residents for their patience during this construction phase. To help minimise disruption as far as possible to surrounding traffic on Ring Road East and Voortrekker Road, construction materials destined for the site are being transported using a gravel construction road,” Du Plessis says.

Du Plessis thanked the community for their continued support of the two existing hospitals that will be amalgamated in the new facility. “The ultra-modern consolidated facility will add considerable value through enhancing healthcare services and infrastructure of the area. We look forward to sharing further details on the progress of the project with the community in the coming months,” he concluded.

Local doctor brings home international badge of honour

Thu, 02 Dec 2021 10:56:31 GMT

Dr Nelson Matsobane Latakgomo, a general surgeon with a special interest in minimally invasive surgery and colorectal surgery who practises at Netcare Pholoso Hospital, recently accepted his fellowship at the convocation of the American College of Surgeons, which took place virtually.

American College of Surgeons awards fellowship to South African surgeon

In a major career milestone, a Limpopo-born doctor with a passion for providing quality care in rural parts of the country was recently admitted to the American College of Surgeons – one of just 42 South African doctors to have received the internationally recognised commendation.

Dr Nelson Matsobane Latakgomo, a general surgeon with a special interest in minimally invasive surgery and colorectal surgery, who practises at Netcare Pholoso Hospital, accepted the fellowship at the convocation of the American College of Surgeons (ACS), which took place virtually in October this year.

“I was born and bred in Limpopo and am passionate about serving the people of Polokwane and surrounding areas. As a local, I am keenly aware of the need for medical care of the highest standards in our province. The ACS is an active community of likeminded healthcare professionals who, amongst other aims, strongly promotes improved health in rural areas globally – a cause that is very close to my heart,” says Dr Latakgomo.

Dr Latakgomo notes that the College also provides a valuable platform for international knowledge sharing and for promoting excellent practice in surgery. He says the fellowship will therefore assist in shining a brighter light on some of the exceptional care that is being provided in Limpopo.

“As head of the trauma programme here at Netcare Pholoso Hospital, I am enthusiastic about the additional benefits that this fellowship will bring to our area. Last year, the hospital was accredited as a Level II trauma centre, certifying that the necessary professional medical services are available at the facility to deal with trauma cases and medical emergencies in line with international best practice in trauma medicine.

“I am hopeful that we will soon be able to take the next step in our trauma accreditation so that we can also provide the highest level of training to doctors in dealing with trauma cases and upskilling healthcare professionals who serve our communities.

“On a more personal note, I am also all too aware of what it is like to grow up in a more rural area, and that it is important to have self-belief when pursuing your passion. I am deeply honoured to have been awarded this international fellowship. I hope that many young people, particularly in our rural communities, will be encouraged to see that South African doctors, and professionals at large, with similarly humble beginnings have every reason to keep reaching for their goals,” says Dr Latakgomo.

According to Johan Smal, North East regional director of Netcare, Dr Latakgomo’s achievement is well-deserved, though it comes as no surprise. “Dr Latakgomo is driven by his passion for the highest possible standards in healthcare. It is therefore fitting that he should receive this international acknowledgement of his dedication to the field of surgery. We are privileged to have him practising here at our facility, helping us to provide such excellent care to the communities we serve,” he concludes.

The ACS is a scientific and educational association of surgeons founded in 1913 with the aim of improving quality of care for the surgical patient by setting high standards for surgical education and practice. Fellowship is awarded to those surgeons who have passed a rigorous evaluation of education, training, professional qualifications, surgical competence and ethical conduct consistent with the standards established and demanded by the ACS.

Twins born four months premature reunite with their NICU carers 17 years later

Mon, 29 Nov 2021 11:19:56 GMT

Twins Stefanos and Alexandros are pictured with paediatrician Dr Neli Stoykova, who is still practising at Netcare Park Lane Hospital some 17 years later.

NICU teamwork and care celebrated on World Prematurity Day

In the early 2000s, babies born four months prematurely were at the extreme edge of what was considered feasible for survival. Today, two teenage twin brothers are however living proof of what can be achieved with the love of their devoted parents, and the dedication of a team of specialists and neonatal intensive care nursing professionals.

“When my babies were delivered by emergency Caesarean section on 5 December 2004, I was in shock. Being a first time mom is usually stressful, but our twin boys were so tiny and underdeveloped that my husband Aki and I were warned that they were extremely vulnerable. It was a surreal, frightening time,” says Yiota Hadjipetros, mother of twins Alexandros and Stefanos.

“We were in survival mode for months, praying and spending every moment we could with our boys in the neonatal intensive care unit (NICU) at Netcare Park Lane Hospital. To this day, we are so grateful for the ‘family’ of caring medical specialists and nurses who took care of our babies and, by the grace of God, saved their lives.”

An anxious December

“Because the twins were so premature there was great concern for their survival, especially for Alexandros,” says Dr Neli Stoykova, who was the Hadjipetros boys’ paediatrician at birth, and is still practising at Netcare Park Lane Hospital, as are several of the NICU nurses who cared for the highly vulnerable premature twins around the clock for the next four months.

“This was a real spiritual journey for everyone involved. As always, we gave our all so that the tiny brothers would not only have the best possible chance of survival but would also have the best possible quality of life, knowing that the clinical decisions we made at that early stage to help save their lives would also influence their future wellbeing,” Dr Stoykova says.

“At that early stage of development every organ is affected, and there are intricate challenges to be managed day by day at every level. The twins had to be intubated, ventilated, and closely monitored around the clock. We spent many days and nights at the hospital with the parents watching over the babies.

“We had no time for Christmas and New Year, who could feel like celebrating when the twins were still in a critical condition? All we wanted was to see an improvement in their condition. After several long and very emotional weeks, one night we were all sitting in the NICU watching over the babies with their parents.”

A nurse’s birthday prayer and community blood drive

The smaller twin, Alexandros, who weighed only 700g at that stage, had to have surgery and then developed life-threatening renal failure. The specialists feared that if he did not pass urine within 12 hours, hope for his survival would be lost.

“There was a tiny drop of urine in a catheter tube, and we were anxiously watching its progress, praying for it to safely leave the baby’s body. NICU nurse, Sr Pat Naransamy came on duty to care for the boys during the night shift, and she told those of us who were still there after our day shift to go home and get some proper rest. It was Sr Naransamy’s 40th birthday, and she told us that she had prayed for one birthday wish – to keep the twins safe and guide their progress,” Dr Stoykova says.

Today, Sr Naransamy is still caring for babies in the NICU at Netcare Park Lane Hospital, and she remembers that night vividly. “I think I remember all the ‘preemie’ babies I’ve cared for, and when you get to know them so well you pick up on their personalities – and some of them have such attitude, I just love them. Even though Alexandros was so tiny, I could see he had a strong spirit and will to survive,” she adds.

“Thankfully, Alexandros made it through the night, and we were so grateful when his condition gradually began to improve,” says Sr Naransamy, who joined the hospital’s NICU in 1991.

Dr Stoykova adds that on another occasion the boys needed a blood donation, and the community enthusiastically responded to the call for donors to come forward to find the matching blood type needed. “It was so rewarding to see the community embrace these babies. Everyone wanted to donate blood to help the twins, the support was really wonderful.”

Progress in neonatal care

“Nowadays, if babies are born four months premature it is considered a viable age, which is an indication of the considerable advancements in neonatal technology and treatment techniques since the Hadjipetros’ twins were born. By aligning our treatment to evidence based best practice, we are constantly refining the techniques available to care for premature babies and to have better outcomes. Sadly, however, some babies who are born so prematurely do not survive despite our best efforts, while others often do not have an easy start and it still may be a long journey for the family,” Dr Stoykova says.

“Since the twins were born, there have been many advancements – even though back then our NICU at Netcare Park Lane Hospital was a very modern unit for its time. Our approach now focuses on multi-disciplinary care, with neonatologists and specialists from various disciplines routinely working together on developing holistic treatment plans for each preemie and other vulnerable babies in our NICU. More formalised support is also available for the parents, who are regarded as integral members of the care team, and also have access to support services such as counselling these days.”

Sr Naransamy adds that the NICU incubators were open top in 2004 when the twins were born, and plastic sheets were used to create a protective humid environment for the Hadjipetros boys because their skin had not fully developed. “Now the incubators are much more advanced and are designed to mimic a womb-like environment for the premature babies. We have input from neurodevelopment specialists, speech therapists and other disciplines, with everything geared towards providing a nurturing and stimulating environment for those who need specialised care in the first weeks or months of life.”

“The establishment of the Netcare Ncelisa human milk banks was another step forward in neonatal care since the twins’ time in the NICU,” adds Verena Bolton, national coordinator of Netcare Ncelisa human milk banks. Verena was one of the NICU nurses who looked after the Hadjipetros twins in 2004.

“There are immense documented health and developmental benefits associated with age appropriate breastmilk for babies. Breastmilk is donated by eligible women who are breastfeeding and have excess milk, which they express under specific hygienic conditions and deliver it to Netcare Ncelisa human milk banks or depots based at Netcare maternity facilities. The milk is then pasteurised, tested, frozen and safely stored, until it is needed,” Bolton explains.

Through Netcare Ncelisa human milk banks, the Netcare Foundation supplies age appropriate breastmilk free of charge to certain identified premature and underweight newborns with compromised health, both within the public and private sectors.

The one thing that has not changed is the absolute commitment of the NICU teams. “You become very attached to the babies for whom you care, and so invested in their progress. You can’t turn it off when you go home. It is a privilege that the parents entrust us with their precious babies, and we care for them as if they were our own. We also support and encourage the parents, because we respect what an emotional time this is for them,” Sr Naransamy says.

A joyous reunion

Shortly before their 17th birthday, the twins’ parents arranged a special reunion with Dr Stoykova and the NICU team who cared for them in the uncertain months before they were finally discharged on 15 March – nearly four months after they came into the world.

“Although we have kept in touch, it felt like time for a get together to celebrate with the amazing team who became like family to us in that time. Dr Neli Stoykova is phenomenal, and we thank God for putting her and this special team of nurses there to care for our twins,” says Mrs Hadjipetros.

“We are so grateful to them, and the nurses were amazed to see how Alexandros and Stefanos are developing into young men – thanks in no small part to the efforts of the specialists and caring NICU team.”

At birth, both twins had bleeding on their brains, however any effects on their development would only become evident later when they were growing up. “We have had a long journey with the twins’ health and supportive therapies. Both Stefanos and Alexandros have worked hard, and Stefanos is now in Grade 10 in a mainstream school,” Mrs Hadjipetros says.

“Alexandros continually exceeds expectations, as one of the specialists told us he would likely be quadriplegic for life but then, with the help of a physiotherapist recommended by Dr Stoykova, he surprised us and learned to walk within 18 months. He has some learning barriers, and we have done a lot of research into various education models, and we work with Alexandros daily to help make the best of his abilities,” Mrs Hadjipetros says.

Stefanos says that as a survivor of prematurity his message to others is perseverance: “Push through the difficult times, believe in yourself and don’t listen to people who don’t believe in you.”

Alexandros adds: “Be who you are and don’t give up. Be gentle because whatever a person shows to the world, inside they are sometimes afraid.”

“The twins show such maturity for their age in many ways, and we have such respect for their parents who have done an incredible job raising them to be the fine young men they are today,” Bolton adds.

“All but one of Netcare’s hospitals with maternity units across South Africa have NICUs. Nurses working in these highly specialised units are trained and experienced in the requirements of caring for premature and highly compromised newborn babies. As with the Hadjipetros family, it is not uncommon for the bond forged with the families while their babies are in the NICU to continue into the future.

“We are delighted to see the Hadjipetroses now together as a family so many years later – this shows the power of what can be achieved for premature babies with the support of a dedicated NICU ‘family’ guided by evidence based best practice and committed to care centred around the unique needs of each baby,” Bolton concludes.

Young granny raring to go after spinal surgery

Fri, 26 Nov 2021 07:49:56 GMT

Denice with her grandchildren

Specialised neuro spinal treatments restore mobility

“I wanted to run around with my grandchildren, but my back was so painful that I could only take 10 or 20 slow steps at a time, and I had to use pain control injections,” says Denice Marais, 50, who suffered a herniated or slipped disc in the lumbar spine of her lower back.

Earlier this year, Denice approached her doctor because her mobility and quality of life had deteriorated to the point where she could not stand it anymore. Denice’s doctor referred her to Dr Ratshidi Rammutla, a neurosurgeon specialising in spinal treatment at Netcare Sunward Park Hospital.

“From what he saw on my MRI scan, Dr Rammutla explained that the disc between my last two lumbar vertebrae had slipped out halfway, which was causing the pain and making every movement harder. He recommended that I have a transforaminal lumbar interbody fusion operation as soon as possible, as the problem was getting worse,” she recalls.

Spinal fusion to relieve pressure and pain

In Denice’s case, the disc of cartilage between the two lower spinal vertebrae was bulging outwards and was no longer able to keep the spinal column stable, causing pressure on the nerves to her legs and severe pain.

“I had realised before that this was serious but wasn’t keen on considering a back operation. I was petrified, I started crying but Dr Rammutla was so reassuring and he talked me through exactly what the procedure and recovery entail. He gave me the confidence to get my life back with this operation.”

“The transforaminal lumbar interbody fusion is a spinal fusion or spondylodesis procedure for the patient’s lower back. This involves spacing and then permanently securing the two vertebrae together, which relieves pressure and stabilises the affected section of the spine to protect the nerves and the spinal cord,” Dr Rammutla explains.

In a procedure lasting some three hours, an incision is made on one side of the affected section of the spine and the space between the vertebrae is decompressed with the greatest care to protect the nerves and spinal cord. A bone graft or interbody cage is positioned to fill the space left by the damaged cartilage disc and secured with special surgical screws attached to the vertebrae inside the body.

In addition to treating degenerative neurospinal conditions, Dr Rammutla’s practice assists adult and certain paediatric patients with spinal deformities, tumours and spine related trauma. At least 40% of the cases are complex, sometimes involving specialists from various disciplines working together to provide the benefit of their joint experience and shared expertise.

“Unfortunately, too often people delay seeking treatment for their back pain until their condition is quite advanced. Individuals hope their condition will improve by itself and may miss the opportunity for more conservative treatments early on if they only seek treatment when they are in a really bad way. Our multi-disciplinary team is highly skilled and experienced in treating a wide range of neurospinal conditions, including those that are very advanced and, where needed, do emergency surgeries,” Dr Rammutla says.

“When I woke up from the spinal fusion procedure, I immediately checked to see if I could feel my toes, and then I thought ‘I am going to walk again’,” Denice says.

“The day after my operation the physiotherapist got me up and the next day, I was able to walk a bit further. After that, I was ready to leave the intensive care unit and return to a normal ward – I didn’t even need help to get to the bathroom.

Raring to go

“I did my physiotherapy diligently, and as soon as I was mobile, I felt better by the day. I was in hospital for five days in total, and the nurses were wonderful. They kept asking, ‘Are you doing your exercises again?’,” Denice recalls.

“At first it was very uncomfortable, and I could only sit for five minutes, but when I was back home two or three weeks later, I could sit up and my back wasn’t sore, it just felt a bit tight. Within four weeks I was able to continue working from home part time, and two weeks later I was back to working full time again,” says Denice, who works in financial services for a motor dealership in Johannesburg.

“Within two months I was mostly recovered, and five months later I cannot believe that I can walk faster, for longer distances and can climb stairs. Back pain makes you feel old before your time, but now I am raring to go.”

Dr Rammutla points out that in-hospital care, physiotherapy, physical rehabilitation and step-down care are all crucial after spinal surgery. “These services are part of the holistic care that patients may require after neurospinal surgery, and with adequate support many patients are surprised at how quickly they regain their mobility and enhance their quality of life,” Dr Rammutla concludes.

Neurosurgeion Dr Ratshidi Rammutla specialises in spinal treatment

Awareness saves lives: Lung cancer can be treated

Thu, 18 Nov 2021 07:52:39 GMT

More options and support for patients

Anyone can get lung cancer, yet few people are aware that testing and treatment are available for this condition, which is one of the most common cancers in South Africa. November is Lung Cancer Awareness Month, and medical progress in personalised cancer care today offers more hope than ever before.

“Although our patients across the country are affected by a broad spectrum of cancers and cancer-related illnesses, in keeping with worldwide data, the largest proportion are affected by lung cancer,” says Amanda Busch, oncology manager at South Africa’s largest national courier pharmacy, Medipost Pharmacy.

“Lung cancer may not always be easy to detect and its symptoms may sometimes be mistaken for other conditions. If you have any concerns, consult with a healthcare professional as soon as possible for early diagnosis and treatment.

“There are two main types of lung cancer, small cell lung cancer and the more common non-small cell lung cancer, which affects nine out of 10 people with lung cancer. Treatments have come a long way in the past decade with many more personalised options available to them. Other than surgery, oncologists may recommend chemotherapy, radiation or more recently immunotherapy or targeted therapy.”

The chemotherapy drugs, medicines and consumables required by oncology practices and their patients are dispensed and delivered by the national courier pharmacy under safe specified conditions.

Many options and informed, personal decisions

Sr Tienie Ackermann, a specialised oncology nurse at radiotherapy and clinical oncology practice Dr DN Chetty Incorporated at Netcare Unitas Hospital, says that the person is counselled and provided with the information they need to make decisions before embarking on any cancer therapy.

“Before I worked in oncology, I did not realise there are so many different types of cancer, with various treatments and options. Cancer can be beaten, but it is a life-threatening disease requiring strong and sometimes highly complex treatments. These decisions are therefore deeply personal for patients, and we provide individual care to support them in their choices throughout,” Sr Ackermann explains.

“A personalised treatment plan is provided for each individual, and we provide all the information they will need before starting treatment. To complement the specific oncology treatment the patient receives in the hospital, they are also provided with a treatment basket containing, for instance, pre-chemotherapy drugs, medicines to stimulate white blood cell development, as well as medications to help relieve side-effects such as nausea.”

Powerful treatments require specialised safe handling

Blood tests are done prior to each round of treatment, and the medicines and dosages may be adjusted accordingly. Medicines, including chemotherapy, are safely transported to the oncology practice, while supporting medication may be delivered directly to the patient for home use.

“Special care is needed when transporting certain cancer treatments, as some are cytotoxic. This means they can be harmful for healthy cells as well as the cancer cells they are intended to target, and additional precautions are needed for handling and transporting these substances, while other items supplied in oncology medicine have cold chain requirements,” Busch says.

Medipost Pharmacy has expert teams well trained in correctly and safely packaging oncology items stationed in Pretoria and Cape Town to effectively assist patients in ensuring treatments reach their destinations within the required specifications to arrive intact and optimally effective.

Side-effects and personal pharmacy advice

“As is well known, cancer treatment unfortunately generally is associated with some common and expected side-effects. Side-effects of chemotherapy for lung cancer may include shortness of breath, fatigue, skin reactions, and gastrointestinal issues,” Busch adds.

“The oncologist often prescribes or recommends supporting medication as part of the treatment plan. It is extremely important that the patient discusses all side-effects they experience with their treating practice to identify any symptoms that do not belong in the expected side-effect profile, as this may point to something else affecting their health that needs to be investigated.”

“There are ups and downs in cancer treatment, and this is why information and counselling are so important before treatment starts. Different types of anti-nausea medicine are prescribed according to the individual and their treatment plan, and it is often recommended that patients take a dose of anti-nausea medicine before coming in for treatment, as it is easier to prevent nausea than treat it once it has set in,” adds Sr Ackermann.

Busch advises that breathing and relaxation techniques may also be helpful. “Peppermint or ginger tea and high-fibre foods will help with the gastrointestinal side-effects of treatment. It is also best to avoid extreme sun exposure, and use gentle and mild skin products to help minimise skin irritation. Ensure good nutrition and get plenty of rest,” she says.

The dedicated oncology pharmacy teams provide personal assistance and advice to registered patients on the medicines dispensed by Medipost Pharmacy. As part of its personalised practical support to patients, Medipost Pharmacy assists with processing medical aid claims and facilitating authorisation where required on behalf of patients, ensuring the treatments are funded from the correct benefits.

“Lung cancer can be treated very successfully, but the importance of early diagnosis cannot be emphasised enough. Genetics, age, environmental influences and smoking are significant risk factors, but anyone can be affected by lung cancer. Screening and awareness can save lives, and help change the lung cancer picture for all,” Busch concludes.

For more information visit https://medipost.co.za/oncology-service-provider/

New medication therapies must form part of the conversation around diabetes

Mon, 15 Nov 2021 07:06:00 GMT

Quality of life for patients takes giant leap forward with recent advances in treatment

So often, the conversation around type 2 diabetes is focused on the impact of lifestyle choices. While the importance of this factor cannot be underestimated, specialists are emphasising the need for awareness around the many advancements in medication, which can dramatically improve outcomes for diabetes patients.

Speaking ahead of World Diabetes Day Sunday, 14 November, Dr Tanya van der Made, an endocrinologist and specialist physician practising at Netcare Alberlito Hospital in Ballito, says that South Africa has one of the highest obesity rates in the world. “Obesity can increase the risk of developing type 2 diabetes by as much as 90-fold. We therefore cannot turn a blind eye to the healthcare crisis we are currently facing, which is directly linked to lifestyle issues, including poor nutrition and lack of physical fitness.

“The fact is that we have a large population of people with type 2 diabetes who are past the point of prevention but who would still be able to live more productive and fulfilling lives if their disease was managed optimally. This involves not only maintaining a healthy lifestyle but also having regular assessments of the effectiveness of the medication they are taking. Many of the older treatments may keep the status quo but more advanced treatments could be so much more effective.”

Dr Van der Made points out that diabetes medication has broken many new frontiers in recent years, which means that there is considerable hope of an even better quality of life for patients. “The possibility of better patient outcomes is now well within reach with a change of medication. It is therefore in the best interest of patients for treating doctors to consider the potential benefits of new medication before renewing an existing script,” she notes.

“For example, a patient may be on a particular treatment that does the basic job of keeping their diabetes under control, but it is always important to weigh up the possible benefits of a new treatment approach. I liken it to an astronaut who has the option of wearing a space suit from the 1980s or a newly developed space suit in the year 2021. Granted, the old one has its place in history and may still get the job done but why wouldn’t the astronaut consider the new suit if it may improve their experience on the journey?”

According to Dr Van der Made, the advantages of new diabetes medications for patients often extend beyond diabetes itself, to include cardiovascular and renal health improvements, to name but a few. She says that if a patient is not on target with their progress, healthcare providers should consider an individualised approach with substitution or simplification of medications, in consultation with other experienced practitioners if required. By the same token, she says patients need not be alarmed when their doctor suggests a different therapy, and recommends that they ask their treating doctor about new medicines at their next check-up.

“The pandemic has highlighted a number of serious health issues, not least of which is the ongoing association between type 2 diabetes and obesity. Again, as with diabetes, the management of obesity is not often discussed beyond diet and lifestyle, yet certain new medications are going as far as to also assist with weight loss, thereby benefiting patients who have been unable to make progress without medication assistance,” she notes.

“GLP1 RA (glucagon-like peptide 1 receptor analogues), for example, were initially used to alter and improve certain functions in the body for diabetics. However, they can also help to control appetite directly via the appetite centres in the brain, thereby reducing the intense hunger described by many type 2 diabetics.”

Furthermore, Dr Van der Made explains that robust research on these medications has shown them to provide additional pharmacological benefits, such as reducing cardiovascular risk in high risk type 2 diabetes patients, as demonstrated during trials for cardiovascular outcomes.

“These medications are administered under the skin and options exist for daily or weekly doses. As is the case with so many new healthcare developments globally, cost can be a determining factor that patients and their doctors will need to discuss.

“Another class of medicines, SGLT2 inhibitors (sodium glucose linked transporter 2), indicated for type 2 diabetes, assists diabetics to pass more glucose through their urine and generally lowers the risk of low blood sugar levels, depending on what other medications the patient may be taking. This medication results in weight loss as well, and has the added benefit of lowering blood pressure, demonstrating a significant reduction in the risk of heart failure for patients.

“These medicines are just some examples of the latest developments in the management of diabetes, and I am excited about the possibilities of improving the quality of life for patients with the condition. We have the science, the research and the technology to safely and boldly go where we could not go before.

“Despite the challenging times in which we are living, it is most encouraging to see the medical evolution in managing conditions such as diabetes, and to know that when supported by responsible lifestyle choices, there are more options available for people with diabetes, offering them a better chance than ever before at achieving the best possible health,” concludes Dr Van der Made.

Fighting cancer together with Motsepe Foundation

Mon, 08 Nov 2021 09:45:50 GMT

In late October, the Cancer Association of South Africa (CANSA) were thrilled to be presented with a generous donation, of R1 million from the Motsepe Foundation, at the African Fashion International opening function held in Gauteng.

For 90 years, CANSA has played a vital role in ensuring that cancer patients have access to the life-saving information, treatment and support they need to overcome their illness. CANSA also stives to support cancer patients, and their loved ones on an emotional level, so that they do not have to walk this road alone, and actively advocates for equal health services for all in South Africa.

COVID-19 put an enormous strain on CANSA’s services as financial support to the organisation decreased. CANSA CEO, Elize Joubert, explains, “Individual donors were now, understandably anxious about salary cuts, retrenchments and the failing economy. Having to cancel our fundraising events, due to the lockdowns, resulted in our fundraising income falling by more than 60%, which adversely affected our operations across South Africa.”

For this reason, the Motsepe Foundation chose to support CANSA. Dr Precious Moloi-Motsepe, Co-founder and CEO of the Motsepe Foundation and former president of CANSA, acknowledged the wonderful work that CANSA has been offering for over nine decades. “They’re an organisation that serves the whole of South Africa, also going into rural areas, to teach communities that they must take ownership of their personal health, know the warning signs of cancer and CANSA delivers a wide range of care and support services to those who have nowhere else to go.”

“Every woman, and man, should take charge of their health and have access to information, screening and treatment. The Trustees of the Motsepe Foundation want to ensure that CANSA can continue offering their much-needed services”, Moloi-Motsepe added.

Overwhelmed with emotion and appreciation, Elize Joubert expressed her utmost gratitude for the donation to CANSA saying, “CANSA recognises that to survive in the current challenging climate, we need strong partnerships that will help us to reach our mission and objectives. We align ourselves with those that have a passion for cancer patients and cancer control in SA. This will help pull CANSA through a very difficult time and for that we are most thankful to the Motsepe Foundation for their kindness and support of our programmes to support cancer patients, caregivers and loved ones.”

Over 110 000 people are diagnosed with cancer in South Africa and many of them face challenges, which lead to a poor prognosis or are fatal to them. Financial assistance to CANSA will ensure that CANSA can continue to access vulnerable communities across South Africa and carry out screening services, as well as provide emotional support and counselling through CANSA Care Centres and CANSA Care Homes.

Men Tackling Prostate Cancer Together

Thu, 04 Nov 2021 05:21:34 GMT

Prostate cancer is the most common cancer among men globally and the number one cancer affecting all South African men (National Cancer Registry 2017), with 1 in 17 men being at risk for diagnosis in their lifetime. International and local research indicates that the risk for aggressive prostate cancer is higher in black African men. It’s vital to note that prostate cancer tends to run in families. The Cancer Association of South Africa (CANSA) encourages men to get to know their family history of cancer and symptoms, not delaying age-appropriate prostate screening, as many men die unnecessarily from the disease due to late diagnosis.

Gerda Strauss, CANSA’s Head of Service explains the important role men can play in encouraging one another to take charge of their health. “We know that cancer has a strong tendency of running in families, so we urge men with a family history of cancer to not only take responsibility for their own health, by going for prostate screening, but to also encourage other male relatives (and friends) to get checked.”

Prostate cancer is detectable with a Prostate Specific Antigen (PSA) blood test. Prostate Specific Antigen PSA is a normal enzyme produced by the glandular tissue of the prostate – it’s always present in the blood, however, a reading of three or higher may indicate inflammation of the prostate or even cancer. If a father, brother, or son has had prostate cancer he needs to encourage other males in his family to go for check-ups from at least 40, due to their higher risk of the disease or if their mother, grandmothers, sisters or aunts had breast cancer, as this is also a risk factor. There is a relationship between a diet high in animal fat and protein (especially red meat), and prostate cancer.” ( https://cansa.org.za/mens-health /)

Strauss continues, “Sons whose fathers have not had prostate cancer should encourage their fathers to go for regular PSA tests from the age of 45, as well as grandfathers, uncles, family friends, neighbours or even colleagues. PSA tests are available, by appointment, at CANSA Care Centres nationwide for R180. Costs are kept low to assist with covering the consumables used to conduct the screening. Patients with medical aid benefits can claim from their medical aids once they have paid for the screening. Testing can also be done via local health clinics, health care practitioners if you present with symptoms.”

Professor Riana Bornman, (Senior Research Professor, Faculty of Health Sciences University of Pretoria, CANSA funded researcher and writer of Research Detective Booklet ‘South African Prostate Cancer Study Survey’ ) emphasises, “It’s important for men to go for an annual prostate screening as it improves the chances of detecting prostate cancer in the early stages before it has spread outside the prostate. Well established risk factors for prostate cancer include older age, family history of the disease and African ancestry. Screening should start from the age of 45 years; but it should start from the age of 40 in black African men and in men who have a family history of prostate and / or breast cancer in a first degree relative.”

Strauss adds, “CANSA is hosting a Prostate Cancer Webinar on 18 November 2021 to discuss the experience of a prostate cancer patient in South Africa, with experts in the field sharing their guidance and experience. We welcome all prostate cancer patients, survivors and loved ones to join us. Details to follow at www.cansa.org.za.”

“We’re also proud to be launching our first CANSA’s ‘Men supporting Men’ Cancer support group on Saturday, 27 November 2021 – details to follow at www.cansa.org.za . What makes this support group special is the fact that it is facilitated and attended by men with different kinds of cancers. The need for men to come together in a space where they can feel comfortable and understood will be an opportunity for many men to reach out and join these online monthly sessions. We welcome all men that have cancer, are in remission or who have been a survivor for some time.”

CANSA also offers various support services through our dedicated virtual and online support groups as well as our tele counselling line to men affected by cancer.

Melanie is on the mend thanks to robotic arm assisted knee surgery

Fri, 29 Oct 2021 10:01:27 GMT

Orthopaedic surgeon Dr Mark van der Kaag is pictured performing a partial knee replacement using the MakoSmartRobotics™ surgical system, which combines 3D CT scan based planning, AccuStop technology and insightful data analytics for total and partial knee replacements and hip replacements.

Western Cape hospital introduces precision high-tech option for knee replacements

“I dreaded going to the shops before I had my partial knee replacement. I was in constant pain and it was stealing from my quality of life. There were so many everyday activities that became virtually impossible for me,” recalls Melanie van Heerden. She was the first person to have Mako robotic arm assisted surgery at Netcare Blaauwberg Hospital, the only facility in the Western Cape offering this advanced precision technology option to patients.

Dr Mark van der Kaag, an orthopaedic surgeon practising at the hospital, performed Melanie’s procedure in March after becoming accredited earlier this year to perform total and partial knee, as well as hip replacements using the Mako SmartRobotics™ surgical system.

“Essentially, this robotic surgical system provides additional safeguards to ensure the surgeon only works within the dimensions required for optimal precision. I am fully in control of this highly sophisticated tool at all times, as the robotic software and hardware elements only work as guided by the surgeon through the pre-defined three-dimensional surgical plan.”

The system combines three key components – 3D CT scan based planning, AccuStop technology and insightful data analytics – into one platform. Internationally the Mako robotic arm surgical system has already translated into well described patient benefits.

“One of the advantages of this approach is that the surrounding soft tissues and bone are preserved, as the system restricts cuts only to the specific dimensions required to achieve the placement and alignment of the prosthetic joint implants to match the patient’s individual anatomy.

“There are three components to the knee joint, and in Melanie’s case, it was not necessary to replace the entire knee joint, and a partial knee replacement was all that was needed. Based on the detailed data of her CT scan we were able to map the surgery in advance with the planning software.

“I was excited when Dr Van der Kaag said that the robotic arm assisted surgery was an option for me because I believe in using up-to-date technology. It is reassuring to have this option when you go for an operation like this,” Melanie says.

In theatre, Dr Van der Kaag aligns the virtual 3D knee and surgical plan to the patient’s actual knee, which sets the boundaries the surgeon will work within. He validates the surgical plan and makes any necessary adjustments. The robotic arm system provides detailed visual, auditory and tactile feedback to assist the surgeon in removing the damaged section of bone, and accurately positioning and aligning the implanted prosthetic component.

“The more precise the fit of the implanted joint, the more comfortable and stable the knee is likely to be. Other potential benefits associated with this advanced surgical option include reduced post-operative pain and shorter recovery times, so it is an ideal option for people who wish to resume their daily lives as soon as possible,” Dr Van der Kaag says.

“The ability to position the prosthetic knee more precisely often achieves a more natural feel to the knee, and allows patients to return to most of the activities they previously enjoyed.”

“Before my knee problems, I was an avid runner and I competed in the Two Oceans and various half-marathons. Now seven months after my partial knee replacement, I am cycling at the gym and I am building up by walking longer distances,” Melanie adds.

Melanie says she was able to get up the day after her surgery assisted by the physiotherapist, and started climbing stairs on the third day after the operation. “My recovery has been amazing, and I only used crutches for the first two weeks after the surgery on my right knee. Next year I will have a procedure on my left knee – which used to be my ‘good’ knee but it’s now my ‘bad’ knee – and then I should be able to get back to normal activities. I am looking forward to getting into jogging or competing in long distance walking races,” Melanie says.

Netcare recently introduced this advanced option for patients requiring knee replacements in the Western Cape, following the demand seen in Gauteng for Mako robotic arm assisted surgery at Netcare Linksfield Hospital, where the system has been used since 2019.

Jacques Du Plessis, managing director of Netcare’s hospital division, commended Dr Van der Kaag and his team on their role in keeping the province at the forefront of technology for patients in need of knee and hip replacement procedures.

“Developments in robotic assisted surgery are ushering in a new paradigm in applying world-class technology to surgery, providing greater choice in terms of the options available for patients. As the only hospital in the Western Cape to offer Mako SmartRobotics™ procedures, we look forward to seeing mobility restored for many more people so that they can enjoy improved quality of life after hip and knee replacements,” Du Plessis concludes.

Melanie van Heerden is back on her feet and cycling at gym after being the first person to have Mako robotic arm assisted surgery at Netcare Blaauwberg Hospital, the only facility in the Western Cape offering this advanced precision technology option to patients.

Saving costs and lives – a more strategic approach to breast cancer risk testing

Thu, 28 Oct 2021 08:34:44 GMT

One-size-fits-all approach no longer acceptable when genomic testing is available

A more selective approach to referring women with early stage breast cancer for costly international laboratory tests can create significant cost savings of up to 20%, and spare many women from the toxicity of chemotherapy, a recent publication from the University of Stellenbosch Business School (USB) has reported.

With more than 1.5 million cases of breast cancer diagnosed worldwide every year, it is the most common cancer that women are faced with today. More effective treatment has greatly improved survival rates but has also resulted in chemotherapy being advised to most patients, with many gaining no benefit.

The research conducted by Jaco de Jager as part of his MBA along with a team of researchers from USB, Stellenbosch University and private practise, analysed referrals of early stage breast cancer patients for the genomic test MammaPrint, which provides a genetic fingerprint of a cancerous breast tumour and accurately predicts the risk of the cancer recurring after successful surgery to remove the tumour.

Used worldwide, MammaPrint testing has identified a low-risk group for whom chemotherapy is not likely to add any further protection against future recurrence.

“A one-size-fits-all approach to breast cancer treatment is no longer acceptable in the genomic era,” said de Jager.

The test is performed centrally in The Netherlands, with a price tag in Euro, making it seemingly unaffordable in the ever-declining South African currency. In previously published work from South African and international researchers, it was reported that about half of patients with early-stage breast cancer may avoid the cost and toxicity of several months of cytotoxic chemotherapy by using MammaPrint.

Several international studies from developed countries have shown its use to be cost-effective, but could the approximately R40 000 price tag for MammaPrint in South Africa be off-set by the approximately R107 000 cost-saving in chemotherapy if fewer patients needed to be treated?

The research team accessed anonymous clinical and pathology data of 583 patients referred for MammaPrint testing since 2007, when MammaPrint was first introduced in South Africa, and then used algorithmic models including “Predict” to classify the cases into clinically high- and low-risk.

Based on the historic use of MammaPrint in South Africa, they found that unselective referral has prioritised patients where chemotherapy might not have been indicated based on clinical grounds and that the addition of MammaPrint testing increased the total costs of care by 57%.

“Based on clinical data, we found that performing MammaPrint testing for patients who were already at low clinical risk of needing chemotherapy adversely impacted cost effectiveness, limiting the widespread availability of the genomic test”, De Jager said.

“Overall, fewer patients would have needed chemotherapy, but the reduced cost of treating fewer patients was outweighed by the increased cost of having used MammaPrint testing in clinically low-risk patients who didn’t need the test.”

Their data was published in June in The Breast, a leading international, peer-reviewed breast cancer research journal. The research at USB is the first cost-impact analysis of genomic testing in breast cancer in South Africa.

The most important aspect of their publication showed that MammaPrint can be used in a cost-saving manner if testing is limited to only those patients where chemotherapy would be considered based on clinical grounds. This identifies about 50% of patients with a genetic low-risk result where the cost and toxicity of chemotherapy can be avoided.

By adopting this de-escalating strategy, fewer MammaPrint tests would be performed, with a total saving of 19.5% in direct costs to medical aids. “Although not currently cost-effective with the historic referral pattern, the MammaPrint testing can be cost-effective in South African circumstances if a different approach is followed,” De Jager said.

De Jager, a pharmaceutical chemist with an MSc in Chemistry from the University of Stellenbosch, worked on a cost-benefit analysis of MammaPrint testing, from the perspective of both medical aids and patients, for his MBA research supervised by Prof Manie de Klerk of USB.

De Jager joined a research team of oncologists, pathologists and health economy academics led by oncology surgeon, Dr Ettienne Myburgh of the Panorama Centre for Surgical Oncology in Cape Town, to propose a more strategic, more cost-effective approach.

Genomic tests such as MammaPrint offer the promise of more individualised treatment and reducing uncertainty in making clinical decisions. In more developed countries they are considered cost-effective and are recommended by 93% of international breast cancer experts.

The researchers recommended that MammaPrint be used selectively in cases where a patient is (1) at high clinical risk and (2) the cancer sub-type is hormone receptor positive and human epidermal growth factor receptor-2 negative and (3) chemotherapy is being considered, and (4) where genomic testing could allow treatment de-escalation.

They hope that managed care administrators in cancer care and medical aid schemes would use the data to adjust their approval criteria for MammaPrint testing, ensuring its sustainable use.

Together with Dr Myburgh, De Jager and Prof De Klerk, the research team consisted of private breast oncology practitioner Elizabeth Murray, Kathleen Grant of the department of biomedical sciences at Cape Peninsula University of Technology, and Maritha Kotze of the chemical pathology division in the Faculty of Medicine and Health Sciences at the University of Stellenbosch.

Mental wellness – it starts with you

Tue, 26 Oct 2021 11:24:55 GMT

Consistent commitment and open communication are key to better mental health for all

Up to one-third of South Africans experience a mental health issue during the course of their lives, yet less than 25% of people seek professional help, according to the South African Stress and Health (SASH) study – one of the few nationally representative studies of common mental health issues – indicating that the country may well be facing a mental health crisis.

One way in which to help address this is through consistency in mental health awareness, advocated by experts as a simple and practical way to change the status quo.

Megan Hosking, psychiatric intake clinician at Netcare Akeso mental health facilities, says that many people tend to think of mental health only in terms of problems that need to be addressed, and not as forming an integral part of one’s overall proactive daily health regime.

“Deteriorating mental health over the past 18 months has been called a parallel epidemic – one we will continue to see the effects of for years to come. COVID-19 has brought to light the many mental health struggles faced by people all over the world. If this is not addressed at an individual level, we are going to end up with a society carrying a legacy of mental health problems into the future,” she cautions.

Commit to 21 days

“Mental health is something we should work on continuously, as part of our regular health routine, just as we do physical exercises or make healthy choices. This is not to over-simplify mental health, but the fact is that many people tend to focus on what happens when things aren’t okay and do not consider what can be done proactively to help keep our mental health tanks full.”

Hosking notes that there are numerous simple, yet effective daily practices that can assist in maintaining mental wellness and preventing possible issues from occurring in the first place.

“This includes habits such as deep breathing, moving your body, being mindful of how you respond to the world around you, and acts of self-care such as keeping a journal or putting time aside for your own needs. Naturally not every type of mental wellness practice will work for everyone, so it is important to find one, or preferably several, that you enjoy and that you can feel the benefit of.

“The real take away, however, is that you commit to doing this daily for at least 21 days. Research tells us that it takes a minimum of 21 days to form a new habit, after which time it should become second nature to prioritise your mental health practice or practices alongside all your other daily health habits. The long-term benefit of consistency will show up in better stress management, a more positive outlook on life and greater overall mental health,” she says.

This Mental Health Awareness Month, Netcare Akeso has designed a deck of cards with 21 tips and easy-to-do activities, one for each day, to promote self-care and mental wellness. The full 21-day deck can be accessed via the Netcare Akeso website here: https://www.akeso.co.za/21-tips-health-habits-for-positive-mental-health

Stick to the plan

When mental health issues do arise, Hosking emphasises the importance of consistent behaviour in the ongoing management of such issues when you are undergoing any form of treatment, whether it be therapy, medication or both.

“This could mean taking your medication as prescribed by your doctor or attending your regular therapy sessions. Some studies have found that up to 60% of patients with depression, schizophrenia or bipolar disorder stop taking their prescribed medication within three months, which can increase the risk of relapse and experiencing another mental health episode. This can have a profoundly negative impact on your wellbeing and that of those around you. Sticking to a treatment plan is essential in the proper management of mental health conditions,” she says.

Make it a habit to talk about it

“Unfortunately, stigmas persist around mental health issues, which discourage many people from seeking help. However, if each of us engaged in mental healthcare practices – be it in the form of prevention, treatment, or management – as part of our daily lives, we could also help to reduce this stigma.”

Hosking points out that many people experience a sense of shame when talking about their mental health challenges, sometimes feeling guilty for what may be seen as complaining when their lives seem otherwise good, in other cases feeling worried about the potential consequences of speaking up about mental struggles.

“The more we talk about mental health, the more we will see it being made a priority in our workplaces, our communities and our own lives. Mental health issues do not discriminate and anyone – regardless of their circumstances – may at some point find that life has taken its toll on their mental wellbeing.

“In those moments, it is understandable if you feel alone, especially in a time that has led to increased isolation for so many. However, there are options available to help you improve and manage your mental state – whether it is starting a new daily mental health habit or reaching out for professional help. Whatever the case, it starts with you. By talking about mental health, the victories, and the struggles, you are effectively laying the foundations for a community that embraces mental wellbeing and supports those who need it,” Hosking concludes.

If you need to talk to an experienced counsellor, Netcare Akeso offers a 24-hour crisis helpline. It can also assist in the case of a mental health emergency and getting you to a point of care, as well as provide information and guidance about mental health and mental health services.

For information about occupational or mental health services, accessing care, information about mental health issues, or if you are in an emotional crisis, Netcare Akeso is there to help. Contact info@akeso.co.za or visit www.akeso.co.za. In the event of a psychological crisis, emergency support can be reached on 0861 435 787, 24 hours a day.

Out-patient psychologist and occupational therapist consultations can be booked via www.copetherapy.co.za and psychiatrist consultations through Netcare appointmed™, online at www.netcareappointmed.co.za or by calling 0861 555 565. The COPE Therapy website www.copetherapy.co.za also contains many useful blog posts on various issues and tips relating to mental health.

Don’t delay, or risk dental decay – and other serious conditions

Tue, 19 Oct 2021 11:29:53 GMT

Why dental appointments must form part of regular health checks

Dental cavities, or tooth decay, in permanent teeth is the most common health condition globally, affecting over 3.5 billion people, according to the World Health Organization. This major healthcare burden can however be largely avoided with regular dental check-ups and good dental hygiene.

So says Dr Oelie van Schalkwyk, dental director of the Netcare Primary Care Division, which includes Netcare Medicross, who finds that many people mistakenly go to the dentist only when they already have problems with their teeth. “The universally accepted interval between dental check-ups is six months. By visiting the dentist regularly you will help to ensure the early detection and timeous treatment of conditions such as dental decay and gum disease,” he says.

“This means that treatment will be mostly painless, quick and inexpensive when compared to costly specialised procedures, which are often necessary when dental issues are not addressed early on. Furthermore, this helps to promote oral and general health and wellbeing, not to mention the long-term retention of teeth.”

Old fears still posing a risk to oral and general health

Dr Van Schalkwyk notes that in addition to the lack of awareness around the importance of regular dental check-ups, there are also those individuals who still perceive going to the dentist as being painful and traumatic, to the point where some will avoid a visit to the dentist even when in terrible agony.

“The vast majority of the time these patients could have spared themselves the pain, the additional treatment and the subsequent costs had they simply scheduled regular check-ups. It is ironic, frustrating and sad for a dentist to see someone in agony because their fear of pain is what prevented them from seeking dental care in the first place,” he says.

“Over and above the premature loss of, or damage to, teeth, gums or other oral structures, avoiding the dentist’s chair can also mean that important red flags for other serious health conditions are overlooked. There is a direct and scientifically proven correlation between dental health and certain serious medical conditions.

“For example, gum disease can indicate an increased risk for cardiovascular disease, as this can result in a bacterial infection in the bloodstream, which in turn can affect parts of the heart. Your dentist may also be able to identify any potential oral cancer concerns, which you may otherwise miss until the condition has progressed much further,” he explains.

Addressing mindset and habits from childhood

Whatever the reasons preventing regular dental visits, Dr Van Schalkwyk points out that the benefits clearly outweigh any apprehensions. He therefore advises parents to begin familiarising their children with going to the dentist as early on as around six months after the first tooth pushes through, as tooth decay can occur anytime from then on.

“Taking your child to the dentist is the best way to prevent problems such as tooth decay and malocclusion, or crooked teeth, from a young age. Dentists can also teach parents how to clean their child's teeth properly and identify their fluoride needs. As they get older, fissure sealant – a durable sealing resin agent applied to decay-prone fissures on the chewing surfaces of permanent teeth – is highly recommended the moment these teeth appear in the mouth.

“To avoid tooth decay as a result of bottle feeding and teeth misalignment due to sucking, try to wean your baby off of the bottle by one year of age, and monitor excessive sucking of pacifiers, fingers and thumbs. Never give your child a bottle of milk, juice or sweetened liquid at naptime or bedtime,” he says.

“Bringing your child to the dentist early on lays the foundations for a lifetime of good oral care habits and helps them to get used to the dentist’s rooms, making for stress-free visits in the future. Ultimately, children with healthy teeth chew food easily, learn to speak clearly, smile with confidence and retain their own teeth to a ripe old age if they continue to practise good oral and dental care.”

Keeping it simple and manageable

Dr Van Schalkwyk says that adults too need to be mindful of healthy oral hygiene and schedule regular check-ups, if they do not do so already. “To help prevent the formation of cavities one should brush twice daily, floss in-between teeth daily and obtain a scale and polish and fluoride treatment at your dentist during your six-monthly visits.

“There is really no need to avoid going to the dentist. We are fortunate to live in an age where modern dental techniques and instruments, highly effective local anaesthetic and specialised tools and treatments virtually guarantee that dental visits and procedures will not be traumatic. In fact some patients even look forward to their bi-annual visit, coming away with wonderfully clean teeth and the knowledge that their oral health is in check,” he concludes.

CMS releases its 2020/21 Industry Report

Wed, 13 Oct 2021 10:18:47 GMT

The CMS has released its 2020/21 Industry Report, which reveals the impact of the COVID-19 pandemic on the medical schemes industry.

Overall, the industry saw COVID-19 claims to the value of R10.10 billion in 2020. There were 422 894 members of medical schemes infected with COVID-19 in 2020, and out of that number, 383 585 recoveries, representing a mortality rate of 3.02%. These numbers are based on data from 73 schemes, representing 99.84% of medical scheme beneficiaries.

Regulating during a pandemic

Through various concessions for medical schemes, the CMS allowed for the utilisation of personal medical savings accounts to offset contributions, the relaxation of credit policies, contribution holidays and lower future contribution increases.

As a result, 19 914 members were granted contribution deferrals to the value of R586.90 million, while 16 654 members received relief through their personal medical savings accounts to the value of R180.11 million.

The CMS also extended a hand to small, medium and micro-sized enterprises (SMMEs) with less than 200 employees, allowing schemes to make payment arrangements with these businesses in order to protect their employees’ cover. This allowed 30 725 members to receive relief through rule amendments and the impact was R133.31 million. A further 5 447 members received other types of relief such as debt policy relaxation to the value of R53.68 million.

The medical schemes industry

The number of medical schemes fell by two to 76 registered schemes, as a result of two mergers. These 76 schemes had a total subscription of 8.89 million beneficiaries in 2020, down from 8.99 million in 2019 – a year-on-year decrease of 1.15%.

The average age of medical scheme beneficiaries in 2020 was 33.4 years compared to 33.04 years reported in 2019, with the average age of female beneficiaries at 34.5 years and that of males at 32.2 years. The pensioner ratio increased slightly to 8.9%, with increases in both males and females.

Healthcare utilisation

The COVID-19 pandemic caused a decrease in healthcare utilisation and expenditure in 2020, due to the varying levels of lockdowns and cancellation of elective procedures and services. The decrease in screening activities during 2020 may also affect downstream costs as early detection normally results in lower costs and better clinical outcomes in the long-term.

Healthcare expenditure on benefits decreased to R178.04 billion, 3.81% down from the 2019 reported amount of R185.1 billion, while hospital expenditure saw a decline of 8.38% between 2019 and 2020, from 68.4 billion to 62.7 billion. The average amount paid per beneficiary for hospital services also decreased by 8.45% to R7 052.00, while over 92% of this expenditure went to private hospitals.

There were also less visits to the doctor as the amount claimed by General Practitioners (GPs) decreased by 10.07% from 10.3 billion in 2019 to 9.21 billion in 2020. There was an overall decline in the amounts paid toward specialists, hospitals, general practitioners, dentists, and dental specialists, 2.26%, 8.83%, 10.07%, 7.19%, and 5.52%, respectively. Despite this, hospital visits by GPs saw a 15% increase in cost, with an average of R1 044.94 per event in 2019 to R1 203.43 in 2020, accounting for 14% of the total expenditure on GPs. Out-of-hospital visits costs increased from an average of R404.62 in 2019 to R424.59 in 2020.

Caesarean sections increased by 7.30% from 651.83 in 2019 to 699.40 in 2020.

Expenditure on medical specialists decreased by 2.2%, from R13.4 billion in 2019 to R13.1 billion in 2020. The average expenditure per event in-hospital increased by 10.99% from R1 549.13 2019 to R1 719.41 in 2020. The average expenditure per event out-of-hospital increased by 4.28% from R1 185.57 in 2019 to R1 236.31 in 2020.

True to form, the only specialist service that increased during the period under review was pathology services, which amounted to R11.6 billion in 2020.

Medicines (and consumables) dispensed by pharmacists and providers other than hospitals amounted to approximately R29.43 billion, representing an increase of 3.73% compared with R28.3 billion in 2019.

Overall, risk benefits paid per beneficiary decreased slightly by 4.31% from R18 791 in 2019 to R17 980 in 2020, and the average spent from medical savings accounts pabpa, increased by 0.04% to R2 029.63.

Prescribed Minimum Benefits

Prescribed Minimum Benefit expenditure, consisting of risk and savings expenditure amounted to R92.4 billion in 2020. As a percentage of total benefits paid, PMB expenditure accounted for 51.9% of benefits paid in 2020, up from 51.2 % in 2019. The cost of PMBs is driven by the beneficiary profile determining the level of cross-subsidisation between the young and the old; the sick and the healthy; the prevalence of chronic conditions and disease burden; and the expenditure on treatment, which is strongly linked to contracting between schemes and providers.

Non-healthcare expenditure

Gross non-healthcare expenditure (NHE) for all medical schemes at the end of 2020 was reported at R17.14 billion, an increase of 3.55% from R16.55 billion in 2019.

Administration expenditure grew by 3.67% to R14.35 billion from R13.84 billion between 2019 and 2020. Administration expenditure is the biggest component of NHE (83.73%), followed by broker fees and other distribution costs (14.81%) and impaired receivables (1.46%).

Administration and co-administration fees paid to third-party administrators were the main component of Gross Administration Expenditure (GAE). It grew by 3.85% to R10.36 billion in 2020 from R9.97 billion in the previous year. These fees represented 81.08% of the GAE of schemes which incurred this expenditure in 2020 (2019: 81.06%).

Broker costs include all broker service fees (or broker commissions) and other distribution costs. Broker costs increased by 3.63% from R2.45 billion in 2019 to R2.54 billion in 2020 (2019: 9.19%).

Net healthcare results and impact on reserves

The net healthcare result for all medical schemes combined reflected a surplus of R19.93 billion in 2020 (2019: R1.03 billion surplus). The improved performance is because of the lower utilisation of benefits during the pandemic.

The 2020 industry solvency ratio stands at 44.55% (2019: 35.61%), and exceeds the minimum required ratio of 25.00%, consistent with regulation 29 of the Medical Schemes Act (131 of 1998).

The CMS Industry Report can be downloaded here .

Breast cancer accounts for a quarter of yearly new cancers in SA women

Fri, 08 Oct 2021 05:46:31 GMT

Breast cancer accounted for more than a quarter of new cancer cases in South African women in 2020, and 8% of cancer deaths.

Women who have an annual mammogram screening for breast cancer are diagnosed with less advanced cancer and smaller tumours, undergo less aggressive treatment and have a lower risk of death – yet most South African medical aids allow for a mammogram only every two years.

Early detection of breast cancer dramatically improves the chances of survival, and reduces the need for aggressive and invasive treatment, in a disease that is the most frequently diagnosed cancer in South African women, with a lifetime risk of 1 in 25.

Breast cancer accounted for more than a quarter of new cancer cases in South African women in 2020, and 8% of cancer deaths.

October is Breast Cancer Awareness Month and Prof Jackie Smilg, chair of the Breast Imaging Society of South Africa (BISSA), stressed that the “gold standard” for detection of breast cancer remains the mammogram, which can find tell-tale changes in breast tissue years before symptoms develop. BISSA is a sub-specialty group of the Radiological Society of South Africa (RSSA).

“The goal of screening for breast cancer is to find the disease before it causes symptoms. Early breast cancer detection reduces deaths, extends life expectancy, and improves quality of life for breast cancer patients. Early detection through mammography also means less extensive surgery, fewer mastectomies, and less frequent or aggressive chemotherapy.”

“Numerous clinical studies have proven that screening mammograms substantially reduce deaths from breast cancer. Given th epositive impact of early detection on the patient’s life and the reduced need for more extensive and expensive treatments, it is disappointing that medical aids and government agencies do not accept the evidence of the benefits of annual mammography,” Prof Smilg said.

She added that annual mammogram screening in women aged 40 to 49 is highly recommended due to the faster speed at which tumours double in size in this age group.

She said that regular screening was more likely to find breast cancers when they are small and still limited to the breast area, and that this was important for successful treatment and survival, since the size and extent of the spread are crucial in predicting the outcome of a breast cancer diagnosis.

“While advances in breast cancer treatment have definitely also contributed to improved survival rates as well as enabling less aggressive and invasive treatment, the foundation remains early detection through regular screening,” Prof Smilg said.

BISSA recommends that women who carry the breast cancer (BRCA) gene or who have a first-degree relative (parent, sibling, child, maternal grandmother), diagnosed with breast cancer are considered higher risk and should begin annual screening five years before the age that their relative was diagnosed.

All women should regularly self-examine their breasts, Prof Smilg said, and women at average-to-mild risk should start having annual mammograms from age 40, regardless of whether they have any symptoms or have found any abnormalities.

Tomosynthesis (a digital technique that enables a 3D view of the breast) and possibly sonar, depending on breast density, are recommended along with the mammogram, while for women at high risk, BISSA recommends MRI scanning as an additional screening measure.

Prof Smilg emphasises that the amount of radiation used in modern mammography is “negligible”, with no evidence of harm to the breasts or the rest of the body – “the benefits of screening and early detection far outweigh any risk associated with radiation” she said.

She also warned against technologies and devices that claimed to offer an equivalent alternative to the mammogram.

Alternatives touted by often non medically qualified people and organisations include a hand-held “breast light”; thermography, which detects temperature variations on the skin surface; and breast “tactile imaging”, which electronically maps breast tissue elasticity.

“There is no evidence that these methods have any value in the screening and detection of breast cancer when compared with mammography. They are often operated by personnel with no medical training and no training in conventional breast imaging and may in fact cause more harm by missing breast cancers, leading to delayed diagnosis and limited treatment options,” Prof Smilg said.

The bottom line? A lump could turn out to be harmless but, regardless of age or a lack of family history of breast cancer, rather be safe than sorry – get it checked by a medical professional.

Early detection of breast cancer is vital

Tue, 05 Oct 2021 10:25:05 GMT

The Cancer Association of South Africa (CANSA) highlights the important role that women can play in taking ownership of their personal health during breast cancer awareness month and that getting checked regularly and early, is vital.

Lorraine Govender, CANSA’s National Manager: Health Promotion says “We encourage women to focus on their breast health by being aware of any changes or irregularities, get to know the signs and symptoms of breast cancer and go for regular breast screenings. It’s always good to practise self care which includes making personal health a priority.”

With 1.7 million women diagnosed each year, breast cancer is the most common cancer among women worldwide. In South Africa, according to the National Cancer Registry (2017), one in 26 women are at risk of developing breast cancer. And 16% of cancer deaths are attributed to it. There is growing concern that most women present with late-stage cancers, which make for a difficult prognosis.

In her CANSA funded research study – Pathways to breast cancer diagnosis and care – Professor Jennifer Moodley, Director Cancer Research Initiative at the Faculty of Health Sciences – University of Cape Town (UCT) – says, “Studies have shown that time to a cancer diagnosis may be influenced by several factors including women's knowledge and awareness of cancer symptoms, whether women see themselves as being at risk for breast cancer, barriers in the health system, knowledge and attitude of health providers, and psychological, and socio-cultural barriers to health care”.

Govender states, “If any women have breast cancer symptoms, it’s so important to present to health practitioners and get checked out sooner than later, as this can lead to an early-stage diagnosis that results in better breast cancer treatment and survival. So do those monthly breast self-examinations , annual medical check-ups and cancer screening for early detection, as symptoms don’t always present until cancer has spread.”

CANSA plays an active role in the promotion of early detection of breast cancer and offers clinical breast examinations (to detect breast lumps) at CANSA Care Centres with strict safety protocols in place to avoid the spread of COVID-19. Costs are kept to a minimum. Patients with medical aid benefits can claim from their medical aids once they have paid for the screening.

Support for cancer patients is plentiful through support groups , online support resources , tele counselling and CANSA also supplies wigs and headwear , bras , and lymphoedema garments (in partnership with The M Store) at CANSA Care Centres.

“We have our specialised online support programme called iSurvivor Metastatic Breast Cancer , which is aimed at assisting and helping mostly metastatic breast cancer patients with their experienced challenges. And we offer a variety of breast prostheses at affordable rates for those who had to undergo a mastectomy/lumpectomy and offer advice to help cope with the side effects of cancer treatment,” concludes Govender.

In celebration of CANSA’s 90th birthday, Novartis is giving back and offering a total of 360 free Clinical Breast Examinations from 27 September to 8 October at selected CANSA Care Centres in Kimberley, Cape Town, Richards Bay, Durban, Pretoria, Rustenburg, Bedfordview, Gqeberha (PE) and Bloemfontein. Bookings must be made through info@cansa.org.za

Anyone can get involved and help CANSA during October: Purchase a ‘Doek with a Difference’ or a pair of earrings as part of the Pink Trees for Pauline campaign, or host a virtual Cuppa For CANSA event with the CANSA SPAR Tea on 30 October 2021. Book a clinical breast screening and encourage family and friends to do the same. Donate via CANSA’s secure, online platforms and subscribe to the enewsletter to stay informed about their various health campaigns and fundraising initiatives.

Bright new era for women’s health in Polokwane and surrounds

Thu, 30 Sep 2021 12:18:27 GMT

Dr Portia Mosadi, an obstetrician and gynaecologist

Two new women-led specialised healthcare centres now available to the community

Access to specialised healthcare has recently been taken to new heights for women in the Polokwane area with the opening of two women led centres at Netcare Pholoso Hospital, focusing on women and baby health and wellness.

According to Fabion Bennett, hospital general manager, the facility has long been known for its high standards in healthcare, but the two centres signal the beginning of a bright new era in meeting the needs of women in the community.

“We are most fortunate to have two leading women’s health specialists practising here at our hospital – Dr Lusanda Jonas, a specialist general surgeon with an interest in breast health, and Dr Portia Mosadi, an obstetrician and gynaecologist. These two formidable doctors have been with us for some time and have now each opened a centre – a holistic breast care unit headed by Dr Jonas, and a comprehensive mother and baby wellness centre under Dr Mosadi’s leadership – here at Netcare Pholoso Hospital,” he says.

Mosadi Wellness Centre

The Mosadi Wellness Centre, which opened at the hospital in June, offers a comprehensive mother and baby wellness service. The centre is the brainchild of Dr Mosadi who was an award winner in the 2019 Inspiring Fifty SA Women in Science, Technology, Engineering and Mathematics and is one of South Africa's early female entrants into aesthetic gynaecology.

“Our new centre provides a full suite of healthcare services to new and expectant mothers, as well as for women looking for gynaecological care, all under one roof in a beautifully designed space. This also acts as a support service for other gynaecologists and obstetricians at the hospital, who can send their patients to us for supplementary services such as 4D scans and baby wellness checks. In addition, our centre offers contraceptive advice, pap smears, antenatal classes, as well as immune and lactation support for new moms,” explains Dr Mosadi.

“This all takes place in a warm and welcoming environment, where women feel supported and comfortable to ask for help and advice. As a healthcare centre, we are on a mission to empower women by informing and educating them about their bodies as they journey through pregnancy and the period thereafter," adds Dr Mosadi.

"We are bringing back a community based approach to caring for women through midwives and other key medical staff. We therefore place a strong emphasis on utilising the depth of knowledge and experience of our midwives and other healthcare providers in guiding women when it comes to nutrition during pregnancy and breastfeeding, how to prepare for birth and what to expect in those first few weeks as a new mother, amongst other important topics.”

Dr Mosadi says that she conceptualised the centre around the needs of the many women living in the surrounding communities, who would like access to more personalised care where they feel safe and understood, but who may not always have private medical cover.

“We have created a serene and nurturing environment here for women and are able to offer affordable maternity plans in a private care setting, with midwife deliveries for low risk patients as well as other essential services during pregnancy and the first six weeks after birth.

“Our multi-disciplinary team of healthcare professionals, which also includes doctors and nurses, is committed to providing each and every patient with quality healthcare. Ultimately, we wish for each of our patients to come away having had a special and memorable experience,” she says.

Breastic centre

In an important development in preventative care for women in the area, a new holistic breast care centre at the hospital was opened in August by Dr Jonas, who also has a private practice at the hospital and is a fellow of the College of Surgeons. Dr Jonas is passionate about breast health and wellness and is trained in treating and diagnosing all benign and malignant breast diseases, as well as in performing different breast operations, including breast conservation surgery.

“The Breastic centre, as it is called, was opened with the purpose of providing an outstanding breast care service that is personally tailored to every woman, thereby reducing breast cancer morbidity and mortality through early detection of breast diseases. We promote breast conservation surgery as the gold standard wherever possible and work with our patients to empower them as key role players in their course of treatment,” explains Dr Jonas.

The centre offers a holistic range of breast care services including screening, diagnosis and medical and surgical treatment of breast cancer as well as treatment of benign breast diseases and referral for genetic screening and counselling. Payment structures for non-medical aid patients paying directly for breast care services at the centre are currently being drawn up.

“We take a multi-disciplinary approach in order to provide the most holistic care possible for our patients and also involve their loved ones, who play an important part in their recovery journey, along the way. The other specialists on our treatment team include a radiologist, an oncologist, a plastic and reconstructive surgeon, a pathologist, a psychologist, a social worker and a wound care specialist,” explains Dr Jonas.

“It is very important to me that women have access to education around breast health and early screening, as breast cancer is highly treatable if detected early on. I myself lost a very close cousin to breast cancer two years ago. It is my great wish that any woman who experiences breast cancer has the best possible care and support available,” she says.

Dr Jonas notes that breast cancer is the number one cancer affecting women in South Africa, with one in 27 women at risk of developing it, and is the most common cancer in the world. “According to the 2020 GLOBOCAN figures, approximately 2.3 million new cases were diagnosed in 2020. Tragically, 685 000 lives were lost to breast cancer in that same year,” she says.

Dr Jonas therefore strongly encourages women to follow these four golden rules:

Have a breast examination by a healthcare professional at least every three years from the age of 20
Have a mammogram by a healthcare professional every year from the age of 40
For women at high risk of breast cancer, such as those whose immediate family members have had the disease, annual screening should include both a breast examination and a mammogram from the age of 35.
It is important for all women to develop awareness of their breasts and to do self-examinations of their breasts every month in order to pick up any changes.

“We are greatly honoured to have these two exceptional specialists practising at our hospital and spearheading such important services. We are certain that this will make a significant difference in the lives of women in the Polokwane area now and for many years to come,” concludes Bennett.

Dr Lusanda Jonas, a specialist general surgeon with an interest in breast health

Contact the centres

Mosadi Wellness Centre – Dr Portia Mosadi

For more information about the Mosadi Wellness Centre, please visit https://www.mosadiwellnesscentre.co.za/

In addition to the mother and baby wellness centre, Dr Mosadi also runs the Dr Portia Mosadi Gynaecology Clinic, a gynaecology and obstetrics practice offering general gynaecology, aesthetic gynaecology and obstetrics at Netcare Pholoso Hospital in Polokwane as well as at the Netcare Doctors Suite in Rosebank, Johannesburg. Please visit https://drportiamosadi.co.za/ for more information.

Breastic Centre – Dr Lusanda Jonas

To find out how to conduct self-breast examinations and for more information about the Breastic Centre, please visit https://breastic.co.za/ To contact Dr Jonas please call 015 296 5152. Alternatively, please email info@breastic.co.za or breasticunit@gmail.com .

Attention Deficit Hyperactivity Disorder not just a kid’s problem

Wed, 22 Sep 2021 13:12:51 GMT

Impact of ADHD into adulthood significant

People with ADHD are often thought of as simply being hyperactive, distracted or generally disorganised. However, there is much more than meets the eye to this attention disorder that is usually associated with children but, interestingly, is also common in adults.

Dr Laura Comrie, a psychiatrist practicing at Netcare Akeso Kenilworth, points out that there are many misconceptions around ADHD – which stands for Attention Deficit Hyperactivity Disorder – and that it in fact describes a very real and legitimate problem with regulating attention.

“This largely hereditary neuro-developmental disorder has to do with the wiring of the brain during development. The research indicates that ADHD has persisted since childhood in 25% - 50% of adults who have it. While current figures for adults with ADHD are at around 4% in the general population, it is suspected that this number is much higher but that due to a lack of awareness, it often goes undiagnosed.”

Is this you or someone you know?

Dr Comrie notes that there are three different sub-types of ADHD, each of which present differently.

1. Hyperactive/Impulsive:

Fidgety, unable to sit still or wait patiently
Talking too much, interrupting others
Highly active – as though there is a motor constantly running inside

2. Inattentive:

Easily distracted and often day-dreaming; seemingly avoiding dislikes
Problems with completing or remembering tasks; making mistakes
Losing things often and difficulty in being organised

3. Combined:

A combination of the above types of symptoms

“ADHD tends to present more commonly in men, with the Hyperactive/Impulsive type being most prevalent in that sex. These individuals will often choose a line of work that involves physical activity rather than sitting at a desk. Inattentive ADHD is more common in women. It is possible that because Inattentive ADHD is less of a visible concern, it is more undiagnosed than Hyperactive/Impulsive or Combined ADHD.

“The disorder occurs on a spectrum, so it is more severe in some than in others. Many people are quite functional and have systems in place to help them manage their condition. Those with ADHD often have a strong entrepreneurial spirit as they tend to be creative thinkers and can experience incredible levels of focus on subjects about which they are passionate. At the same time, they can really struggle with more mundane tasks in life, such as doing the bookkeeping or remembering to run an errand, for example.

“This type of behaviour can be frustrating for family members and colleagues but it is quite literally out of the control of the person with ADHD. Because it is a neurological disorder, it often requires medical intervention to help regulate it. It is most certainly not the case that these individuals lack discipline or are lazy, as some people believe. In fact, they have the potential to make valuable contributions to society, provided they receive the medication, psychotherapy and societal support that they need,” she says.

Why medication?

Dr Comrie explains that ADHD affects the delivery of two neurotransmitters – namely dopamine and noradrenaline, also known as norepinephrine – to the front part of the brain that controls planning, organisation, maintaining focus during routine tasks and similar neural processes.

“These neurotransmitters are important for ensuring that such processes in the brain take place effectively. In people with ADHD, dopamine and noradrenaline are not being properly delivered to the front part of the brain, affecting the brain’s function. This has been studied with the use of magnetic resonance imaging (MRI), which has clearly shown measurable differences in the brains of those with ADHD and those without it.

“Medication is important for these individuals to function in a neurotypical or ‘normal’ world, like school, university or certain workplaces. This helps them to gain and maintain confidence, to absorb and retain information and generally to develop and grow,” she says.

According to Dr Comrie, ADHD medication works by delivering the missing stimulants, dopamine or noradrenaline, to the brain. “The more common type of medication used assists with the delivery of dopamine and works quickly, sometimes within 20 minutes. It also leaves the system quickly – within four to eight hours. Dosage and type will therefore depend on whether you need short-acting or long-acting medicine. Adults usually require long-acting medicine, because their workday is typically longer than a school day.

“This type of medication is not a huge commitment, as the person is able to try it out and see fairly quickly if it works for them. Many adults choose to take this medication only when they need it, in circumstances which they know will require strong focus – for example they may skip it on weekends. This medication can however make you feel wired and over-stimulated, in which case the other form of medication needs to be explored.

“The second type of ADHD medication available works on noradrenaline. This requires you to gradually build up towards the full dosage over ten weeks and must be taken daily without skipping a dose, in order to build and maintain efficacy. This is often seen as the second line in treatment as it is a bigger commitment.

“The medicines are costly but it is important to weigh up the cost versus benefit ratio against how difficult your life can be without the help. Fortunately, generics have become available in recent years so the medication is more affordable now than previously. Again, ADHD occurs on a spectrum and only those with impaired functioning in daily life really need to consider using medication,” she says.

Dr Laura Comrie

Other factors to consider

Addressing the concern that many people have around they or their children taking medication for ADHD, Dr Comrie points out that if untreated, ADHD can lead to a serious lack of confidence as well as low academic or career performance.

“Some individuals are afraid of addiction to ADHD medication. However, by not having the clinical support they need, people with ADHD may seek out the stimulants their brains need elsewhere, such as in certain illegal and seriously addictive drugs. If used properly, ADHD medication can in fact help to avoid substance addiction into adulthood.

“Upon receiving an ADHD diagnosis, it is important to fully discuss both medication and psychotherapy treatment options with a psychiatrist, as contributing factors such as anxiety or depression need to be taken into account in creating the right treatment programme.

“The medical management of ADHD can only be improved with a healthy lifestyle such as avoiding stimulants like caffeine, eating a balanced diet, exercising regularly, getting enough sleep and practising daily mindfulness in the form of a breathing exercise, for example. This approach, along with understanding and support from family and colleagues, can go a long way to positively impacting the life of someone with ADHD,” concludes Dr Comrie.

Solutionist Thinkers protest

Fri, 17 Sep 2021 14:26:25 GMT

Solutionist Thinkers presents the memorandum to the CMS

The Council for Medical Schemes (CMS) welcomes engagement with all stakeholders, including health care providers represented by the Solutionist Thinkers on matters that affect beneficiaries of medical schemes. The CMS embraces the exercise of all rights, including the democratic right to demonstrate, protest and to present petitions enshrined in the Constitution.

The memorandum presented to the CMS, by the Solutionist Thinkers, reiterates issues that were ventilated in the Section 59 Investigation, chaired by Advocate Tembeka Ngcukaitobi SC. In January 2021, the Section 59 Investigation Panel issued an interim report and invited comments that were due 5 April 2021.

Despite the COVID-19 pandemic affecting work progress on many fronts, the CMS made extensive comments that may go a long way to resolve the disputes raised in the Section 59 Investigation.

As a creature of statute, the CMS and all its powers fall within the provisions of the Medical Schemes Act (131 of 1998). As such, the CMS urges Solutionist Thinkers to assist in the process of resolving the disputes under section 59 in terms of the law.

The protest action of today, 17 September 2021, is preceded by several difficult but fruitful engagements between the CMS and Solutionist Thinkers.

Finding a solution to the dispute over application of section 59 of the Medical Schemes Act (131 of 1998) remains a pressing problem which the CMS wants to resolve as much as the Solutionist Thinkers.

Teachers at risk of anxiety amidst pressure and disruption

Thu, 16 Sep 2021 08:31:30 GMT

Just over a month after schools returned to full-time, in-person classes after a third round of lockdown closures, the pressure is on and teachers expected to deliver the learning and to support stressed and anxious learners are themselves exhausted and at risk of burnout.

After 18 months of on-again-off-again, rotational and remote schooling, the South African education system has lost ground. Some learners are up to one school year behind and up to 500,000[i] have dropped out altogether.

Amidst reports of rising levels of anxiety and depression in children and teenagers, mental health professionals warn against neglecting the wellbeing of teachers too – “the unsung heroes of the pandemic” – who are expected to be able to provide psychological support to struggling and traumatised learners, but are struggling to cope mentally themselves.

Dr Alicia Porter, a member of the South African Society of Psychiatrists (SASOP) with a special interest in adolescents’ and women’s mental health, said: “For teachers to be able to offer positive support to learners, it is important that they are able to understand, identify and address their own emotional needs and possible mental health issues.

“It is important not to fall into the trap of giving relentlessly without stopping to take stock of one’s own psychological needs.”

Dr Porter said that teachers had faced challenges of having to rapidly adapt to remote learning and unfamiliar technology, and how to support learners who didn’t have access to technology, while juggling the needs of their own families and fears of contracting Covid-19, as well as coping with losses of loved ones and colleagues.

The return to in-person learning brought its own stresses of a lack of masks and sanitisers, challenges in monitoring learners’ compliance with the rules, fears of contagion and children being sent to school while showing Covid symptoms, while also supporting learners who have experienced losses on multiple levels.

The unrest and looting in Gauteng and KwaZulu-Natal added further to the stress and challenges faced by teachers, Dr Porter said, as they tried to help their pupils to process the disruption, injuries and deaths, while also coping with their own response to the situation.

She said that research in various countries had pointed to teachers’ already-high rates of stress, anxiety and depression rising through the Covid-19 pandemic, impacting negatively on morale and job satisfaction, along with increased sick leave and absenteeism, and causing many to consider leaving the profession altogether.

Dr Porter said that for teachers the challenge was two-fold – learning how to maintain their own mental health and also how to support their pupils – and encouraged teachers to “put your own oxygen mask on first”.

“It is important to safeguard the emotional health of teachers. A recent study highlighted that teacher-student relationships are also stressors for the student, and that the teacher’s behaviour predicts the emotional wellbeing and commitment of the students, which are also important factors for reducing their stress levels,” she said.

Dr Porter recommended practical steps that teachers can take to maintain their mental health and reduce stress levels, starting with focusing on what they can control.

Choosing how to spend their time and making healthy choices such as getting sufficient sleep, staying hydrated, limiting alcohol intake and eating regular, healthy meals.
Make time for self-care – exercise, rest, reading, writing in a journal, meditating or spending time on a hobby helps to create balance and promote mental health.
Model self-compassion. “We teach students the basics of self-compassion, but we also need to model it. Be kinder to yourself. This will benefit your mental wellness.”
Set reasonable expectations. “We have to acknowledge that we are in the midst of a pandemic and it is not business as usual. We can't expect to be as productive or as organised as before while having to balance teaching, caretaking and managing households. Set small realistic goals and expectations.”
Maintain connection. Covid-19 shutdowns and restrictions have made the last 18 months a time of isolation, while social connection promotes mental health and wellness. Dr Porter recommends keeping in touch with family, friends and colleagues, making time to connect and catch up, to share challenges as much as good news, even if only virtually.
Micro-recharge – make time for “micro moments” to pause and allow your system to recover and re-set amidst stress. Dr Porter suggests small activities such as being mindful while hand-washing, taking deep breaths and observing your movements; or climbing stairs slowly and mindfully to give yourself a small break.
Dr Porter also recommends the “30-3-30 approach” – actions that can be taken in 30 seconds, 3 minutes or 30 minutes to take a break and switch off to recover when feelings of panic or being unable to cope arise. These could include:

30 seconds – take slow deep breaths, counting to 3 on inhale and exhale; look out of a window and focus on each thing you can see; sit on a chair and focus only on the feeling of the chair pressing into your back and bottom; learn a favourite, inspiring quote to remember in times of stress.
3 minutes – do a quick household task; make a quick phone call to a friend; do a word puzzle or listen to a favourite piece of music; make a hot drink and focus on the steps and the feeling of the warm mug in your hands.
30 minutes – take a pampering bath; de-clutter one cupboard; watch a TV programme or listen to a podcast; get out for some fresh air and sunshine.

In all of these actions, she said, the importance was in doing it mindfully and focusing only on the activity at hand.

On supporting learners coping with uncertainty, stress and grief, Dr Porter advised:

Admit that the event/s happened. Acknowledge the reality of being scared, worried or upset.
Do not pretend that this is all normal. Acknowledge that the “new normal” is not normal at all.
It is helpful to communicate the optimism of support, that asking for help can ease panic and distress and provide hope.
Encourage students to express their fears and anxiety openly.
Allow students to feel like they can also help – ask them to think about how they could make a difference.
Take concerns of depression, suicide and anxiety seriously and make contact with professional support of a psychologist or psychiatrist, or contact a helpline such as SADAG.

References:

[i] UNICEF. Press release, 22 July 2021. “Learners in South Africa up to one school year behind where they should be.” https://www.unicef.org/press-releases/learners-south-africa-one-school-year-behind-where-they-should-be

Eight-month-old set to thrive after lifesaving donations

Sun, 12 Sep 2021 17:55:21 GMT

Baby Muhammad Noor Ismail recently received a lifesaving heart operation sponsored by Medipost Holdings and the Netcare Foundation at the state-of-the-art Maboneng Heart and Lung Institute at Netcare Sunninghill Hospital. The team of specialists who performed the surgery also gave their services pro bono. The eight-month-old baby boy, is recovering well after the procedure to correct a hole in the heart known as a ventricular septal defect. He is pictured with his mother, Sana Maher, in the cardiothoracic intensive care unit at Netcare Sunninghill Hospital only a few days after his surgery.

Pulling together for Baby Muhammad’s heart operation

A baby boy is back home with his mother and recovering well after undergoing a life-saving operation to fix a large hole in his little heart. With no time to lose, healthcare companies and top medical specialists teamed up to ensure eight-month-old baby Muhammad Noor Ismail could receive the urgent surgery he needed at the world-class cardiothoracic centre at Netcare Sunninghill Hospital.

“When he was two weeks old, I noticed he was a bit congested and wasn’t feeding well, and at first we tried some of the recommended home remedies. When he didn’t improve, we took him to the doctor, and when he still wasn’t thriving, we were very worried that there could be something wrong with our baby’s heart,” says Sana Maher, Muhammad Noor’s mother.

Baby Muhammad Noor is the latest beneficiary of the Heart-to-Heart campaign, a corporate social investment (CSI) match funding challenge by the Netcare Foundation and Medipost Holdings, for operations to disadvantaged children with life-threatening heart conditions by specialists at the Maboneng Heart and Lung Institute.

The doctor suggested he might have a heart defect, and Muhammad Noor was first referred to Kalafong Hospital and from there to Steve Biko Academic Hospital.

A large hole in the baby’s heart

“Earlier this year Muhammad Noor was diagnosed with ventricular septal defect [VSD], or a hole in the wall between the two lower chambers of his heart. It was not clear at first how badly his tiny heart was affected, but it soon became evident that the hole was so large that it would likely become debilitating, potentially even life-threatening, if not corrected soon,” says cardiothoracic surgeon and co-founder of the Maboneng Heart Institute, Dr Erich Schürmann.

“As the child grows, this type of heart defect damages the arteries of the lungs, and a specialised procedure is required to correct it, ideally as soon as possible. Sadly, there is a considerable waiting list for such resource-intensive procedures, and when we heard about Muhammad Noor’s condition, we were determined to find a way to assist,” he says.

“We prayed for a solution to help get the operation for our baby sooner but we aren’t on medical aid and at times it felt like there was little hope. Interventional paediatric cardiologist Prof Lindy Mitchell at Steve Biko assisted with the application, and soon we got the good news that he was accepted for surgery at Netcare Sunninghill Hospital. We couldn’t believe it, Muhammad Noor would have his operation much sooner than expected as a beneficiary of the Heart-to-Heart campaign, ” Sana says.

A slight delay

This match donation initiative between Netcare’s CSI arm and Medipost Holdings provided the necessary funding for Muhammad Noor to have his operation. There was, however, an unforeseen delay when the family tested positive for Covid-19 the day before he was first scheduled to be admitted for surgery.

“We had no symptoms at any stage fortunately, but it meant Muhammad Noor’s operation had to be postponed as a precaution. We had to be patient for just a few weeks longer, and thankfully towards the end of August his procedure could go ahead,” his mother remembers.

Life-saving procedure

Cardiothoracic surgeons Dr Schürmann and Dr Hendrick Mamorare of the Maboneng Heart and Lung Institute, paediatric cardiologist Dr Kenny Govandrageloo, anaesthetist Dr Krishnee Naidoo and cardiac perfusionist Mr Mogotsi Mophosho, who all practise at Netcare Sunninghill Hospital, committed their time and expertise pro bono to provide baby Muhammad Noor with the specialised procedure and care. The cost for theatre and his hospital care was covered by Medipost and the Netcare Foundation.

“Thank goodness, the operation went well. He is recovering quickly and was back home after a few days. Muhammad Noor and I had never been apart before, and now that he is home and the hole in his heart has been repaired it is such a relief, I cannot express my gratitude,” says Sana, who lives with her son in Erasmia, Pretoria.

“God sent angels to look after our baby boy. The doctors and nurses both at Steve Biko and Netcare Sunninghill Hospital were wonderful, and it was very reassuring to know he was in such good hands at the hospital. A huge thank you to everyone involved in making this possible for my son and for your kindness. Everyone will always be in our prayers.”

A chance at life

“Coming together to help a child have the chance of a full and normal life is an enormous privilege, and we thank the Netcare Foundation for doubling the reach of this CSI initiative with us to benefit more children,” says Rentia Myburgh, group sales and marketing director of Medipost Holdings, comprising Medipost Pharmacy, MediLogistics, Kawari Wholesaler and Distributor and the Medi Training Academy.

“We are most grateful to the medical team who donated their time and expertise pro bono and the nursing staff who put so much care into their work with little patients,” says Mande Toubkin, general manager emergency, trauma, transplant and CSI at Netcare, and a trustee of the Netcare Foundation.

“It is deeply rewarding to invest in the future of a child, and there can be no greater return than seeing a family so relieved and the bright eyes of a healthy baby with a whole lifetime of opportunities ahead. Many more children with serious heart defects are in need of similar operations, and it is only through working together to find solutions that we can reach more children in time,” she concludes.

For more information about the Maboneng Foundation, which coordinates sponsorship of the procedures, or to make a donation please visit http://www.mabonengfoundation.co.za

Proactive healthcare behaviour can save women’s lives

Fri, 10 Sep 2021 09:26:27 GMT

High prevalence of cervical cancer can be curbed

Healthcare professionals are cautioning South African women not to skip their regular check-ups in light of the ongoing pandemic. While many are postponing a visit to their doctor for anything that is not immediately uncomfortable or noticeably concerning, the risk of undiagnosed illness increases.

This is according to Dr Emmanuel Majachani, a specialist gynaecologist practising at Netcare Sunninghill Hospital, who notes that by skipping regular screenings women are in fact putting their health at risk, particularly when it comes to highly prevalent and serious illnesses, such as cervical cancer.

“Cervical cancer is the second most common type of cancer and the leading cause of cancer related death in South African women. However, it need not be a death sentence, as it is highly treatable if detected in its early stages through a simple pap smear. The lack of regular screening is what has caused this terrible statistic to become an avoidable reality for so many women out there.

“Furthermore, cervical cancer can largely be prevented by having the HPV vaccine earlier on in life. We are well equipped to not only treat but also to avert this devastating illness, however we need proactive thinking and behaviour to do so,” he says.

HPV a clear cause

Dr Majachani points out that while it is not always known what leads to cancer, when it comes to cancer of the cervix – the passage to the womb – the human papillomavirus (HPV) is the primary cause.

The Cancer Association of South Africa (CANSA) sites high risk strains of HPV as causing up to 70% of cervical cancers, while early diagnosis and treatment of pre-cancerous lesions prevent up to 80% of cervical cancers in high resource countries, where regular cervical cancer screening is routine.

“HPV is a very common virus that most people will come into contact with in the course of their lives. Certain strains of HPV are transmitted sexually, and some of these present a particularly high risk for cervical cancer. In South Africa, types 16 and 18 are particularly dangerous.

“Unfortunately, women with HPV who do not go for a regular pap smear would not know that they have the virus unless they develop a secondary condition, such as genital warts. These warts can occur externally, in which case you would notice them, but they can also occur internally. Treatment may require surgery, depending on the size of the warts, but topical creams or gels containing immune modulators help your immune system to fight the virus in that area and will treat the warts effectively.

“Perhaps more importantly however, is that once you know you have HPV it becomes much easier to manage the risk. Women with high risk strains of HPV should go for a pap smear every year. All other women should start having pap smears at the age of 18 and should go every one to three years, depending on the advice of their healthcare practitioner. Pap smears involve taking a sample of cervical cells and are quick to do but may be a bit uncomfortable for some women,” he says.

HPV vaccination an important form of protection

Further to regular screening, vaccination provides significant protection against HPV and therefore protection against cervical cancer, notes Dr Majachani. He says that the HPV vaccine can be given between 10 and 26 years of age, and preferably to young women who are not yet sexually active, as it is then most effective.

“Young women who are sexually active can still receive the vaccine, however, and if the results of a pap smear indicate that a woman within these age groups has abnormal cells, we can remove them and there is still a benefit of receiving the vaccine at that point. For women who are older than 26, the benefit is minimal and the vaccine is therefore not recommended beyond this point.

“Other forms of protection against sexually transmitted HPV include using a condom, as the virus is transmitted

through genital contact,” he says.

Encouraging communities to vaccinate young girls

While conversations around sexually transmitted diseases remain a sensitive subject for many, parents of young girls can be reassured that allowing their daughters to receive this potentially life-saving vaccine at a younger age before they are sexually active is a highly responsible decision, in Dr Majachani’s view. Furthermore, the HPV vaccine can simply be administered at a local pharmacy.

“As a gynaecologist and obstetrician, I know all too well the devastating effects that cervical cancer can have in a woman’s life, and just how tragic it is when it has been caused by a common virus that is so easy to protect against. So important is this healthcare intervention that the Department of Health’s HPV School Vaccination Programme has been rolled out nationally to help young girls understand the benefits of the vaccine and to encourage its wide use across our nation’s communities,” he says.

Dr Emmanuel Majachani

Cervical cancer and what it means

“Early stages of cervical cancer will not display any symptoms,” says Dr Majachani. “This is another reason for having a pap smear done regularly, so that any cancerous cells can be detected early and treatment can begin. Those who are in the later stages of the illness may experience abnormal bleeding between periods or changes such as heavier or longer periods, pain or bleeding after sexual intercourse, bleeding after menopause, unusual vaginal discharge and pelvic pain. However, it becomes much more difficult to treat the illness by the time symptoms are apparent.

“The treatment decisions will depend on the stage of the cancer, however all patients can expect to undergo at least some form of surgery to have a biopsy taken. It may then be advisable that a trachelectomy is conducted, whereby cancerous tissue is removed by amputating the cervix. This procedure is normally done to preserve fertility in cervical cancer patients. Alternatively, a hysterectomy may be performed and the total removal of the uterus will take place. Chemotherapy and radiation are the other methods of treatment that may be included in later stages of the illness.”

Dr Majachani notes that aside from having HPV, being HIV positive can put women at a higher risk of developing cervical cancer, as can poor lifestyle choices, such as obesity, lack of physical activity, excessive alcohol intake and an unhealthy diet.

“While cancer treatment has advanced dramatically it is simply not worth taking the risk of skipping routine screenings or of avoiding the HPV vaccine in younger years. We as healthcare professionals wish nothing more than to see our patients take charge of their health and make it a priority so that unnecessary tragedy can be avoided,” he concludes.

Don’t gamble on your odds of surviving the pandemic, clinical expert warns

Wed, 08 Sep 2021 06:58:53 GMT

What over-18s can expect after their C19 shot

All over-18s, representing some two-thirds of the population, are now eligible for the Covid-19 vaccine. As SA’s levels of Covid-19 protection get a major shot in the arm with millennial vaccinations, a clinical pharmacologist explains how vaccination reduces clinical risk and what young people can expect.

“The opening of vaccination to young people is really significant for our country, and a major milestone towards greater protection from Covid-19 for all,” says Dr Jacques Snyman, clinical risk expert and medical advisor to Health Squared Medical Scheme.

“Anyone who may be worried about getting the Covid-19 vaccine should be aware that the risks of not being vaccinated completely outweigh any other concerns, as the numbers demonstrate. Mild side effects may be experienced after the vaccine and are no cause for concern when you know what to expect.

He points out that vaccines, irrespective of the type, stimulate the immune system to recognise a foreign pathogen such as a virus. This reaction elicits the release of cell mediators, which are responsible for the flu-like symptoms or injection site tenderness some of us experience after a vaccine.

Risk of Covid-19 death in numbers

“To illustrate the dangers of not being vaccinated, it has been estimated that your odds of being struck by lightning in South Africa is approximately 1 in 350 000. Whereas, in a largely-unvaccinated population of 60.1 million people with over 81 595 recorded confirmed Covid-19 deaths since the start of the pandemic, the odds of dying from Covid-19 over this time can be conservatively estimated at 1 in 736,” he says.

The South African Medical Research Council [SAMRC] has been tracking excess deaths since the beginning of May 2020 for all causes of mortality, which include deaths both directly and indirectly related to the pandemic and appears to correlate with the waves of Covid-19 infection the country has experienced.

“The total number of deaths from all causes SAMRC recorded over this time is 986 248, and compared to pre-pandemic years this amounts to some 244 846 excess deaths so far. Therefore, of all deaths since the start of the pandemic in SA, one in 12 deaths was due to Covid-19 with laboratory confirmation. The excess deaths suggest that as many as one in four deaths could be, either directly or indirectly be ascribed, as a result of the Covid-19 pandemic.

“These numbers illustrate the statistically significant dangers of not being vaccinated. Don’t gamble with your life, overwhelming evidence shows that vaccines hugely reduce clinical risk and are the best protection we have against Covid-19. I really encourage everyone to register and have their vaccines as soon as possible,” Dr Snyman says.

The lessons from other almost fully vaccinated countries such as the UK, illustrate to us that the infection can still spread, but that the chance of hospitalisation and death is now significantly reduced allowing a move back to some normality.

How the Covid-19 vaccine builds protection

“It is most important to understand that the Covid-19 vaccine does not contain the live virus and it cannot cause you to fall ill with Covid-19. Rather, there is a tiny fragment of protein or RNA, depending on the vaccine manufacturer, in the vaccine which teaches your body how to identify and build resistance to Covid-19 so that your immune system will be ready to recognise and fight off infection in future,” Dr Snyman explains.

“If a vaccinated person encounters the real virus, their body is able to generate what is known as ‘an adaptive immune response’. As part of this response, the immune system’s special ‘memory’ cells recognise the virus as a threat and activate other cells to either attack the virus directly or secrete antibodies to neutralise the virus.”

When pathogens enter the body, the immune system triggers an inflammatory response as your body’s defence mechanisms kick in, to ward off these pathogens. Sometimes when people are vaccinated, including for the COVID-19 or influenza vaccines, they may experience this inflammatory response, especially in the arm where they received the injection.

The body is learning to identify and build resistance to these presented antigens, or foreign matter from the pathogen, in the vaccine so that the immune system will be ready to recognise and fight off infection associated with that antigen in future. Many people do not experience any symptoms and still produce good antibodies to protect them against Covid-19 infection.

Mild side effects are common

“It is normal to have some mild side effects such as pain in the arm, ‘feeling off’ and slight fever as part of an inflammatory response, which are usually manageable and can often be treated with paracetamol at home. Seek medical attention if you experience severe fever and chills similar to the symptoms of an infection, or if you feel pain in body areas such as your legs, which in very rare cases could indicate clotting abnormalities,” Dr Snyman says.

In addition to the government’s toll-free Covid-19 hotline (0800 029 999), contact your doctor or clinic to discuss any symptoms of concern. Health Squared members have generous access to General Practitioner consultations, either in person or telehealth appointments, through an extensive national primary healthcare network. In addition, members have access to a dedicated telephonic health advice line to speak with a registered nurse.

Precautions still necessary

“It is very important to remember that anyone can transmit Covid-19, whether or not they have been vaccinated. It therefore remains crucial for everyone to continue to take personal responsibility in their actions to help prevent the spread of the virus, irrespective of their vaccination status,” Dr Snyman says.

“While vaccines provide an excellent measure of protection against severe illness for vaccinated individuals, they can still become ill with Covid-19 and can transmit the virus to other people. Daily screening, wearing masks, social distancing, regular sanitising of hands and surfaces, and good ventilation, as well as self-isolation and testing, in line with the recommended guidelines will need to remain in place for the foreseeable future,” Dr Snyman concludes.

Dr Jacques Snyman

Coping with the cares of an unwell child

Thu, 02 Sep 2021 06:34:47 GMT

How families can stay strong and support a child with a long-term medical condition

Cancer, heart disease or a debilitating injury do not usually feature in the world of playdates, sports days and bedtime stories – the world of children. Yet for some parents, having to face a long-term medical condition that threatens the wellbeing of their child, and finding a way to cope, is a difficult reality.

Dr Terri Henderson, a child psychiatrist practising at Netcare Akeso Kenilworth says that knowledge and communication are essential components in such a family’s mental health toolkit. “As a parent, your greatest concern is the health and safety of your child. Finding out that this precious life – which you treasure above your own – is at risk, brings on a range of emotions that are quite normal under such distressing circumstances.”

Expect a tidal wave of emotion

“The primary, most dominant emotion is shock. There is also going to be confusion and trying to make sense of why this has happened to your child. Naturally there will be a period of anger too, as all your expectations for your family’s future have now been turned upside down,” explains Dr Henderson.

“Eventually there will be a certain amount of acceptance as the family tries to adapt, although ongoing distress is to be expected. Dramatic changes to daily family life may include the need for one parent to stay with the child whilst the child is receiving treatment in hospital, or to care for the child at home, for example. Difficult medical decisions may need to be made and the financial implications of the situation can be a major additional stressor.”

Exercise your right to know

The severity of the emotional experience will depend heavily on the communication, support and explanations provided by the treating medical team, says Dr Henderson. “Knowledge is power. Having a good understanding of the full picture about your child’s condition, treatment options and prognosis is essential and you have a right to ask the medical team treating your child for information.”

Dimakatso Motiang-Ngoveni, a clinical psychologist at Netcare Akeso Arcadia, points out that further to this, parents and guardians need to know they are in fact part of the team providing medical care to their child, as their presence and support are critical for the wellbeing of the child. “It is important for parents to engage the healthcare professionals in communicating to their child when procedures are being done, for example, and to allow room for the child to ask questions too.

Talking with your child and his or her siblings

“When discussing the situation with your child and his or her siblings, there are many aspects that need to be considered and which may not seem obvious. It is common for children in this situation to feel anger and resentment towards others or themselves. They may also fear having brought their condition about by something they did or said. It is therefore important to reassure children from the outset that they are not responsible,” says Motiang-Ngoveni.

Dr Henderson notes that the child’s reaction to the situation will depend entirely on what they are told and how it is communicated to them. “Without any communication, they are likely to feel overwhelmed and afraid and may be wondering if they will ever recover, ever get to go home and be with their family again. They might be fearful of medical procedures and going to hospital, and they may become quiet and reserved. They may also feel lonely.

“If the child has siblings, they too will be experiencing unsettling emotions and may be wondering if they might also get sick or if their brother or sister and parent staying at the hospital will ever come back. They will also have practical concerns, such as ‘Who is going to make my lunch?’, for example.

“In communicating with the child and siblings, it can be beneficial for parents or guardians to jot down some notes in advance. A simple, clear and age-appropriate explanation is what is required at this stage. Reassurance throughout conversations is important, letting your child and his or her siblings know that the doctors are doing everything they can and that while it may be a difficult time ahead, mom and dad are here,” she says.

The specialists advise that it is important to let the affected child and siblings know what changes may be taking place in their family life so they know what to expect, and that keeping them abreast of any updates and regularly reminding them that they can ask questions also helps them to feel included and considered.

Maintaining a sense of normality

“Keeping things normal as far as possible provides some stability for the family. If a child with a serious medical condition is realistically able to participate in family events and outings, then the whole family should be together on such occasions. To break the family down into separate units is not a recipe for success, as the child in question will then end up feeling as though they are the cause of separation,” says Dr Henderson.

“If a child is unable to walk, for example, then the family should go for a drive in the car together on a regular basis, and family game nights at home can also be a good way to ensure that there is family time in the mix, amongst everyone’s individual lives.”

It’s ok not to be ok

“Most parents in this situation will feel a sense of guilt or shame and wonder what they could have done differently to have prevented their child’s medical condition or injuries caused by, for example, a bicycle or motor accident,” explains Motiang-Ngoveni. “Therapy is an important part of addressing those issues, getting parents to open up and to begin working through their emotions.”

Dr Henderson adds that some parents or guardians believe that by hiding their own vulnerability, they will be better able to address the needs of the family, but that this is not the correct approach. “As a parent, being able to acknowledge your own vulnerabilities, feelings and fears, is very important. No parent can go through such a major disruption without being personally affected, and those who are not communicative will struggle to support each other, and to be genuinely caring and responsive to their children.

“All families going through this type of experience need to have counselling, and parents should attend couples counselling as well. People are all individuals and have different ways of coping. Even healthy children can get depressed, and studies show that those with a long-term illness are more likely to become depressed. These are all perfectly normal responses to a very difficult situation and it is not only ok, but in fact important to express that.

Support systems

“Joining a support group for the particular condition that a child has is highly beneficial, as this helps to make the parents or guardians feel connected to others who know best what they are going through. There may be additional social worker support offered by the facility, of which the family should most certainly avail themselves.

“The best way for friends and family to be supportive is to be available and present with a hands-on approach, such as grocery shopping, doing a load of washing or preparing a meal. When the unwell child is home, family gatherings should take place around the child as far as possible, so that they feel included.

“It is ok for friends and family to express their sadness at the situation but then presenting a solution to a particular problem is what is truly helpful. For example, allowing the parents or guardians some time together by offering to stay with the child or to take the child for an outing,” notes Dr Henderson.

Motiang-Ngoveni adds that the unwell child should be spoken to and treated normally by family and friends, as any special treatment can damage their self-esteem, and more normal interactions can help them to feel more capable.

Cultural interpretations

“While long-term medical conditions may be assessed in a Western medicine context in South Africa, it is important for healthcare professionals, friends and family members to be sensitive to any cultural interpretations of a condition. It is therefore important that medical teams ask how a family interprets what has happened,” says Dr Henderson.

“Western and cultural medical interpretations are not mutually exclusive. In some cases, a family may choose to pursue a traditional healing approach but treating teams should make it clear to them that they are welcome to seek medical treatment, should they wish to, which they often do,” she concludes.

Women’s health issues on the medical scheme agenda

Thu, 26 Aug 2021 07:03:17 GMT

Women: Back yourself and take control

Bearing the brunt of increased responsibilities at home alongside growing workplace pressures due to repeated lockdowns has placed the economic progress of women under threat.

Against this background, having a wellness check may seem like a luxury for some. However, according to Dr Simangele Nkosi, general practitioner and trustee of CompCare Medical Scheme, it is now more important than ever for women to assert their power over their health.

“Women’s health issues take an alarmingly prominent seat amongst some of the most serious medical conditions in South Africa. According to the World Health Organization (WHO), the two most prevalent cancers in the country occur in women, with breast cancer as the number one cancer affecting 13.2% of South African women and cervical cancer following closely at 12.1%.

“Furthermore, the WHO sites cardiovascular disease as the leading cause of death in women globally. So often these conditions can be prevented or successfully treated if detected early on,” she says.

Dr Nkosi notes that women find themselves experiencing additional strain on an ongoing basis with the majority of household duties and caregiving falling to female partners and mothers who, in addition, also manage workplace demands. The economic fallout from the pandemic may also mean that many women are more vulnerable to retrenchments and demotions due to increased commitments at home.

Dr Simangele Nkosi, general practitioner and trustee of CompCare Medical Scheme

Leveraging preventative and wellness benefits

“As a woman and a medical doctor, I am all too aware of the dangers facing those who have put their own health near the bottom of the priority pile. Prevention is unquestionably better than cure and belonging to a medical scheme that offers a comprehensive bouquet of routine health benefits is a good start.

“An essential component for women’s health includes taking care of reproductive health including contraception and that all-important annual pap smear, as well as access to the HPV vaccine, which is key in helping to prevent cervical cancer. Better still if members don’t have to dip into their savings to fund this and other preventative treatments.

“Further to this, scheduling annual health check-ups and maintaining a balanced lifestyle is directly linked to reducing the chances of developing preventable lifestyle diseases like hypertension and diabetes. Access to a fitness and nutritional programme with an assessment from a biokineticist and registered dietitian supports healthy choices.

“Looking after your body can go a long way towards helping you to manage increased stress levels. However, for those who are taking strain, a psychosocial counselling benefit can be a lifesaver. All the better if this benefit can be paid from risk, so members are never left out in the cold when it comes to their mental wellbeing,” she says.

Good family health benefits essential for mothers

Dr Nkosi points out that women who are pregnant or who have children rely heavily on maternity and family healthcare benefits, with excellent kids benefits that offer value over and above standard baby wellness and childhood immunisations, being particularly helpful.

“Mothers know all too well that the active pursuits of their children can result in the need for an additional emergency room visit, while unlimited GP visits for kids under the age of six are most beneficial in those immunity-building years. An added bonus is to have the option of an occupational therapy assessment, exercise prescription programme and healthy eating plan, so that women with children do not have to feel as if it all rests on their shoulders,” she says.

“And while none of us would ever wish to imagine receiving a positive cancer diagnosis, there is great peace of mind in knowing that you have access to an unlimited cancer care benefit should you ever find yourself in that unfortunate position.”

Financial fitness for the female decision-maker

Dr Nkosi makes the observation that as decision-makers and often as breadwinners, women are increasingly conscious of the need for financial wellness as part of the overall health of the household in this strained economic climate.

“A scheme offering a wide range of benefit options provides a solid base for the decision-maker so that healthcare needs can continue to be met without sacrificing financial wellbeing.

“However, this is not enough. A thorough review of a medical scheme should reveal a stable solvency ratio and while South African medical schemes are only required to maintain a solvency ratio of 25%, a higher percentage translates to lower annual increases and contribution rates, an excellent indicator of value for money.

“Ultimately, women are well practised when it comes to facing challenges head on but when it comes to our health, it’s good to know we have someone in our corner to back us up,” she concludes.

Fibromyalgia – misunderstood and medically ill-defined

Tue, 24 Aug 2021 14:02:07 GMT

63%[i] of patients with fibromyalgia suffer from mood, sleep and cognitive disorders, and depression

Fibromyalgia is a widely misunderstood condition, causing chronic pain and fatigue, impacting sufferers’ mental health, ability to work and quality of life – and predominantly affecting women, 6 to 9 times more than men. [ii]

It is a condition considered “medically ill-defined”[iii] and confirming a diagnosis can take up to up to five years[iv] of eliminating other possible causes while battling stigma and scepticism, causing severe mental strain and a significant financial burden even for patients with medical aid cover.

With health in focus in Women’s Month of August, specialist neuropsychiatrist and member of the South African Society of Psychiatrists (SASOP), Dr Anersha Pillay said that a growing understanding and recognition of fibromyalgia as a genuine disorder, and not something “all in the mind” as it was seen in the past, had led to a range of treatments that are credible, scientifically evaluated and making a real difference in sufferers being able to live more normal lives.

There are medications to assist with the most common symptoms of severe pain and sleep difficulties, whilst cognitive behaviour therapy (CBT) has been shown to be effective in managing the psychological aspects of fibromyalgia. In addition, exercise, relaxation and stress-reduction techniques have been proven beneficial for pain management, improved sleep and overall wellbeing, she said.

Dr Pillay, said that fibromyalgia affects 2 to 5% of the population1 globally, and an estimated 3% in South Africa,[v] causing chronic pain that mainly affects the musculoskeletal system (muscles, bones and joints).

Along with widespread pain, the most common symptoms of fibromyalgia are muscle tenderness and stiffness, sleep disturbances, fatigue, mood and depressive symptoms, and cognitive problems often referred to as “fibro fog” – difficulties with memory, focus, attention, concentration and slowed thinking.

Sexual dysfunction and other physical symptoms such as migraines, headaches, irritable bowel or bladder, and a painful jaw are also seen in fibromyalgia.

“With its combined physical and cognitive impact, together with challenges to executive functioning such as the ability to plan, organise and complete tasks, fibromyalgia can have a severe impact on a person’s ability to perform optimally at work, leading to absenteeism and even physical impairment and disability. “These symptoms also impact on the sufferer’s social functioning and interpersonal relationships, due to depressive symptoms and difficulty regulating emotions and moods, as well as their feeling of being isolated by their illness and the lack of people’s understanding of their condition.

“Altogether, fibromyalgia can have a profound impact on a sufferer’s life,” Dr Pillay said.

The prevalence of psychiatric symptoms in up to 63%[vi] of patients with fibromyalgia, consisting of mainly mood, sleep and cognitive disorders, with depression the most common, means that the condition is often best managed by a multi-disciplinary team involving psychiatrists and psychologists working alongside general practitioners, specialists in rheumatology and pain management as well as other disciplines such as occupational therapists, physiotherapists and biokineticists.

The understanding of fibromyalgia has evolved over the past few decades and the roots of the condition are now seen in neurochemical imbalances in the central nervous system that cause the “volume control setting” for pain to act abnormally thereby amplifying/increasing the perceptions and experiences of pain.

“In essence, this ‘volume control setting’ for pain is abnormally high, resulting in the body experiencing pain more severely and at the same time being unable to access the central nervous system’s usual mechanisms to naturally reduce or inhibit the experience of pain,” Dr Pillay said.

The condition can be genetically-linked and can arise at anything from 30 to 60 years of age, although it can also have an onset in childhood; and can exist together with other rheumatological disorders including rheumatoid arthritis, lupus and Sjögren’s syndrome.

Fibromyalgia symptoms are often also triggered or worsened by recent physical trauma, infections, major adverse life events and psychological stress. Dr Pillay said that the difficulty and delays in diagnosing fibromyalgia are partly because there are no objective diagnostic tests for the condition. The diagnosis is thus made by a process of elimination of other causes of pain and use of the American College of Rheumatology guidelines for assessment of the extent of pain, severity of symptoms and impact on functioning.

In terms of treatment, she said that the European League Against Rheumatism (EULAR) recommended that any treatment should take into account the availability, cost and safety to the patient, and be tailored to the individual’s needs.

Treatments scientifically evaluated and recommended by EULAR include:

Physical exercise , which is easily available, cost-effective and beneficial for pain management, physical functioning and overall well-being. This could involve aerobic or strengthening types of exercise.
Other therapies including meditative movement therapies , mindfulness-based stress reduction, acupuncture and hydrotherapy have showed varying benefits for improved sleep, fatigue, pain and quality of life.
Psychotherapy is considered the most beneficial for fibromyalgia patients who experience mood, depression and anxiety difficulties, and who struggle with healthy coping mechanisms for the condition. Cognitive Behaviour Therapy (CBT) has been assessed as effective in producing a reduction in pain, disability and improving mood.
Medication: A number of medications are recommended for severe pain, poor sleep and comorbid psychiatric disorders such as depression and anxiety. Fibromyalgia sufferers should contact their general practitioner or psychiatrist for a prescription for the most appropriate medication.
Multimodal rehabilitation , combining selected therapies, is recommended for fibromyalgia patients with severe disability, and has been shown to result in improvement.

Dr Pillay said that common over-the-counter pain- and fever-relieving drugs (non-steroidal anti-inflammatories, or NSAIDs), anti-depressants in the SSRI and MAOI categories, as well as growth hormones, strong opioids, sodium oxybate and corticosteroids were not recommended for treatment of fibromyalgia, due to lack of efficacy and a strong risk of adverse side-effects.

She said that prompt diagnosis and patient education on the nature of their condition and how to manage it across the dimensions of pain, work and social functioning, and psychological impact, would be key to helping a fibromyalgia sufferer cope with their condition and achieve optimal quality of life.

Resources for support and patient information for fibromyalgia patients:

Fibromyalgia Support Group South Africa: http://www.fibromyalgiasa.co.za/index.php?page=support

SADAG – The South African Depression and Anxiety Group: www.sadag.org

My Fibro Team (connect with other fibromyalgia patients worldwide): www.myfibroteam.com/

Mayo Clinic: www.mayoclinic.org

US Centres for Disease Control: www.cdc.gov

Healthline: www.healthline.com

REFERENCES

[i] Kleykamp B, et al. 2020. The Prevalence of Psychiatric and Chronic Pain Comorbidities in Fibromyalgia: an ACTTION Systematic Review. Seminars in Arthritis and Rheumatism. https://pubmed.ncbi.nlm.nih.gov/33383293/

[ii] Marques, AP et al. 2017. Prevalence of fibromyalgia: Literature review update. Revista Brasileira de Reumatologia (English edition). https://www.sciencedirect.com/science/article/pii/S2255502117300056?via%3Dihub

[iii] Cooper S, Gilbert L. 2017. An exploratory study of the experience of fibromyalgia diagnosis in South Africa. Health (London). https://pubmed.ncbi.nlm.nih.gov/28521648/

[iv] National Fibromyalgia and Chronic Pain Association (USA). https://fibroandpain.org/diagnosis-2

[v] Lydell C, Meyers OL. 1992. Referenced in Govender, CO. 2007. MA dissertation. University of Pretoria. https://repository.up.ac.za/handle/2263/22974

[vi] Kleykamp B, et al. 2020. The Prevalence of Psychiatric and Chronic Pain Comorbidities in Fibromyalgia: an ACTTION Systematic Review. Seminars in Arthritis and Rheumatism. https://pubmed.ncbi.nlm.nih.gov/33383293/

Electrician’s life recharged in a first for SA

Tue, 17 Aug 2021 09:53:44 GMT

Johan van Wyk recently became the first person in South Africa to have the latest state-of-the-art mechanical heart device implanted at Netcare Christiaan Barnard Memorial Hospital.
He is pictured with his wife, Alicha, and daughter, Dihante.

State-of-the-art heart pump device the final option for young father

Almost 10 years after being diagnosed with heart failure at the age of only 29, qualified electrician Johan van Wyk is regaining strength after becoming the first person in South Africa to have the latest state-of-the-art mechanical heart device implanted in his chest. With no donor heart available for the life-saving transplant he desperately needed, new technology provided the final option for the young father and husband.

“You never know what an asset your health is until you are put in a situation like this,” says Johan, now 38. “It came as a real shock to discover that I had a serious heart problem at such a young age.”

Earlier this year, Johan and his family were devastated when his health suddenly sharply deteriorated, placing his life at major risk and robbing him of all physical energy.

“Johan just could not wait anymore. His heart failure had reached end stage and a suitable donor heart could not be found for a transplant,” says Dr Willie Koen, world renowned cardiac and transplant surgeon and pioneer of ventricular assist device (VAD) implantation in South Africa.

In a first for South Africa at Netcare Christiaan Barnard Memorial Hospital (NCBMH) in Cape Town, Dr Koen assisted by cardiac surgeon Dr Loven Moodley, performed the procedure to insert a tiny device, known as the Abbot HeartMate 3™ LVAD left ventricular assist device, next to Johan’s heart on 18 June.

“The device replaces the function of the failing heart muscle, pumping the blood around the body to provide vital circulation. Previously, VADs have mainly served as a temporary option to keep a patient alive until a heart transplant could be performed. Technological advances in VADs have increased the longevity of these devices, increasingly supporting their use as a potential long-term solution for heart failure,” says Dr Koen, who has been performing VAD implant surgery for some 20 years.

“Finding matching donor hearts has been even more challenging during COVID-19, and with heart transplants there is the additional concern that patients need to be on immunosuppressants and are therefore more vulnerable to developing severe COVID-19 complications. Immunosuppression is not required, however, for implantation of a mechanical heart pump such as this.”

While the LVAD component that pumps the blood is implanted within the patient’s chest, it is connected by a driveline, which protrudes through the abdomen, to a controller and battery pack outside the body. Several charging options and back-up batteries provide power to the Heartmate 3 LVAD device, ensuring that even in the event of loadshedding or power cuts the patient still has plenty of battery life to sustain the device’s operation.

In addition, the device records clinical data that the treating specialist needs for monitoring the patient’s condition remotely.

“My wife and I have had a tough emotional journey, but we believe that the Lord will not put you in a situation that you can’t handle. We take one day at a time and we appreciate every day,” Johan says.

“The thing I have missed the most is spending time in nature. I used to really enjoy hiking, and it was nothing for me to go for a 10km or 15km walk before my heart problem. “In the months before I had this operation, I would become exhausted walking just a few steps. It has been only two months since I had the mechanical heart pump implanted, and already I can walk one or two kilometres, and I am building up slowly as part of my therapy,” Johan says.

“The device is electrical and I can’t get it wet, so I can’t bath or swim, but this is a small compromise that is giving me the chance to have a new life. I have more energy, and I’m starting to notice I can do things again that my body just couldn’t manage previously.”

“Heart failure is a progressive condition, and in Johan’s case it had reached the stage where his life was at considerable risk. Often such patients repeatedly have to keep going back to the intensive care unit because their health is so precarious.

“It was extremely fortunate that this new generation Heartmate 3 LVAD was available when Johan needed it, and there is every hope that this young man will have a good quality of life again and many more years with his family, even if a donor heart does not become available for him,” Dr Koen says.

When a former patient who had an early version of a VAD known as a Berlin Heart fitted when his heart failed some 18 years ago, it was considerably bulkier and remained outside his body. When the patient died of cancer recently, his family expressed their gratitude for the many extra years the device afforded them with their loved one.

“This field of electromechanical cardiac assistance is advancing all the time. Moving to this latest technology as a long-term option makes it possible for patients with heart failure to regain their mobility and independence, to return to work and participate in family activities once more – potentially for decades or long enough for a patient who has a young child to see their grandchildren take their first steps,” Dr Koen says.

“We are already working towards future developments and soon it may become possible for VAD devices to be entirely implantable, including all the necessary components and batteries that can be wirelessly recharged.”

“Dr Willie Koen and the multi-disciplinary team have introduced yet another pioneering treatment. Procedures such as this one demonstrate the living legacy of Professor Christiaan Barnard in a time of rapid technological progress, and on behalf of all of us at Netcare Christiaan Barnard Memorial Hospital, we wish Mr Van Wyk every strength for his continued recovery,” concludes Dr Louis van der Hoven, general manager of the hospital.

Cochlear implant procedure now available at Netcare Kuils River Hospital

Thu, 12 Aug 2021 06:00:02 GMT

Patient’s hearing successfully restored, more to follow soon

One of the five senses, hearing, allows us to listen to a favourite piece of music, become alerted to a ringing doorbell or hear another’s voice. Life without this sense can be productive and rich, however, there is a procedure – cochlear implant surgery – that can for many restore sound and enhance their quality of life.

Nowadays considered a fairly routine procedure, cochlear implant surgery is nevertheless complex and is becoming increasingly sophisticated. It is consequently offered only at some healthcare facilities and has recently become available to patients at Netcare Kuils River Hospital. Pieter Botha, a patient who underwent the second cochlear implant surgery at the hospital earlier this year, has found his post-operative experience of the world to be “truly remarkable”.

Performed by Dr Jaco Terblanche, an ear, nose and throat (ENT) specialist practising at the hospital, Botha underwent the operation following a serious vehicle collision in February 2020 in which he sustained severe injuries. “The accident left me with broken ribs, a broken clavicle, injured spine and head injuries that impacted my left ear. I was in the intensive care unit for eight and a half weeks and over time completely lost the hearing in my left ear, which previously had functioned completely normally.

“Dr Terblanche suggested performing the cochlear implant surgery at the time, however I had endured so much trauma from the accident and undergone so many operations and at that point, I was very hesitant about any further procedures. I tried for a year to live without hearing in my left ear but eventually I decided to proceed with the surgery. Knowing what I know now, I would never have hesitated,” says Botha.

According to Dr Terblanche, Botha was a good candidate to receive the implant, as while his cochlea had been damaged, the nerve was still intact.

A cochlear implant is a small electronic device, which helps deaf or severely hard of hearing people to recognise sounds. The device has an external component, which is usually positioned behind the ear, and an internal component that is surgically implanted into the ear. The external sound processor captures the sound before filtering and processing it and turning it into digital code. The internal implant converts the digital code into electrical impulses and sends these to an electrode array in the cochlea or inner ear. These electrodes stimulate the cochlea’s hearing nerve and send impulses to the brain where they are interpreted as sound.

“This procedure does involve some fairly detailed surgical work, as you are operating between tiny facial nerves,” says Dr Terblanche. “I am fortunate to be able to work alongside Dr Louis Hofmeyr, an ENT surgeon specialising in neurotology and otology at Netcare Christiaan Barnard Memorial Hospital.

“Dr Hofmeyr is one of the most practised specialists in South Africa when it comes to cochlear implantation, so he brings further expertise to our theatre for these procedures. It takes around three hours to complete the surgery and requires the patient to have follow-up mapping with an audiologist who makes adjustments to the implant device to get the levels right,” notes Dr Terblanche.

Botha explains that his implant is still being fine-tuned but that his hearing in the affected ear is already significantly improved and that he can take phone calls and attend virtual meetings. “The device is really very advanced and has Bluetooth capabilities, so I can not only control the volume of the device directly from my phone but am able to take calls and tune in to online meetings with the implant directly,” he says.

Cochlear implant technology has evolved significantly over time and is now at a super-sophisticated level, according to Dr Terblanche. “These implants began with just one electrode and over the past few decades have been developed to now include 14 electrodes, providing an incredibly wide range of frequencies and a much broader capability for distinguishing sounds. It is a technology that continues to be developed, and ENT specialists performing these implants are now able to take an individualised approach for each patient.

Since the first two implants at Netcare Kuils River Hospital, we now have a further four patients being assessed for cochlear implantation and we look forward to being able to make a difference in the life of many more people in the months and years to come,” says Dr Terblanche.

Dirk Truter, general manager at Netcare Kuilsriver Hospital, notes that this development will have a positive impact on people in the area seeking cochlear implantation. “It is our aim and our greatest wish to serve the communities in the vicinity of our hospital. Cochlear implants can benefit the lives of so many, from small children through to mature adults, and we are very pleased that this procedure is now available at our hospital,” concludes Truter.

Having hip replacement surgery? You could touch a life

Tue, 10 Aug 2021 18:03:45 GMT

Pieces of donated bone are converted for use in bone cancer treatment, corrective surgery, spinal fusions and tooth implants.

Netcare encourages South Africans to donate femoral heads

Hip replacement surgery, while a major operation, has become routine with 200 to 300 procedures taking place monthly in South Africa. Yet hip replacement patients are often unaware of the opportunity for them to make a difference in the life of another by donating their femoral head, at no risk or cost to them.

This is according to Reka Dulandas, regional transplant manager for Netcare hospitals’ coastal region. Dulandas explains that the femoral head is the uppermost part of the femur, or thigh bone, which if not donated is discarded as medical waste. “More than 90% of femoral heads in South Africa are unnecessarily discarded, which is most unfortunate. Like organs and other types of human tissue, donated bone can help to ease suffering and significantly improve the quality of life for someone in need.

“Bone can be converted for use in bone cancer treatment, corrective surgery, spinal fusions and tooth implants. Usable donated bone is processed into bone cement, chips and matchsticks, which are used as a framework for the recipient’s bone to grow into, modify and make its own,” she says. “The femoral head donation programme is carried out by Bone SA, a non-profit organisation, under the auspices of Netcare’s transplant division in the

Group’s hospitals nationally. According to Bone SA, bone is the most frequently transplanted human tissue after blood,” explains Dulandas.

The very first femoral head donation in a Netcare hospital in KwaZulu-Natal was made by Netcare St Augustine’s Hospital’s very own human resources manager, Uday Valjee when he underwent hip replacement surgery. “I had been experiencing terrible pain in December 2020 and was soon after diagnosed with avascular necrosis in both hips, a condition in which blood supply to the bone is temporarily or permanently interrupted, eventually causing it to collapse. This meant I needed to have bilateral hip replacement surgery,” says Valjee.

Valjee’s first hip replacement operation took place at Netcare Umhlanga Hospital in April 2021, where his first femoral head was procured for donation.

“The process was simple. A facilitator from Bone SA met me at my place of work to sign consent for the donation and for bloods to be drawn for virology testing. As a donor, there were no risks to me as my femoral head was being removed in any case, nor did it cost me anything. In theatre the femoral head was removed and from there it was taken by Bone SA to a laboratory together with blood samples to ensure there were no infections. That was it from me, nothing more was required,” says Valjee.

“Making the decision to donate was an easy one. I drew inspiration from my late father-in-law, who – before passing on – told me that he was an organ donor and that we should ensure his organs would be donated as per his wishes. The femoral head donation programme immediately reminded me of him and I was determined to make a difference in someone's life. This has been such a rewarding personal experience for me knowing that instead of wasting my bone tissue, I was giving back to those in need.”

Dulandas says that three months after his first replacement, Valjee is progressing well and is soon to undergo his second procedure, where he will be donating his second femoral head. “Since commencement of the femoral head recovery programme in KwaZulu-Natal, we have procured eight from Netcare Umhlanga Hospital and 10 from Netcare Alberlito Hospital. We aim to collect many more in conjunction with Bone SA with the help of patients like Uday, as the demand for bone product currently far outweighs the supply,” she says.

Mande Toubkin, general manager: emergency, trauma, transplant and corporate social investment, notes that the Netcare transplant division supports tissue banks responsible for skin, bone and corneal harvests and is responsible for the coordination of kidney, heart, liver and lung harvesting and transplants in Netcare hospitals nationally.

“Our internationally recognised transplant programme aims to increase the lifespan of patients and improve their quality of life. We are thankful for every person who assists us in making this possible with their generous donations and encourage others to do the same. Their generosity may very well be saving a life,” she concludes.

“Don’t worry, Mommy, I’m fine…”

Wed, 04 Aug 2021 08:48:31 GMT

After just over 100 days in the neonatal intensive care unit at Netcare Blaauwberg Hospital, Baby Ephraim Maleho is now thriving at home with his family: (left to right) big brother Llyle, mother Beneline, and father Melvory holding little Ephraim.

Parents and medical team refuse to give up on Baby Ephraim

Born with his intestines and half his liver protruding from his body in a translucent ‘bubble’, few could have imagined that baby Ephraim Maleho could survive – but his parents and medical team at Netcare Blaauwberg Hospital refused to give up on him. After some three months of painstaking, advanced neonatal intensive care, including an ingenious technique involving the use of amniotic tissue saved from his birth, the baby boy is now thriving at home with his family.

‘How can our child live?’

“At the 13-week ultrasound scan of my pregnancy, the doctor picked up something unusual about the baby. We found out that some of his internal organs were developing outside his body, a condition known as exomphalos,” says Ephraim’s mother, Beneline Maleho.

“We wondered, how can our child live? Ephraim’s father and I knew there is something special about this child, and even though there were major risks, we would stop at nothing to give him the chance to live. I thanked God every day when I opened my eyes and I felt the baby kicking. It was like he was saying, ‘Don’t worry, Mommy, I’m fine’.”

“Ephraim’s birth was powerfully emotional,” Ephraim’s father, Melvory van Wyk, recalls. “We were so relieved that he had survived, but the neonatal intensive care team needed to stabilise him and he was immediately taken to the neonatal intensive care unit [NICU] so we were very worried, and we knew it was the start of a long journey. Beneline told me she was okay, and that I should follow the medical team to be with our son.”

Exomphalos is a defect in the central abdomen, resulting in a sealed sack outside the body containing some of the abdominal organs, resembling a bubble with the organs clearly visible. “What made Ephraim’s lesion particularly unusual was not only its size, but the fact that not only the small and large intestines but also half of his liver were protruding through his abdominal wall within this translucent bubble, redefining this lesion as a hepato-omphalocele,” explains Dr Ricky Dippenaar, principal neonatologist practising at Netcare Blaauwberg Hospital.

“Our biggest challenge was that as a result of all of those contents being outside his body, his abdominal cavity had not developed. His intestines and organs could not simply be moved into the position they would usually be in, we needed time for the skin to grow to make enough space in his tummy.”

So began a long and extremely delicate process during which Ephraim was kept in a carefully controlled environment within the NICU to protect the thin membrane forming the bubble around his organs and to prevent infection. “Crucial to the process was maintaining this membrane, which was completely transparent initially, as it matured and gradually contracted,” Dr Dippenaar explains.

Amniotic tissue: natural healing power from mother

During this process, the membrane started to break down in two areas, putting Ephraim at risk for life-threatening septic complications. This is where the amniotic sac, which Dr Dippenaar had carefully preserved at Ephraim’s birth, became a crucial part of his highly specialised treatment. The amniotic sac is a clear tough membrane formed inside the mother’s uterus to encapsulate the growing unborn baby and amniotic fluid.

“Dr Dippenaar must be applauded for anticipating the need to preserve the amniotic tissue at the time of the caesarean section, as this extra tissue containing stem cells undoubtedly saved little Ephraim,” says Dr Beelke D’hondt, a paediatric surgeon and member of the dedicated NICU team at Netcare Blaauwberg Hospital who had been caring for Ephraim since his birth.

“This amniotic ‘sheet’ was used by Dr Dippenaar and I on two occasions where any other treatment modality would have proven to be insufficient to prevent infection and buy time to let the abdominal cavity grow and the skin to creep over the ventral abdominal defect.

“Ephraim’s case was very challenging but his progress has been remarkable, and the classical treatment modalities would most likely not have allowed us to achieve such good results. This is a new advance in treatment modalities, supporting the feasibility of amniotic tissue for specialised neonatal grafting in circumstances such as this, and might need to be considered as temporary graft in other congenital disorders,” she says.

“It just seemed logical to use the very membrane that protected baby Ephraim inside the womb as a natural barrier. This membrane is known to contain a number of healing cytokines and essential growth factors and help reduce pain. It also has anti-bacterial properties, as well as reducing inflammation and scar tissue,” Dr Dippenaar adds.

Rapid progress and home

“The amniotic tissue incorporated well, reinforcing the bubble of tissue around Ephraim’s organs, which then underwent a transformation and started contracting. Together with the constricting dressing, the bubble reduced dramatically, gently squeezing the organs into his abdomen, and allowing Ephraim’s abdominal cavity to expand,” he says.

After two months, the cavity was large enough to fit all Ephraim’s organs safely inside and the external sac had shrunk to resemble “a tiny rhino horn, tough, firm and providing total protection”. At last, at the optimal point, he was ready for surgery and Dr D’hondt, together with plastic and reconstructive surgeon Dr Alexander Zühlke, performed the intricate procedure to close Ephraim’s abdominal wall, with all his organs in their correct place.

“The surgery was interesting and multifaceted but proved to be very feasible and successful. Ephraim showed us what it is to be a little hero. The anesthesia was led by two experienced pediatric anaesthetists. Thanks to their excellent knowledge and skills and guided by cerebral and renal oximetry, Ephraim remained stable without even a hint of noticeable operative challenge,” Dr D’hondt adds.

“During his time in the NICU, before and after his major surgical intervention, no effort was spared to ensure Ephraim was kept entertained and well stimulated. He was offered an amazing neurodevelopmental path for those crucial first months. The neonatal ICU staff and all the individuals involved in caring for him, not least Dr Dippenaar, are dedicated and allowed Ephraim to have a holistic experience of optimal clinical and psychological care; they all did an amazing job,” Dr D’hondt says.

Despite experiencing some initial difficulty in feeding, Ephraim was growing and made an excellent recovery after this surgery, and was soon ready to go home with his family. “We were ecstatic when Ephraim was finally ready to be discharged. The NICU team gave me special training and support so we could be confident caring for him at home, as he needed to be fed through a feeding tube at first,” Beneline says.

“We were all surprised how well he started feeding when he was back home, he gained weight quickly and very soon we no longer needed to feed him with the nasogastric tube. Dr Ricky [Dippenaar] said, ‘You see, that’s the miracle a mother can do’.”

Ephraim’s father expressed the family’s appreciation to Dr Dippenaar, the other specialists and the NICU team, particularly Sr Kelly Delaney, for their efforts in bringing Ephraim safely through his first critical months.

“We thank God for sending these angels to look after our son. They were open about the risks, and supported us to make the necessary decisions for our son informed by the facts. We want other families to know that there are people who understand what it is like to go through a difficult journey like we had with Ephraim, and that there is hope. He is our little miracle warrior,” Melvory concludes.

Tribute to a stalwart of Ga-Rankuwa’s medical community

Fri, 30 Jul 2021 09:24:59 GMT

Paragon of patient centered care, Dr Allan Soundy fondly remembered

The dedication, warmth and professionalism of the late Dr Allan Soundy, a general practitioner and friend to many in Ga-Rankuwa and the wider South African medical community, will be fondly remembered by those who knew him.

“On 21 July, we got the sad news that Allan had passed on. He will be sorely missed by family, friends and colleagues. The community of Ga-Rankuwa have expressed their sorrow at his death – he was a hardworking, caring doctor who was always there for them,” says Dr Peter Makhambeni, chief clinician of the National HealthCare Group network.

Before his time with the National HealthCare GP network, Dr Soundy studied medicine at the Medical University of Southern Africa (MEDUNSA), qualifying in 1985.

“My first contact with Allan was in the 1980s when he came to consult at the Campus Health Service at MEDUNSA, now called the Sefako Makgatho University. I was then the Director of the Campus Health Service and Allan was a second-year medical student. Little did I know then that our paths would cross many times in the years to come,” Dr Makhambeni recalls.

Dr Reinder Nauta, executive chairman of National HealthCare, expressed the Group’s condolences to Dr Soundy’s family and loved ones on their loss. “We offer our deepest sympathies to his family and those closest to him. They are in our thoughts and prayers at this most difficult time.”

“Colleagues and patients alike deeply appreciated and respected Dr Soundy. He will be remembered for his warmth and humour, as well as for his dedication to the health and wellbeing of his patients. He has been described as ‘a classic, caring family physician’, one of the many general practitioners who protect the health of South Africa’s communities and workforce,” Dr Nauta says.

Patrick Lubbe, chief executive officer of the National HealthCare Group adds that Dr Soundy was one of the first doctors to join the Enablemed Network in 1995. “Dr Allan Soundy was a family physician in the true sense who placed family above all else.”

“As a close-knit healthcare community, we are deeply saddened by the loss of a valued colleague. Our hearts go out to his family and loved ones to whom we offer our unconditional support at this very difficult time.”

“A consummate professional, Dr Soundy dedicated his life to serving and caring for humankind. He will be remembered by all at National HealthCare for his dedication to his patients, professionalism, commitment to quality patient care, excellent skills and clinical knowledge.”

Dr Makhambeni says Dr Soundy was well liked by all his patients. “He was what I call an ‘old style’ GP who practised patient-centred care, which we taught medical students at MEDUNSA during their rotation in Family Medicine.”

After completing his medical studies, Dr Soundy took over Dr Makhambeni’s practice in the TEBA Building in Zone 16 Ga-Rankuwa. The pair grew closer as they met many times over the years, often through primary healthcare networks. “He would sometimes accompany me when I went to visit network doctors in the remote areas of Limpopo and Mpumalanga, and I used to enjoy his company on those long journeys,” he remembers.

“He was always jolly and had a loud laugh that you could hear from a distance. He was well loved by all those who knew him. He was the perfect gentleman, courteous and affable. Allan was very health conscious. He exercised regularly and was a jogger of note, taking part in many races and fun walks. He was very fit,” he recalls.

“I was one of the first to be informed when, one day as he was running, he was knocked down by a careless driver of a motor vehicle, fracturing his leg in the process. The amazing part was that when he related the incident to me, he laughed as he described how he ‘flew through the air’ after the impact. He was that kind of guy who still saw the funny side of a very serious situation.”

“Dr Soundy’s legacy of health and caring will live on in the many thousands of patients who benefitted from his care throughout his career. He will be sorely missed, and we will continue to uphold the same high standards in quality primary healthcare services that he represented as a paragon of patient-centred care,” Dr Nauta concludes.

Medical first for SA saves brave baby AJ’s sight

Tue, 27 Jul 2021 07:27:05 GMT

Baby AJ in mom Erica’s arms after the operation had been successfully completed

Rare eye condition treated using internal radiation therapy

Hearing that your baby boy needs to undergo sight-saving surgery at the age of just nine months is difficult news for any parent to receive. Especially when the condition is so rare that options are limited to a highly specialised procedure that requires a particular team of medical experts, in another province.

This was the experience of Erica Croxford, whose son Anthony – known as AJ to his family – was diagnosed with a rare skin condition, juvenile xanthogranuloma, which resulted in a growth inside his left eye.

According to Dr Hamzah Mustak, an ocular oncology and oculoplastics specialist practising at UCT Private Academic Hospital, the condition most often presents as a benign lump or bump on the skin and is not usually cause for concern. However, more than one lesion on the skin can also be accompanied by a lesion in the eye, which can be serious. In AJ’s case, it had resulted in a growth causing glaucoma, or severe pressure in the eye, that could lead to loss of sight or even loss of the eye itself.

“When AJ came to us in June this year, we immediately began to prepare for a highly specialised procedure using brachytherapy, most often used to treat certain types of cancer. This is a form of internal radiation therapy, whereby the radiation is temporarily implanted or placed at the affected area. While the growth in AJ’s eye was not cancerous, it needed to be eradicated to prevent the eventual loss of his eye,” explains Dr Mustak.

While Dr Mustak does use brachytherapy as a form of treatment on tumours in the eye, this is the first time it has been used in South Africa as a treatment for a patient with this particular condition. The unique collaboration between UCT Private Academic Hospital and Groote Schuur Hospital affords the opportunity for this highly specialised care to be available at the facility.

A mother’s instinct

This was neither the beginning nor would it be the end of AJ’s long journey with this rare condition. Erica explains that she felt a strong mother’s instinct about a small mark she noticed shortly after the birth of her son. “From the time AJ was just two days old I was aware of this mark on his cheek and I had a feeling there was something not quite right about it. The doctors I spoke to couldn’t tell me what it was but did not seem too concerned, so I tried to put it out of my mind,” she says.

“Then in December 2020 I noticed another mark on AJ’s armpit but little did we know that this was juvenile xanthogranuloma and that more than one skin lesion could indicate another in his eye. Shortly after that, around New Year, he woke up one morning with a terribly swollen, milky eye and no movement in the pupil. I rushed him to the doctor and that is when the journey really began. At the time he was just four months old,” says Erica.

The weeks and months that followed would prove to be some of the most difficult that AJ and his family would have to endure. During this time AJ was referred to an ophthalmologist who, after taking a biopsy of the mark under AJ’s arm, was able to diagnose his condition.

By this stage the pressure in AJ’s eye had increased dramatically and he had to undergo several treatments as well as four operations to try and treat the glaucoma and the tumour in his eye. Despite all these efforts the membrane of AJ’s eye had grown out of control, and he was referred to Dr Mustak.

Specialised treatment at UCT Private Academic Hospital

“After an initial appointment with AJ in early June, it was clear we needed to try brachytherapy, which reduces the chances of unaffected tissues getting some radiation, as is the case with external beam radiation,” notes Dr Mustak. “We are the only unit in South Africa that offers customised brachytherapy for the eyes and it was necessary for us to custom-design the radiation implant for AJ, which was done in consultation with my colleague at the hospital, radiation oncologist Dr Julie Wetter. The process begins with examining the eye, taking measurements and then designing a template. A dosage is then calculated for the delivery of focused radiation to the tumour.

“From there the template and dosage calculations are provided to physics experts who, using complex mathematics, calculate and create the plans for the production of the implant, which in this case was made of stainless steel, with the precise radiation dosage embedded within.

“When it comes to brachytherapy in the eye, there is an additional layer of complexity to the process, as this is an organ that moves a lot. We therefore needed to use a particular design, like a big ring, to secure the implant so that when there is movement the implant remains anchored to the eye muscles.

“It took around 40 minutes to perform the procedure on AJ, after which the implant remained inside his eye socket for 17 hours to allow the radiation to be delivered to the tumour, before being removed again. The success rate for brachytherapy in the eye is over 90% so we are hopeful that the tumour will not grow back and that AJ will have vision in that eye again,” says Dr Mustak.

Finding a way to make it happen

Such a complex procedure requires considerable resources, and before the procedure took place it became apparent that affordability would be a challenge for the Croxfords, because UCT Private Academic Hospital is not part of the contracted hospital network of their medical scheme. This would result in the cost of the procedure not being covered fully and would therefore be virtually impossible for the family to afford.

“The fact was, there was no other solution for AJ to get the care he so desperately needed – this was the only option. I brought this to the attention of the hospital management and, after some discussion, we found a way to ensure that AJ had a chance at having his eyesight saved,” said Dr Mustak.

According to Lizl Rodrigues, hospital manager at UCT Private Academic Hospital, the facility and its staff were honoured to have played a role in providing little AJ with the opportunity to have his sight restored. “We are so privileged that this highly specialised form of treatment could be provided here at our hospital and we are glad that we could help to make it more accessible for this little patient and his family. We wish AJ all the best on his road to recovery.”

Just over three weeks have passed since AJ’s brachytherapy and, having taken him for two pressure check-ups back home in KwaZulu-Natal, his mom is happy to report that his eye pressure has now stabilised at a healthy level. “It’s not yet the end of the road, as AJ will be scheduled for cataract surgery at some point in the near future.

“Only after that will we really know what his vision is going to be like in that little eye. However, the outlook is for now very positive, thanks to the work of the incredible Dr Mustak, his colleagues and the amazing team at UCT Private Academic Hospital. You guys are truly special,” concludes Erica.

On a national scale, local doctors make a big health impact

Wed, 21 Jul 2021 09:10:23 GMT

Rustenburg GP Dr Leon Pieter de Villiers, is well-known for his holistic approach to caring for his patients, as well as his characteristic footwear and is so committed to the community he serves that he commutes from Pretoria every day, 140km each way. Photographed here is Dr De Villiers with Ursula, his friendly and caring colleague who is both the face and the voice of the practice.

GP network has SA covered, affordably

A veritable army of general practitioners – from Rustenburg to Ladysmith, Vredendal to Kariega and everywhere in between – are working to provide quality healthcare affordably throughout South Africa. This growing network of GPs is providing a reliable and caring service in rural and urban areas, catering for the health needs of local communities and often bringing their own unique character to their vocation.

“The vastness of South Africa – some 29 times the size of the Netherlands – brings a certain complexity to the provision of quality healthcare. Ensuring that people have access to reliable healthcare, and that it is not prohibitively expensive, requires a solid, geographically diverse general practitioner network,” says Dr Reinder Nauta, executive chairman of National HealthCare Group, a healthcare provider in the low-cost and emerging segments of the healthcare market.

Last year National HealthCare Group substantially grew its contracted network of general practitioners (GP), pharmacies, radiologists, pathologists, and other healthcare service providers. With an 11,600-strong national network of healthcare practitioners, including Rustenburg GP Dr Leon Pieter de Villiers, healthcare is becoming more accessible and more affordable than ever, driving better health outcomes.

The practice of Dr De Villiers, one of National HealthCare’s contracted GPs, is at the heart of the community in Rustenburg’s central business district. “Everyone needs a doctor, and we are proud that so many people from all walks of life, including from the mining community and those living in the surrounding rural areas, entrust us with their greatest asset – their health,” comments Dr De Villiers. Well-known for his holistic approach to caring for his patients, as well as his characteristic footwear, Dr De Villiers is so committed to the community he serves that he commutes from Pretoria every day, 140km each way.

“It is important to me to apply my medical knowledge to take care of the health of my patients by providing a quality service, and hopefully, making a positive difference to people’s lives every day. When you become part of a community like Rustenburg, it is not an inconvenience to travel so far to work – it is a labour of love,” Dr De Villiers says.

“Not all patients can afford medical aid, such as the lower-income mine workers, however it is still possible to provide for most of their common health needs at primary healthcare level and make a significant difference to their wellbeing.”

Dressed in his typical consulting attire of shorts, or jeans on very cold days, and a pair of well-known clog-style branded shoes that has become something of a trademark for the doctor, he leads a friendly practice with a small staff who have come to know many of the town’s families over the years.

“The story behind my famous shoes is that they were a present from a girlfriend who went to the USA. And that’s it, if you get a present like that – no matter what – you’ll use it,” Dr De Villiers explains, laughing.

A family man with a passion for dogs, Dr De Villiers’ had a practice in Mabopane before relocating to Rustenburg with his late wife. “With contracted providers such as Dr De Villiers forming a national footprint of locally respected, highly accessible healthcare practitioners, employers can now provide for the health needs of their staff members, no matter where they are based,” Dr Nauta adds.

“In terms of workforce productivity, quality individual medical attention in the private setting more than pays for itself, and we have been able to develop highly cost-effective solutions to answer the needs of large corporate clients.”

Over and above the primary healthcare provider network, the National HealthCare Group specialist network now includes a growing number of obstetricians, cardiologists, ophthalmologists, paediatricians, urologists, physicians, general surgeons, and pulmonologists across South Africa.

In addition to in-person consultations, National HealthCare Group last year launched MediClub ConnectTM, an innovative service using mobile communications and chat commerce technology, the latest in a series of ground-breaking primary healthcare options geared towards practical, affordable healthcare solutions.

The low-cost, WhatsApp-based primary healthcare service provides members with online interactive access to doctors and nurses on WhatsApp, physical consultations with doctors on referral, and all prescribed medication along with other key services for a maximum of R95 per employee per month.

“New healthcare models such as this extend the benefits of first world healthcare delivery and systems, in a manner that suits our local context. Even within a country as vast as ours, with a strong national footprint of providers it is possible to ensure access to quality private healthcare that is cost-effective enough to be within the reach of any employer,” Dr Nauta concludes.

Teaming up for emergency food and medicine deliveries

Mon, 19 Jul 2021 06:53:12 GMT

Noel Guliwe, Group Chief Executive of Medipost Holdings

Partnerships bring vital parcels, relief to unrest-hit areas

Emergency deliveries of food and medicines are arriving in KwaZulu-Natal bringing relief to people in areas affected during the recent civil unrest thanks to a partnership of organisations coming together to support the united effort to restore access to vital supplies.

“Working together with one of our courier partners, Medipost Pharmacy has joined the Skynet Humanitarian Drive KZN initiative, which is delivering food and urgent medicines to people in the areas of KwaZulu-Natal that were inaccessible,” says Noel Guliwe, Group Chief Executive of Medipost Holdings.

“By taking hands with our extensive network of partners, and thanks to the quick implementation of detailed contingency measures, deliveries of medicine parcels resumed on Friday. We are sparing no effort to clear any backlogs to ensure minimal disruption, especially for people with chronic health conditions.”

Get involved

Businesses and individuals wishing to sponsor food parcels for those in need should contact diedericks@skynet.co.za.

Need medicine delivered?

Members of the public in KwaZulu-Natal can arrange for delivery of their chronic medicine, as well as other medical and baby care items they require, by sending prescriptions and requests to Obakeng.nbc@medipost.co.za, or via the Medipost Pharmacy WhatsApp Contact Number on 076 890 6883.

Where supplies of a particular brand of medicine may not be available, Medipost Pharmacy can assist with generic substitutions to ensure patients are able to continue with their chronic treatment.

“We are deeply moved by the outpouring of support and interest from many other corporates offering assistance and the dedication of our colleagues nationwide, including the many additional drivers assisting to prioritise delivery of urgent medicines,” Guliwe says.

“Extensive precautions are in place for the safety of all concerned, including continuous careful monitoring of the unfolding situation for coordinating medicine deliveries to the patient’s chosen address. Medipost Holdings is also ensuring staff in affected areas who have not been able to source essentials have food and other basic provisions to sustain their families, as we are aware supplies remain constrained in some parts of the province.”

For more information, or to register for delivery of chronic medicines nationwide, please visit www.medipost.co.za

Unrest places further pressure on already constrained healthcare services

Wed, 14 Jul 2021 05:54:26 GMT

Netcare contingency plans ensure safe care continues

Dr Richard Friedland, chief executive officer of Netcare, today confirmed that contingency plans were timeously implemented to ensure patients could continue to benefit from healthcare services amid violent protests in some parts of the country. However, the situation is fluid, and Netcare remains on high alert to respond promptly to possible new developments.

“We are deeply saddened to see the suffering of our fellow South Africans and wish that our nation and its people could have been spared this trauma, particularly in light of the hardships and loss of life already being experienced due to the ongoing COVID-19 pandemic,” Dr Friedland says.

“Extensive contingency measures are in place within Netcare Group facilities and, where needed, have been implemented to provide individuals in need of medical care with the best and safest care possible even under the current circumstances. Unfortunately, the violence in certain parts of KwaZulu-Natal and Gauteng is placing additional pressure on both the public and private healthcare systems.

“Like many other businesses, we have experienced some challenges due to staff shortages as a result of staff not being able to reach their place of work, however Netcare’s hospitals remain open throughout the country. We have treated a number of people for protest-related injuries, placing further pressure on an already constrained healthcare system, including emergency medical services,” he says.

He confirmed that Netcare currently has sufficient oxygen, medicines, food and water and is continuing to monitor supplies to ensure that the health of patients is in no way compromised. “We have sent a team of specialised trauma nurses to KwaZulu-Natal and have flown urgent medicines to the region, following the inability of one of our major suppliers to get stocks of medicines out to our hospitals. For now we have had to suspend vaccinations in KwaZulu-Natal.

“As a precautionary measure a few of our primary care facilities, Netcare Medicross and Netcare Prime Cure in KwaZulu-Natal have been temporarily closed. We will continue to monitor the situation to assess when it will be reasonable and safe to reopen these facilities.”

Netcare Medicross facilities that are temporarily closed include: Medicross Malvern, Medicross Bluff, Medicross Hayfields, Medicross uMhlanga, Medicross Richards Bay and Medicross Meerensee. The Netcare Prime Cure facilities that are temporarily closed are: Prime Cure Verulam, Prime Cure Prospecton, Prime Cure Smith Street, Prime Cure Bluff and Prime Cure Pinetown.

According to Dr Friedland, to support patients during this time, Netcare VirtualCare GP consultations are available with many GPs at Medicross, so that patients can consult a general practitioner over the phone or via a secure video link, either on mobile devices or computers, to keep patients in contact with doctors without the need for in-person consultations.

“It is always better to be safe than sorry if you suspect you may be experiencing a medical emergency, and in the case of COVID-19 unfortunately many patients appear to be waiting too long to access healthcare, even when they are having a medical emergency,” he added.

“If you are ever unsure of the level of medical care you need, the Netcare 911 national emergency operation centre [EOC] is equipped and ready to provide expert assistance in determining what steps may be necessary, 24 hours a day, seven days a week, on 082 911.

“Netcare 911’s EOC has trained emergency medical personnel available to support callers via telehealth services remotely. This can be significant for clinical decision making and help in the co-ordination of resources to safely transport the patient to hospital where needed.”

Keeping lines of communication open

"We have employed more social workers in our hospitals to counsel our valued patients, and their loved ones. Next-of-kin to patients are encouraged to call the Netcare Family Connect Line on 0800 111 266, and one of our trained call centre professionals will facilitate a dedicated hospital representative to provide them with personal daily feedback on how their loved one in hospital is doing.

“We wish to assure you that we will continue to do the very best we can while ensuring your safety and that of our frontline heroes. We commend and thank our healthcare workers for their diligence and commitment to patients in our care in these difficult times. Despite the pressures placed on us, providing care is our calling, it is our driving purpose, and we are privileged to be of service to you at this challenging time.

“We thank you in advance for your understanding and sincerely apologise for any inconvenience that may be experienced,” concluded Dr Friedland.

Burnout: When there’s nothing left to give

Fri, 09 Jul 2021 06:16:54 GMT

Dr Dumakazi Mapatwana, a psychiatrist practising at Netcare Akeso Alberton

Spot the signs early to help prevent more destructive effects

Burnout can result in even the most dedicated and passionate individuals feeling overwhelmed, helpless and disengaged in their working and private lives, with potentially severe consequences for their mental and physical health, relationships and productivity.

Given the pressures of the current COVID-19 pandemic, much greater awareness of this often-overlooked syndrome is needed to help prevent its destructive progression, warns Dr Dumakazi Mapatwana, a psychiatrist practising at Netcare Akeso Alberton.

“Burnout is a complex reaction to sustained extreme stress. It is not an overnight phenomenon, but rather a gradual process defined by emotional, physical and mental exhaustion that follows chronic and severe stress, which is most often work-related but may include other kinds of stress, like caring for a sick family member,” she says.

The concept of burnout was developed to describe a multi-faceted syndrome characterised by depersonalisation, emotional exhaustion and a sense of low personal accomplishment that eventually leads to decreased effectiveness at work.

“Sadly, it is often only when burnout has progressed to the point where it is seriously impacting their lives, that people seek the help they need. Persons experiencing burnout may develop depression or anxiety, and they often misuse alcohol or substances in an attempt to cope with their situation, which they often perceive as hopeless.”

Burnout could contribute to heart disease, high blood pressure, type 2 diabetes, obesity, metabolic syndrome, chronic insomnia, high cholesterol and chronic pain, and could make one more vulnerable to illness. “It can also impair job satisfaction and performance, increase absenteeism, and may ultimately lead to dismissal in extreme cases,” Dr Mapatwana adds.

Diaan Bisogno, a clinical psychologist practising at Netcare Akeso Stepping Stones, says that emotional detachment, hopelessness and helplessness are characteristic of burnout. “People with burnout struggle to find meaning in anything they do, often feel powerless and that nothing they do will make a difference,” she notes.

“We are living in an extremely stressful time, and when there are not enough resources, people get burnt out. We’ve been coping with the pandemic for a long time, and every time people get a little bit of hope that the situation may improve it seems there is some new blow, such as a higher level of lockdown restrictions or a new variant of concern. When you are burnt out, these changes require energy many people just don’t have anymore. The reserves are empty, there is simply nothing left to give,” Bisogno says.

“When you start detaching emotionally, it often numbs relationships with those closest to you. There is no energy left for nurturing other aspects of your life, which further diminishes social support, over and above the physical distancing measures we are practising to prevent contracting and spreading COVID-19.

“It is not uncommon for people facing burnout to turn to drugs or alcohol, or misuse medication, as they struggle to cope. For instance, a person may take cocaine or tik so they can get through 18 hours of work without sleeping, or abuse sleeping pills to counteract insomnia, leading to dependence and addiction that is often linked to depression, anxiety or other mental health conditions,” Bisogno adds.

Burnout in the workplace

“For employers, the consequences of burnout in their team include more absenteeism, reduced productivity, high staff turnover and instability, which only creates more anxiety among the staff members,” Bisogno says.

“For many frontline workers, vicarious or indirect trauma resulting from continuously dealing compassionately with others in distressing situations is an inevitable part of the job. While this occupational hazard can’t be avoided, it can often be managed better through building resilience and spotting and addressing the warning signs early with the help of mental health professionals, so that it does not lead to burnout.”

According to Dr Lerato Motshudi, head of clinical research and programme development at Netcare Akeso, it is possible for individuals to develop skills and techniques to help address these kinds of pressures effectively before they become overwhelming.

“Through a unique combination of skills development and talk therapy, the Netcare Akeso burnout management programme strengthens individual awareness of risk and builds resilience for prevention of burnout,” she says.

The programme makes use of evidence-based psycho-emotional tools shown to be effective in building resilience and grit. The individual is assisted to appreciate their own level of risk of burnout, and this enables them to focus on the areas of greatest personal relevance. Our experience has led to the identification of common workplace stressors which are prevalent in a wide range of corporate and working environments.”

Know the symptoms of burnout

“It is important for all of us to take care of both our mental and physical health, especially in difficult times. We need to be alert to initial signs and red flags, and act on those because if they are ignored and not addressed, burnout can have significant consequences, including serious medical conditions,” Dr Mapatwana says.

The symptoms of burnout may be physical, emotional and behavioural, and could comprise the following:

Physical

Feeling tired and drained most of the time
Changes in sleeping and eating habits
Frequent physical complaints: unexplained headaches, stomach problems or muscle aches
Muscle tension
Frequent illnesses from lowered immunity

Emotional

Sense of failure and self-doubt
Feeling helpless, trapped, and defeated
Emotional detachment from others
Feeling alone in the world
Lack of drive or motivation
Increasingly cynical, critical and generally negative outlook
Feeling irritable and impatient with co-workers, customers or clients
Decreased satisfaction and sense of accomplishment

Behavioural

Poor concentration, making mistakes at work
Withdrawing from responsibilities
Isolating yourself from others
Procrastinating, taking longer to get things done
Using food, drugs, or alcohol to cope
Taking out your frustrations on others
Skipping work, or coming in late and leaving early

For information about mental health issues and services, accessing care, and for professional help in a mental health crisis, Netcare Akeso is here to help. In the event of a psychological crisis, emergency support can be reached on 0861 435 787, 24 hours a day.

Contact Netcare Akeso on info@akeso.co.za; visit www.akeso.co.za; or book psychologist and occupational therapist consultations via www.copetherapy.co.za and psychiatrist consultations through Netcare appointmed™, online at www.netcareappointmed.co.za or by calling 0861 555 565. The COPE Therapy website www.copetherapy.co.za also contains many useful blog posts on various issues and tips relating to mental health.

Don’t miss your meds as Delta variant gains ground in SA

Wed, 07 Jul 2021 08:31:52 GMT

Convenient pharmacy-to-your-door service with phone advice in all SA languages

With mounting concern over the more contagious Delta variant of COVID-19 now circulating in South Africa, it is more important than ever to limit opportunities for the virus to spread while ensuring other health conditions remain well controlled.

“In light of the new information emerging about the Delta variant, which the World Health Organization has described as the most highly transmissible form of the SARS-CoV-2 virus identified to date, we need to work together to urgently reduce chances for the virus to spread to flatten the third wave,” says pharmacist Joy Steenkamp, of Medipost Pharmacy, South Africa’s largest national courier pharmacy.

According to the National Institute for Communicable Diseases (NICD), the Delta variant first identified in India is now confirmed to be circulating in South Africa. It is believed to be 97% more transmissible than the original strain of COVID-19, meaning it can spread much more easily between people.

“It is important to remember that even people who have already been vaccinated can get COVID-19 and pass it on to others – even though they may not experience symptoms and it appears they are much less likely to become as severely ill. It is therefore essential that we all continue to follow the recommended prevention measures, including self-isolating for 10 days if you have had contact with a person who has COVID-19 and avoiding any unnecessary interactions,” Steenkamp says.

Since the start of the pandemic, Medipost Pharmacy’s convenient free medicine delivery service has been crucial for keeping hundreds of thousands of people’s chronic treatment on track without the need for them to visit a pharmacy in person.

“For medication to work best, it must be as simple as possible for patients to adhere to their prescribed treatment, and they should have the opportunity to raise any questions with a registered pharmacy professional in a language they fully understand,” adds Rentia Myburgh, group sales and marketing director of Medipost Holdings.

“People who have their medicine dispensed and delivered, safely and reliably, by Medipost Pharmacy have access to pharmacy advice in any of South Africa’s official languages over the phone, offering personal attention in their mother tongue in an optimally safe, socially distanced manner,” she says.

“This aspect of our pharmacy service complements the telehealth consultations many doctors and specialists now offer, with a wider range of monthly prescribed medicines now available for affordable and convenient home delivery. As always, patient privacy is paramount so there is no indication on the outer packaging of what the medicine parcels contain, and confidentiality is guaranteed,” Myburgh says.

Saving time and money, Medipost Pharmacy’s dispensing fees are considerably below the market average, and customers are not billed for the administrative or courier delivery aspects of the chronic medication service. An additional benefit for medical scheme members is that the pharmacy ensures their medicines are claimed from the appropriate benefit category to conserve benefits and savings, where applicable.

“For people who are self-isolating by necessity, as well as anyone who is cautious about visiting public places, there is no need to go to the pharmacy when the pharmacy can come to you,” Myburgh concludes. With mounting concern over the more contagious Delta variant of COVID-19 now circulating in South Africa, it is more important than ever to limit opportunities for the virus to spread while ensuring other health conditions remain well controlled.

Help prevent a third wave becoming a tidal wave, warns clinical risk expert

Mon, 05 Jul 2021 08:22:34 GMT

Open windows – even in winter – to reduce risk

Confirmation that the Delta variant – the most highly transmissible form of Covid-19 identified to date – is now spreading in South Africa demands urgent action from every person to help prevent the third wave of Covid-19 becoming a tidal wave, a South African clinical risk expert warns.

“Although limited information is available on this variant, indications so far suggest that it can spread much more easily – and it could be 55% to 97% more transmissible than the original strain of the virus,” says Dr Jacques Snyman, medical advisor to Health Squared Medical Scheme.

“This appears to be driving a rapid increase in infections. The number of people being hospitalised in our country for Covid-19 is picking up fast, and many more people are getting sick – irrespective of which variant they have. We all need to take steps to protect ourselves, our loved ones and South Africa. A great deal is at stake, and if we don’t act now, we could face a tidal wave of infections in the coming weeks.”

Simple measures can save lives

“Fortunately, there are many simple things we can do individually to reduce the risk of transmission, which can make a great difference collectively and save lives. At the rate of infections seen recently in Gauteng, we all have a responsibility to slow the spread and prevent too many people becoming seriously ill at the same time, potentially outstripping the country’s healthcare resources,” Dr Snyman points out.

“It’s human nature for us to want to be physically close to our loved ones and spend time with our friends, but this is not the time to be socialising – especially since we are far behind in vaccinating, with people in their fifties only now being vaccinated. Many young people may feel invincible, but it is reported that younger people are becoming seriously ill with Covid-19 in the third wave, possibly as a result of the Delta variant.”

“It is important to understand that with the Delta variant, in particular, it appears that the viral particles can remain airborne in an enclosed space – such as a room or vehicle – for many hours, potentially infecting anyone else in that space. It has also been suggested that the quantity of viral particles a person is initially exposed to could influence the severity of COVID-19 illness they will develop in some cases.”

“In winter, people tend to gather indoors and keep windows closed because of the colder weather. This can create ideal conditions for the spread of Covid-19, especially if people are not wearing masks correctly. Good ventilation is essential, and it is important to open windows for airflow whenever possible in shared spaces – even with your close family.”

Cold weather does not cause people to develop colds, as is commonly believed. “Whether it is a cold, influenza or Covid-19, the viral particles are what causes the illness. If you are in an enclosed area, breathing in air that has a high concentration of these germs, you are much more likely to become ill. Rather let fresh air circulate even if it is cold, wear masks, and self-distance if those around you are not keeping a safe social distance.”

Wearing a clean mask that covers the nose, mouth and chin helps to contain the virus particles when people breathe or speak so that fewer infectious viral particles are released into the air, or onto surrounding surfaces.

The World Health Organization (WHO) recently reiterated that the guidelines for prevention advised since the start of the pandemic remain effective, even against the Delta variant. “In South Africa we were among the first countries to adopt wearing of masks in public, which can be extremely effective but only if everyone does it correctly at all times,” he says.

As part of HEALTH SQUARED’s sustainable, member-centred approach to healthcare funding, it was the first scheme to cover Covid-19 tests irrespective of the result, thus encouraging responsible testing behaviour early on to help prevent community spread. “The gold standard for Covid-19 testing remains the polymerase chain reaction [PCR] test. The rapid tests, however, should only be used for simple screening by professionals in specific situations and should not be used by the general public as a basis for making decisions,” he adds.

Health Squared also covers the Covid-19 vaccine in full for members on all benefit options as part of its commitment to cover from every angle.

“We really need to consider all aspects of our daily lives and see how all of us as responsible individuals can practically limit opportunities for the virus to spread,” Dr Snyman emphasises.

“Local testing capacity may be stronger now than it was in the first wave, meaning that a higher proportion of cases are detected. However, this does not diminish the fact that it is more transmissible than the dominant strains we had in the first two waves. If we act immediately, many thousands of lives could be saved in the months ahead.”

Dr Jacques Snyman, medical advisor to Health Squared Medical Scheme

The power of talking it out

Wed, 30 Jun 2021 10:05:07 GMT

Loyiso Maqubela, a clinical psychologist practising at Akeso Milnerton on the left and Alexander Oosthuysen, a clinical psychologist at Akeso Parktown in Johannesburg

Mental health not to be overlooked this Men’s Health Month

Have you ever said the words, or heard someone say: “Boys don’t cry”? According to mental health experts, the historical gender role-based norm of encouraging men to suppress their feelings and act strong has had a destructive impact on the male population. However, with a more conscious approach, this can change.

Loyiso Maqubela, a clinical psychologist practising at Akeso Milnerton, a private mental health facility in Cape Town, notes that men are facing a ‘silent crisis’. This is underscored by the World Health Organization reporting that men in South Africa are four times more likely to commit suicide than women*. “This should indicate far higher rates of depression amongst men in South Africa, and yet we see significantly more women seeking help for depression,” he says.

Maqubela considers that the way in which men present mental health issues may be misread and pathologised as disordered behaviour: “Presenting with anger and frustration, acting out physical violence, engaging in substance abuse and similar behaviours may often relate to suppressed mental health issues and may indicate depression.”

Finding a similar set of circumstances in his own professional experience, Alexander Oosthuysen, a clinical psychologist at Akeso Parktown in Johannesburg, notes that around 80% of the general population seeking help for conditions such as depression at the mental health facility, is female. “On the other hand, approximately 75-85% of those receiving treatment for substance abuse and similar disorders are male.”

Silenced from the roots

Oosthuysen points out that from a young age, boys are told not to show their feelings. For example, someone might say ‘take it like a man’ or ‘man up’ when advising another not to express natural feelings of discomfort. Likewise, men will often support one another by suggesting a night out at a bar in place of a conversation about an issue at hand.

“It often starts at home, when parents feel the need to redirect their children – and boys in particular – from showing emotion. This sends a message that there is shame in certain feelings when in fact there is power in being able to name emotions and to face difficult experiences head on. It is also important to be mindful of what we portray to young people and how this can affect their view of themselves in the world,” he says.

According to Maqubela, men are faced with a double-edged sword, where they may feel that seeking help is problematic as it goes against societal constructs of what a ‘strong or masculine’ man should be. “On the other hand, not getting the professional help needed can leave the individual feeling misunderstood and alone.

“At the heart of this dilemma is the idea of vulnerability, which does not mean the same thing to everyone. It is the job of a therapist to help navigate this and create a space, in which the individual can explore vulnerability on their own terms,” he says.

It happens to everyone

Maqubela points out that both men and women at times face enormous change in life, which may trigger some mental health difficulties. These might include major events, such as marriage, becoming a parent, relocating, changing career, divorce, losing a job, change in financial status, or loss of a loved one, for example.

“These types of events can affect how you view yourself and can trigger a very wide range or a particularly intense experience of emotions. It is important for the individual in question to be able to express and address these feelings. Emotions are just part of the contract in this thing called life,” says Maqubela.

When to get help

Oosthuysen likens seeking help to a driving metaphor: “If you are at the wheel and it’s starting to get a little dark but you’re unsure whether you need to have the lights on yet, then you should turn them on. Therapy is much the same – if you are starting to wonder whether you need it, you probably do.

According to the experts, there are certain warning signs that tend to present in people experiencing mental health issues, such as:

An inability to function normally on a daily basis
Decreased self-care
A change in relationships
Dramatic changes in sleep pattern
Unintentional changes in eating patterns
An increase in risky behaviour
An increase in apathy
Being emotionally dysregulated – an emotional state or response that is not normal for the individual and would be considered deeply worrying

Finding the right fit and feeling supported

When it comes to starting therapy, Oosthuysen notes that finding the right therapist is very personal. “It is not like buying paracetamol and any pharmacy will do. You need to find a therapist that you are comfortable with,” he says.

For concerned loved ones, Maqubela emphasises that unless the person is not of sound mind it is important to take a supportive stance rather than trying to take over. “It may be good to start by saying something like ‘I am concerned and I’d like to know how I could support you at this time.’ If the individual responds positively then you could suggest professional help and research a selection of mental health experts who are male, as many men prefer talking to a male therapist.

“Bear in mind that the individual is more likely to try therapy if someone else they know has had a positive experience with it. It may also mean looking at different types of therapy. Group therapy in different settings, such as on a hike in nature, can often work well for men. Remember, it’s not about rescuing the person. It’s about empowering him,” he concludes.

For information about concentration and memory concerns or accessing mental health services or if you are in an emotional crisis, Akeso is here to help. Contact info@akeso.co.za or visit www.akeso.co.za or www.copetherapy.co.za. In the event of a psychological crisis, emergency support can be reached at 0861 435 787, 24 hours a day.

* https://www.who.int/publications/i/item/suicide-in-the-world

Employee health the backbone of functional teams

Fri, 25 Jun 2021 07:22:13 GMT

Josua Joubert, CEO and principal officer of CompCare Medical Scheme

Wellness structure in the workplace of the ‘new normal’

While working remotely comes with a new set of challenges, agile businesses are seizing this opportunity to increase efficiencies and reduce expenses – along with the added benefit of boosting employee wellness in many cases, it would seem.

“What started out as a temporary solution to a dramatically changed world has fast-tracked multiple industries into a more technologically advanced and flexible work environment,” says Josua Joubert, CEO and principal officer of CompCare Medical Scheme.

This may not sit well with everyone affected, however it certainly seems to be an improvement for many, as indicated in the Robert Walters 2021 Salary Survey, conducted amongst 2000 professionals in SA.

Work-life balance and wellness

The survey found that almost one third of employees (29%) working from home have enjoyed the more flexible hours afforded to them, and a further 29% feel the experience allows for an increased focus on wellbeing.

“One could easily make the argument that this response is linked to the growing needs of a society that has in recent decades become increasingly competitive, financially pressurised and starved of time. In short, a society treading an unhealthy path,” says Joubert.

While competition and financial security continue to be of major concern for most employees, the reduction in time spent travelling to and from work is opening up significant space for employees to include more healthy daily routines.

“For example, early mornings or late afternoons spent exercising rather than sitting in stressful traffic jams, and the preparation of quick fresh lunches instead of opting for less healthy meals to-go.

“The reduced spend on daily coffee, meals and snacks – not to mention rising fuel costs – may have a further positive impact on the financial wellness of employees, many of whom are feeling the pinch without the usual salary increase or, in some cases, with a salary reduction,” Joubert notes.

Most importantly for employers, 66% of professionals in the survey reported an increase in their productivity. This would reinforce the idea that a well workforce is a well-functioning one, where an improved lifestyle balance means greater work focus and better outcomes.

Making the most of medical aid wellness benefits

Supporting and strengthening employee wellness may be more easily achieved with medical scheme benefits that provide reliable cover as well as delivering personalised attention to the needs of each individual.

“A scientific fitness assessment and exercise prescription programme at no extra cost, for example, will ensure that each employee can benefit from regular interaction and monitoring with a registered biokineticist and an accredited exercise facility,” says Joubert.

“Furthermore, an exercise-from-home benefit with guidance from a biokineticist will entitle employees to an individualised programme. This would be particularly helpful for those who do not necessarily go to gym but who take part in outdoor activities, such as running and cycling.

“And perhaps now more than ever it is important to offer meaningful support to employees wishing to strengthen their immune systems, whether this means improving nutritional intake or getting into better shape. A nutritional assessment and healthy eating plan in consultation with a registered dietitian will go a long way to supporting employees wherever they may be on their wellness journey.”

Staying connected

Foregoing human contact has without doubt been one of the greatest challenges in most recent human history and many are concerned about the impact this has on employee mental health.

While this is a very real concern, it is interesting to note that over one third (35%) of the survey respondents found that touching base regularly with their managers and teams resulted in a positive change to work style. This may indicate that some employees perform better with fewer workplace distractions while maintaining contact with colleagues, though not in person.

“Those remote-work employees who live alone or who struggle with their home situation will need access to mental health support. Providing medical aid cover that includes an unlimited psychosocial counselling helpline 24 hours a day, seven days a week, 365 days per year as well as a number of face-to-face sessions when needed, and reminding all employees that this service is available, will go a long way to bolstering a staff base in their times of need,” Joubert points out.

Coping with change

For many employers, the idea of remote work is a worrying one – 24% of employers taking part in the survey reported feeling concerned about the effects on productivity with working from home long-term. Others appreciate the difference remote work makes to overhead expenses, as well as the possibilities it opens up for hiring new talent, who may not be locally based.

“Working from home may not be the ideal solution for all and it is now a time for striking the balance between addressing employee expectations and what makes actual business sense. Whatever the case, providing access to excellent medical scheme wellness benefits for employees should not be overlooked. By doing so you may be supplying a catalyst for important lifestyle changes as well as a real source of comfort,” concludes Joubert.

A child’s journey to recovery, one step at a time

Wed, 23 Jun 2021 07:58:20 GMT

Olerato Legong at 20 months old, recovering through play with physiotherapist Charne Cox (left) and occupational therapist Jamie-Lee Janks (right) in the paediatric unit at Netcare Rehabilitation HospitalNew Paragraph

Specialised paediatric rehabilitation facility ensures children and their families are not alone

It is a parent’s worst nightmare – when your young child is badly injured or is suffering from a debilitating condition, and you do not know if or to what extent they will recover. However, there is a place dedicated to the rehabilitation of children, where they can receive the specialised care they need to start moving forward in their young lives.

One such child is little Olerato Legong, who at the age of just one year and seven months was involved in a serious car accident. According to Prof Andre Mochan, a neurologist practising at the paediatric unit of Netcare Rehabilitation Hospital in Johannesburg, the collision left her with several skull fractures and a severe traumatic brain injury, with bruising and bleeding in parts of her brain.

An earth-shattering event

“While surgical intervention at Netcare Garden City Hospital successfully healed Olerato’s skull fractures, the little girl had to spend a month in the hospital’s intensive care unit [ICU] before being transferred to Netcare Rehabilitation Hospital for rehabilitation therapy to help address the effects of the brain trauma. When she arrived she was conscious and attempting to sit but her entire left side was very weak and she presented with visual difficulties. “At that point she was poorly responsive and unable to interact,” recalls Prof Mochan.

Prior to the accident, Olerato had reached all her developmental milestones and was a happy and active toddler, walking and talking as any healthy child of her age would. The sudden impact of the accident on her life was devastating for her family.

“Our lives changed just like that, from one day to the next. It shook my whole world,” says Thabang Legong, Olerato’s mother. Despite the ordeal, Olerato showed enormous resilience. With the support of her mother and the specialised multi-disciplinary team in the paediatric unit at Netcare Rehabilitation Hospital, she made significant progress.

A highly specialised type of care

Dr Anri Carstens, a general practitioner with a particular interest in children with special needs, notes that the journey of a child in rehabilitation requires a very specialised approach. “Many people think of children as being small adults, but they really do need very particular care. So much so that there is a special kind of dedicated paediatric team of clinicians required for a children's unit in a rehabilitation centre. Their physiology is different to that of adults, they have varying communication capabilities, their nursing requirements are very specific and their family involvement needs to be far greater than in the case of an adult.”

“It is also important for children and their families to have assistance with transitioning from rehabilitation back to daily life. For many this includes finding a suitable outpatient facility for follow-up sessions in their area, possibly special needs schooling and continued care at home. This alone can be an overwhelming experience after an already difficult time, and we find that families gain great value from having a professional team such as the one at our hospital to help them join the dots and support them through this adjustment process,” she notes.

This certainly seems to have been true for Olerato, whose mother Thabang was fully involved and dedicated herself to the needs of her child, according to Charne Cox, a physiotherapist on Olerato’s dedicated paediatric team. “Thabang really became part of the team in treating Olerato while she was here with us. Even though she had to travel all the way from Pretoria to be here, the time we were able to spend working so closely together made a huge difference to ensuring continuity of care after Olerato’s discharge,” says Cox.

Olerato was able to benefit from a full range of on-site treatments during her time at the paediatric rehabilitation unit, including physiotherapy, speech therapy and occupational therapy, incorporating therapy on land as well as hydrotherapy. While she was admitted, she was also assessed by a paediatric optometrist and an audiologist, both of whom are regular referral sources for the unit.

Children admitted to Netcare Rehabilitation Hospital’s paediatric unit have access to a dedicated, multi-disciplinary paediatric team comprising doctors, paediatric nurses, a physiotherapist, an occupational therapist, a speech therapist, a social worker, a psychologist, case manager as well as an on-site state of the art orthotics and prosthetics service, should they need it.

“We are a very close-knit team and communicate about our patients in great detail in our weekly team meetings,” says Anna Potgieter, speech therapist at the unit. “This allows us all to be on the same page when it comes to each child’s needs, treatments and progress. Our specially trained nurses will pick up the smallest detail while caring for their young patients and relay that information to us, so there is a bird’s eye view of progress at all times.”

One step at a time

Potgieter recalls that Olerato visibly improved almost daily. “While in the beginning she was only managing very small amounts of food and not initiating any communication at all, she quickly progressed, imitating us and actively wanting to engage, so we could be quite creative in our therapy with her.”

Cox too recalls Olerato’s steady progress, her personality starting to shine through after just a few days, enjoying playing in all of her therapy sessions, getting to know everyone caring for her and blowing kisses when moving from one part of the unit to another.

Olerato was discharged approximately two months after her arrival at the unit, with marked progress, much to the joy of her family. Now, two years later she is a healthy three-year-old, happily attending crèche, learning new things every day and making friends. “She is still recovering, but the progress is huge – far quicker than I thought it would be. It’s better and better all the time,” says Thabang.

Dr Carstens notes that the paediatric unit at Netcare Rehabilitation Hospital is the only licensed paediatric rehabilitation unit with a dedicated paediatric team in the Johannesburg area. With a total of eight beds, it is small enough to provide highly personalised, one-on-one care. “Being situated in Auckland Park, our close proximity to Netcare Garden City Hospital means there is just a short distance to go if further specialised care or scans are required,” says Dr Carstens.

“Whether it is several months or just a few days, time spent in rehabilitation is invaluable. For referring specialists, paediatric rehabilitation is an important stepping-stone for their patients, providing the opportunity to truly bridge the gap in ways that would otherwise not be possible. For this team and I, it is our greatest calling and a privilege to work with these young patients, for whom we will continue to care as long as there is a need,” concludes Dr Carstens.

Seek medical attention early, and do your part to flatten the curve

Mon, 21 Jun 2021 05:00:02 GMT

Where and how to seek the level of care you need in the third wave

As COVID-19 cases in the country, and particularly in Gauteng, continue to rise, Netcare urges the public to adhere to COVID-19 prevention measures and seek help early if they are unwell.

“Netcare continues to monitor the situation closely and adjust its strategy to make the most effective use of healthcare resources wherever needed, while maintaining an abundance of caution,” says Jacques du Plessis, managing director of Netcare’s hospital division.

“With our experience of the first and second waves, Netcare hospitals are well equipped and can quickly maximise capacity with a strong emphasis on safety, to keep healthcare services operating as effectively and efficiently as possible for our all patients.

“Although the situation remains fluid, at present our facilities in Gauteng are under pressure, while Netcare facilities in all other provinces remain on high alert, but for now have not yet seen a surge in COVID-19 admissions.

“We echo the President’s call for every person to do their part towards flattening the curve of the third wave by maintaining social distancing, the appropriate wearing of masks, avoiding crowded and poorly ventilated areas, washing hands regularly and thoroughly, and self-isolating if you may have been exposed to the virus.”

“Flattening the curve of the third wave and seeking healthcare from a general practitioner early if you or a loved one starts to feel unwell will go a long way towards improving individual health outcomes in many cases, and preventing bottlenecks in accessing emergency care at this critical time,” he says.

If you start to feel unwell, contact your GP for a virtual or in-person consult immediately

“Medicross medical and dental centres have put extensive precautions in place to keep patients, healthcare professionals and staff as safe as possible, so that they don’t have to be concerned when accessing primary healthcare services,” says Dr Billyy van der Merwe, managing director of Netcare’s primary care division.

To further support patients during the pandemic, Netcare VirtualCare GP consultations are available with many GPs at Medicross, so that patients can consult a general practitioner over the phone or via a secure video link, either on mobile devices or computers, to keep patients in contact with doctors without the need for in-person consultations.

“In the case of an individual who is concerned they may have COVID-19, for example, the doctor may ask specific questions to assess your risk, advise whether you need to be tested for COVID-19, and give you a referral to a pathology laboratory for testing to be done.”

“In common with other Netcare group facilities, Medicross medical and dental centres have rigorous preventative precautions in place. This includes, for example, pre-screening, disinfection, and air purification units with three modes of protection: virus-destroying filtration; sterilising UV-C light; and powerful photocatalytic oxidation air purification technology that neutralises pathogens safely,” Dr Van der Merwe adds.

Unsure if it is a medical emergency?

“Netcare 911’s EOC has trained emergency medical personnel available to support callers with telehealth patient remotely. This can be significant for clinical decision making and help in the co-ordination of resources to safely transport the patient to hospital where needed.”

Emergency medical attention

If an individual experiences difficulty breathing or any other signs that could indicate a medical emergency, emergency medical services, such as Netcare 911 and the emergency departments such as those located at Netcare hospitals, are there to provide the necessary assistance which could be lifesaving.

Patients requiring urgent care at hospital emergency departments are triaged and assisted as soon as possible, alternatively they may be referred to other facilities as we continue to work closely with all parties in the best interests of patients.

“As part of our disaster management planning, we have commissioned temporary Clinical Decision Units (CDUs) at certain hospitals in Gauteng to accommodate additional emergency patients. These CDUs proved very helpful in the second wave to ease the burden on the emergency departments and to enable the stabilisation of patients prior to hospitalisation,” Du Plessis adds.

Netcare has spared no effort or expense in adding extra resources, including oxygen supply, drugs and consumables, as well as sufficient personal protective equipment (PPE), to assist with managing an anticipated increase of COVID-19 admissions, and last week non-urgent surgeries requiring post-operative critical care were suspended to free up capacity where needed.

“We have also taken the difficult decision to suspend visiting hours, other than in exceptional circumstances and end-of-life situations and then only with the express permission of hospital management on a case-by-case basis,” Du Plessis adds.

Netcare hospitals have bulk liquid oxygen supply tanks, as well as oxygen cylinders as a back-up. We have invested in increasing bulk supply tanks as one of several strategies to ensure sufficient continuous oxygen supply for patients. As a further safeguard, 1 400 oxygen concentrators were procured to draw oxygen from the air to bolster supply, if needed.

To keep families informed on the progress of their loved ones in hospital, next-of-kin nominated by patients admitted to hospital are encouraged to contact the Netcare Family Connect line on 0800 111 266 to facilitate personal feedback from a dedicated hospital representative on a regular basis.

“We wish to assure the public that we will continue to do the very best we can for all patients seeking care at any of our healthcare facilities, while ensuring the safety of our patients, frontline staff, doctors, nurses and other healthcare workers,” Du Plessis says.

South Africa first in line to experience new leading-edge medical consultation technology

Mon, 14 Jun 2021 08:33:39 GMT

Dr Johan Pretorius, Chief Executive Officer of Universal Healthcare

Virtual appointments casting doors of access wide open

Conducting consultations and working through that waiting room queue is being revolutionized with the introduction of uConsultTM, a multi-sided virtual consultation platform, making home-based care singularly accessible in South Africa.

According to Dr Johan Pretorius, Chief Executive Officer of Universal Healthcare, this fully integrated system allows healthcare providers to connect with patients no matter whether they have medical aid cover or not, or which medical scheme they may belong to. There is no need to download a restrictive medical scheme prescribed app only available to select groups.

“Healthcare provider and patient are additionally able to connect with other providers from multiple healthcare disciplines without having to switch between systems – a revolutionary development,” asserts Dr Pretorius.

Created by Universal Healthcare, this South African product was developed by the company’s California-based team in Silicon Valley, the birthplace of some of the world’s greatest tech innovations.

Unlike certain other virtual consultation platforms, uConsult connects healthcare providers with patients using safe, scalable microservices technology making it accessible any time from any device, be it a smartphone, tablet, laptop or desktop. “Full accessibility to quality healthcare for all South Africans is uConsult’s ultimate objective,” Dr Pretorius says.

As a comprehensive suite of services with full office software integration, uConsult streamlines administrative tasks with an offering that includes electronic diary management tools, patient file management, generation of clinical notes and prescriptions, requests for radiology, nuclear medicine, pathology and specialist referrals. The predictive text functionality of the platform is a particularly advantageous timesaving tool, eliminating the need to fill out prescriptions, and pathology and radiology forms.

Patients are able to search for healthcare providers on uConsult by name, speciality or geolocation and virtual consultations can take place no matter whether the patient or the practitioner is based in South Africa or not.

“The vision for this leading-edge technology is rooted in the firm belief that anyone, anywhere should be able to access the best quality healthcare available. uConsult is an important step in that direction making physical and financial accessibility a reality for so many more South Africans,” notes Dr Pretorius.

“The advent of Covid-19 has changed the face of healthcare and indeed how we communicate. It is the beginning of a new era for the management of our health and how we interact with our healthcare professionals going forward. At Universal, this comes down to innovating and creating solutions that ultimately hinge on so much more than convenience – it is about making inroads into inclusivity, sustainability and connectivity for South Africans and beyond,” he concludes.

‘A fairy tale come true’ for little girl and her parents

Tue, 08 Jun 2021 11:45:50 GMT

Four-year-old Amara Ngwenya recently received a lifesaving heart operation sponsored by Medipost Holdings and the Netcare Foundation at the state-of-the-art Maboneng Heart and Lung Institute at Netcare Sunninghill Hospital. The team of specialists who performed the surgery also gave their services pro bono. Amara, who has ambitions to become a fairy when she grows up, is recovering well after the procedure to correct a hole in the heart known as an atrial septal defect. She is pictured here with Sister Lindelwa Msimango in the cardiothoracic intensive care unit at Netcare Sunninghill Hospital only a few days after her surgery.

Amara, four, receives lifesaving heart operation

Four-year-old Amara Ngwenya has big ambitions even though she is physically small for her age, as her growth was stunted by a serious heart condition. Thanks to lifesaving donations from two leading South African healthcare companies and a committed medical team, she is recovering well after recently benefitting from intricate cardiac surgery to repair a hole in her heart.

“I want to be a fairy when I grow up. A fairy who uses her magic to make other children fairies, so that they can help others too,” says Amara who is recovering at home, gaining strength and raring to go and play, just days after undergoing the operation to repair the heart defect at the renowned Maboneng Heart Institute at Netcare Sunninghill Hospital in Johannesburg.

Amara is the latest beneficiary of the Heart-to-Heart Campaign, a corporate social investment (CSI) match funding challenge to raise resources for life-saving operations for children suffering life threatening heart conditions. The heart surgery covered by donations from Medipost Holdings and the Netcare Foundation, which is the CSI arm of the Netcare group.

“Two years ago, Amara developed a fever and was so ill that she had to be admitted to Steve Biko Academic Hospital – the same hospital she was born in – for about two weeks. The doctors diagnosed rheumatic fever, and found that her heart was beating abnormally,” says her mother, Runel Ngwenya.

“After that, Amara wasn’t eating or growing normally like other kids. I would have to find ways to persuade her to eat and try to tempt her appetite with her favourite foods: potatoes and porridge.”

“Amara, who was referred to us from Steve Biko Academic Hospital by interventional paediatric cardiologist Prof Lindy Mitchell, had an atrial septal defect, or a hole between the two upper chambers of her heart, which required a specialised procedure to correct,” explains cardiothoracic surgeon Dr Erich Schürmann, of the Maboneng Heart and Lung Institute at Netcare Sunninghill Hospital where the operation was performed.

“As parents, we have been so worried about our daughter’s health, especially because we are both unemployed and cannot afford medical aid. We couldn’t believe it when we heard that Medipost Holdings and the Netcare Foundation would cover the costs of the operation, it was like a fairy tale come true,” Runel says.

Cardiothoracic surgeons Dr Schürmann and Dr Martin Myburgh of the Maboneng Heart and Lung Institute, paediatric cardiologist Dr Janine Meares who practises at Netcare Sunninghill Hospital, as well as anaesthetist Dr Krishnee Naidoo and cardiac perfusionist Mr Mogotsi Mophosho committed their time and expertise pro bono to provide Amara with the lifesaving procedure and care she needed.

“If untreated, a hole in the septum the size Amara had, unfortunately can be debilitating, and even life-threatening, as the child grows the heart defect ultimately damages the arteries of the lungs. Fortunately, Amara’s procedure went smoothly, and was completed in three hours,” Dr Schürmann explains.

“So far, indications are that the operation was a complete success and, while we will monitor her progress, we expect she will now be able to live a full and normal life.”

“We are delighted that Amara is recovering well after her operation. She has been incredibly brave, and children like her represent the future. It has been our privilege to contribute funding for her procedure through Medipost Holdings’ corporate social investment,” says Rentia Myburgh, group sales and marketing director of Medipost Holdings, comprising Medipost Pharmacy, MediLogistics, Kawari Wholesaler and Distributor and the Medi Training Academy.

“We are extremely grateful to the Netcare Foundation for their half of the donation, which enabled this promising young girl to get the specialised medical intervention to hopefully live a full and normal life.”

Runel says that the family are immensely relieved that Amara is going from strength to strength since having the operation. “Now, she has a real appetite! We are trying to keep her still for a few weeks while she recovers, and because she already feels better Amara wants to play like a healthy child,” she says.

“Amara doesn’t walk in the house, she always wants to run. And, as you know, she wants to be a fairy when she grows up – and she has even developed her own method of ‘flying’. She has a habit of climbing up the inside of a doorframe right to the top, then she leaps – or ‘flies’ – to the ground.

“The sky is the limit, as far as Amara is concerned. Now that she has had her operation there are no limits to what she can do and achieve,” her proud mother says.

“We thank God for the many people and organisations that have helped our daughter. We are astonished at this generosity, and we feel very blessed. A big thank you to the Netcare Foundation and Medipost Holdings for covering the costs to allow our daughter to have this operation so soon, as we have had many sleepless nights worrying about her health.”

“As a family we are very grateful to the teams from the Maboneng Heart and Lung Institute, the theatre and cardiothoracic intensive care unit at Netcare Sunninghill Hospital for the highly specialised treatment and care they provided to Amara,” adds her father, Mugisha Francis.

“The synergy between these teams has been very reassuring for us during this anxious time. In the three hours we were waiting for Amara to come out of surgery I took comfort from something Dr Myburgh told me – that it is their life’s commitment to look after patients such as my daughter.

“We have seen this wonderful dedication from everyone involved in her care. The specialists and the nurses, both at Steve Biko and at Netcare Sunninghill Hospital, have been amazing. I would also like to thank the team from the Maboneng Institute for their daily updates and for being so encouraging.

“The Netcare nurses treated her like a princess – even painting her nails and entertaining her in the ward. When you see these acts of caring, and the people who do it with a loving heart, it is so inspiring,” he says.

Mande Toubkin, general manager: emergency, trauma, transplant and corporate social investment at Netcare adds: “On behalf of the Netcare Foundation, we wish Amara all the very best as she gets stronger every day.

“Through the Heart-to-Heart Campaign, we hope to assist eight young children to receive these lifesaving procedures at the state-of-the-art cardiothoracic centre based at Netcare Sunninghill Hospital. There are, sadly, still many more children with serious heart defects in need of similar operations, and we challenge other corporates to join us in supporting this extremely worthy cause,” she concludes.

For more information about the Maboneng Foundation, which coordinates sponsorship of the procedures, or to make a donation please visit www.mabonengfoundation.co.za

Hospital saddened by passing of highly respected nephrologist

Wed, 02 Jun 2021 05:59:36 GMT

Doctor who participated in over 600 kidney transplants remembered

Highly respected nephrologist, Dr Hendrik Viljoen, who practised at Netcare Garden City Hospital for some 27 years of his long and distinguished career, sadly passed away in the early morning of Wednesday, 26 May 2021.

“On behalf of the staff and management of Netcare Garden City Hospital, we wish to convey our deepest condolences to Dr Viljoen’s wife Sandra, his sons Gerrit and Hein, and his daughters Marina, Luré and Arden. Our sympathies also go out to his loved ones, friends and colleagues,” says Jacques du Plessis, managing director of Netcare’s hospital division.

Born in Leyden in the Netherlands in 1955, Dr Viljoen’s family relocated to South Africa when he was a child. After high school, he first pursued a BA Law degree, then earned his Honours in Latin before studying medicine through the then-University of the Orange Free State (UOFS) and completing his MBChB with a distinction in psychiatry in 1983.

Dr Viljoen then trained in Internal Medicine at the Universitas and Pelonomi academic hospitals. There he attained experience with sub-specialities including clinical haematology, pulmonology, cardiology, gastroenterology, endocrinology, nephrology and rheumatology. Once qualified, he worked in the Department of Internal Medicine in Bloemfontein as a physician while sub-specialising in nephrology.

Later, as head of the Department of Nephrology at UOFS, Dr Viljoen was instrumental in training the next generation of medical professionals and leaves behind a strong academic legacy. Having authored numerous academic articles and presented papers at international conferences, Dr Viljoen greatly contributed to the field of nephrology and meaningfully touched the lives of many thousands of patients who benefitted from his considerable expertise over decades of service.

“Dr Viljoen participated in over 600 kidney and 25 combined pancreas-kidney transplants during his career. His passing is an immense loss to the Netcare family and his fellow specialists, and he will be greatly missed,” Du Plessis concluded.

Vital decisions can’t be postponed in a pandemic

Fri, 21 May 2021 04:51:56 GMT

(Left to right) Clinical pharmacology expert Dr Jacques Snyman, MC Nandi Molefe, health and social security systems specialist Prof Alex van den Heever, and virology expert Prof Sim Mayaphi are pictured during a panel discussion hosted by leading managed care provider and medical scheme administrator Agility Health.

Experts weigh in on managing the risks of Covid-19

Aiming for the moving target of Covid-19 herd immunity may be unrealistic, potentially requiring an annual global booster vaccine to fend off emerging variants, according to experts speaking at Agility Health’s most recent Quarterly Healthcare Review.

“Many governments are targeting herd immunity, but it is unachievable in the same way it is unachievable for flu,” said Professor Alex van den Heever, health and social security systems specialist of the University of the Witwatersrand (Wits) School of Governance, during the panel discussion hosted by leading managed care provider and medical scheme administrator Agility Health on Wednesday.

“We are starting [the South African Covid-19 vaccine rollout] in May, and we should have started in January or February… So, it is good that we are rolling out, but it does have consequences that we are rolling out this late.”

Prof Van den Heever was speaking on an expert panel with virology expert Prof Sim Mayaphi and clinical pharmacology expert Dr Jacques Snyman, reflecting on the local and global handling of the Covid-19 pandemic, the vaccine rollout and crucial lessons for the third wave and beyond.

Time is of the essence

Dr Snyman, clinical development expert for Agility Health in Africa and Agility Risk Solutions in Asia, added that while the contexts of vaccine rollout are very different between, for example South Africa and Singapore, there are lessons to be drawn from the Southeast Asian nation despite it being an island that has simpler logistics to manage.

“What we can learn from them is the speed of decision making. For instance when should lockdown be implemented, and the science applied to the decision-making. What is key for me, is that a decision must be made; you cannot postpone a decision during a pandemic,” Dr Snyman said.

Regarding the local delays in securing vaccines, Prof Van den Heever added: “A number of bilateral agreements were not entered into in 2020 on the basis of cost. A number of us did analyses of the costs of the complete vaccination programme. The costs ranged from R7.5 billion to reach what was understood as herd immunity at that point, to about R15 billion.”

He added that this was “well within the capability of South Africa”. “One of the parts we took into account in terms of the fiscal impact was the fact that all healthcare workers are on medical schemes, therefore their [vaccine] costs would not be for the State,” Van den Heever said, adding that the Sisonke Programme also made vaccines available to healthcare workers without diminishing State resources.

Preparation for the next pandemic

“If there is any pandemic that has caught us by surprise, it’s this one,” Prof Mayaphi, head of the Department of Medical Virology at the University of Pretoria and National Health Laboratory Services’ Tshwane academic division, said, adding that better planning is needed to prevent the next pandemic.

“At a global level, there is a lesson in pandemic preparedness. This has shown us that the world is not ready for any pandemic. We need to ask critical questions such as, could we have predicted this and are our healthcare systems geared for pandemics.

“Surveillance programmes are needed to look at the animal-human interface of viruses and the prevalence of viruses in animal hosts to see if we can predict these viruses being transmitted from host animals to humans. We already have many examples of this, including Covid-19,” Prof Mayaphi said.

Dr Snyman adds that virus mutation is likely to mean that Covid-19 will continue to produce new variants of concern. “If we are vaccinated this year, this could mean we don’t necessarily have immunity for the strains that emerge next year.

“Various vaccines are targeting various sites of the virus. That particular antibody will only be effective as long as that part of the virus has not mutated. The Johnson & Johnson and Pfizer vaccines are only partially effective, but they reduce the likelihood and severity of illness. Will these vaccines protect us into the future? We simply don’t know. The next strain may not be affected by the antibodies we have vaccinated for. It is therefore likely that long-term vaccination strategies will be required.”

Going viral

Prof Van der Heever added that global pandemic planning had not factored in the possibility of an airborne infectious disease, and that it took some time before it could be established that Covid-19 could be transmitted this way. “This poses the most extreme risk for a pandemic, it’s the fastest [way] it could be transmitted…. That’s the one that’s going to overrun testing and tracing, it’s going to overrun border controls,” he said.

“[Covid-19] also has the problem that some people may have very high viral loads and transmit the virus without symptoms, as a consequence people are unaware of their status and there’s a high-risk window period where they are infectious. We didn’t initially understand the asymmetric nature of transmission. In other words, it’s not 2.5 people being infected by one person every day, it is one person potentially infecting 50 people in one sitting.”

Strong, sustainable health resources needed

Prof Mayaphi said a vital lesson for the future is the importance of strengthening healthcare systems. “All over the world, even in high income countries, healthcare systems were overwhelmed by Covid-19, although low-income countries have suffered the most… We need to invest in infrastructure to be able to cope better in future such as developing laboratory tests and facilities.”

Prof Van den Heever pointed out that developing local manufacturing capacity for treatments to achieve resilience would require production for a wider market in order to be feasible. “You’ve got to basically set up a commercial arrangement, which is mostly going to be for export, but which government can contribute towards on condition that there is going to be a redirection to the domestic or regional market as a condition for those subsidies… Otherwise, the irony is that a vaccine is going to cost 20 times what it costs to produce by, for instance, the Serum Institute of India. Scale is very important.”

Dr Snyman said that medical scheme data from the first and second waves showed different patterns in hospital admissions and claims. “During the first wave, out of those admitted to hospital almost 80% had co-morbid conditions. Specifically, more than 50% had cardiovascular co-morbidities or diabetes.

“In the second wave, we saw a 10 to 15% absolute reduction in patients with those types of chronic conditions. They still suffered co-morbid conditions, but it was a reduced proportion of diabetes and cardiovascular disease comorbidities compared to other comorbidities,” he said.

“In terms of claim profiles, there was a drive to better compliance with chronic care. Patients started making sure their diabetes and cardiovascular conditions were under control. There was a reduction in elective hospitalisations, and the members were seeking outpatient and primary care rather than inpatient care.”

“Patients started taking ownership of their diseases and medicine compliance increased. The awareness of risk and comorbid conditions seemed to have helped and should be capitalised on as this is the correct behaviour. The one good thing we have seen in the Covid-19 pandemic is the fact that people now take their chronic conditions more seriously and understand the importance of good disease control.”

Looking at private public partnerships and the relevance for the future, Prof van den Heever pointed out that it is a requirement that a country uses its total capacity to care for its people and that Government should embrace and expand their consultative and delivery processes to ensure best outcomes.

Doctor Snyman also pointed out that the pandemic forced better public private partnerships and that private healthcare facilities could also help to extend the reach of the national vaccination programme.

“We have the tools, and we should use the tools,” Dr Snyman said.

New technologically advanced cancer treatment now in KZN

Mon, 17 May 2021 15:32:26 GMT

Precisely targeted HDR brachytherapy system

A state-of-the-art new high dose rate (HDR) brachytherapy system has been introduced at Netcare Parklands Hospital in Overport, Durban.

The new Varian Bravos HDR afterloader system, which is the first of its kind in KwaZulu-Natal, is an integrated radiation treatment planning and delivery system, delivering a powerful and localised form of radiation therapy.

“Brachytherapy is an important treatment modality for cervical, endometrial, and oesophageal cancers, among many others. Netcare Parklands Hospital is the only private health facility in the province providing this type of cancer care and we have extensive experience with brachytherapy treatment over many years,” says Prea Naidoo, Netcare’s regional radiation manager in KwaZulu-Natal.

“Brachytherapy has demonstrated improved survival rates globally, both as a stand-alone treatment or in combination with other treatments such as external beam radiation therapy, chemotherapy and/or surgery where a combination of treatments is determined to be clinically appropriate for the individual.

“This advanced Bravos afterloader system has been engineered with an emphasis on patient safety and convenience, with the whole process being more streamlined. The innovative technology enables very precise and quick verification of the positioning to ensure the brachytherapy is applied to the exact target area for optimal effectiveness. This means that a high radiation treatment dose can be delivered with minimal impact on healthy surrounding tissues and that treatment sessions are often shorter,” Naidoo says.

This type of brachytherapy involves positioning a high dose rate radioactive source directly at the site where cancerous (malignant) cells are inside the body, this new technology enables the radiation oncologist to treat the cancer with a higher total dose of radiation in a smaller, precisely targeted area for a shorter time, compared to external beam radiation.

“People in the province now have access to this state-of-the-art treatment for a wide range of cancers at the dedicated cancer care centre based at Netcare Parklands Hospital, which is staffed with an experienced cancer care team working closely together with the radiation oncologists.”

General manager of Netcare Parklands Hospital, Fuad Salie, points out that the new brachytherapy system further strengthens the existing extensive cancer care services at the hospital, available to the communities it serves.

“Every advance in medical technology that we can harness in the fight against cancer represents hope for safer, more effective treatments and better outcomes. Our facility has extensive experience with brachytherapy and the radiation unit also offers external beam radiation therapy, intensity modulated radiotherapy, volumetric arc radiotherapy, stereotactic irradiation and radioisotope therapy all under one roof.

“Our cancer care services also include chemotherapy, various types of surgery, as well as a range of support services including personalised guidance by a trained patient navigator throughout a patient’s entire treatment journey,” Salie says.

“A CANSA support group to assist patients in coping with the emotional toll of fighting cancer and a Look Good Feel Better programme to help with managing the appearance-related side effects of cancer treatment, were unfortunately disrupted due to the COVID-19 pandemic, however these will be re-introduced as soon as it is practical and safe to do so.

“Every cancer journey is unique, and while this can often be a most difficult time for the individuals who are impacted, we strive to ensure a tranquil, caring and convenient service to holistically support each person on their custom-designed treatment path,” Naidoo concludes.

What might extra sanitising mean for our immunity?

Wed, 12 May 2021 05:53:26 GMT

We’re entering an ‘era of uncertainty’

Heightened global awareness of cleanliness and Covid-19 preventative measures may influence human immunity, although whether these changes will ultimately benefit human health has been hotly debated.

Clinical risk management expert and medical adviser to Health Squared Medical Scheme , Dr Jacques Snyman, considers the potential unintended consequences for immunity that might arise from the large-scale move towards disinfecting, mask wearing and other measures to prevent the spread of illness-causing pathogens.

“It is indisputable that hygiene is essential to preventing the spread of many infectious illnesses and diseases, including Covid-19. However, we have no way of determining with certainty what the longer-term effects of this dramatic shift towards disinfecting, sanitising and eliminating germs may be,” he says.

“Long before the pandemic, questions were being asked about the use of increasingly sophisticated home disinfectants and hand sanitisers. A particular area of debate was whether this constituted potentially unhealthy ‘germaphobia’ or served as reasonable precaution against the immediate health risks posed by infection from pathogens and germs in general.”

According to some schools of thought, ‘overzealous’ hygiene might threaten our natural defences by depriving the body’s immune system of opportunities to recognise and build resistance to germs. “However, as with Covid-19, some people appear to be more susceptible to certain infections and are therefore at greater risk if they are exposed, while the majority of the population may experience only relatively mild illness. In many cases, the immune systems of those who survived the illness may be better equipped to defend against the same pathogens in future.”

According to Dr Snyman, in the past year increased awareness of infection prevention measures brought about by the pandemic have had a clear impact on public infectious illnesses. “The 2019 influenza season was fairly brutal with a significant number of hospitalisations and deaths globally. However, there does appear to be evidence from countries including South Africa that indicates the number of influenza cases declined dramatically from 2019 and 2020.

“A recent study from the US Centre for Disease Control (CDC) found that positive flu tests declined from 20% to below 2% or even undetectable levels in some regions, while local pathology survey reports of the major pathology groups in South Africa indicated very low incidence, if any, of the influenza virus being present during the winter of 2020,” he says.

“Last year, we therefore did not experience our typical flu season – far fewer cases were reported. It does seem as though the enhanced hygiene precautions due to Covid-19 may well have helped to stem flu infections. Although it would take longer to reflect in the published data, it may also be possible that efforts to prevent Covid-19 such as mask wearing and an emphasis on good ventilation could slow the spread of other diseases, including tuberculosis (TB) for instance.

“On the other hand, proponents of the hygiene theory of allergies would argue that our immune systems need exposure to a wide variety of germs to make it stronger and less prone to allergic reactions to otherwise fairly harmless environmental factors such as pollen,” Dr Snyman notes.

“In Eastern Europe, for example, it was observed that people living in traditional wooden houses, where the ground floor is used as a stable, suffered significantly fewer allergies – 20% to 50% less – than the typical population, where approximately 10% of people suffer allergies in Western Europe,” he says.

“It has been hypothesised that the germs and/or toxins from the animals on the lower level would rise through the houses to where the people lived and, from birth, the children’s immune systems were constantly stimulated through continual exposure.

“It has been suggested that this could have a protective effect through building natural immunity, which may not only assist the person for their lifetime, but may also be passed down through their genes to future generations,” Dr Snyman says.

“Covid-19 has been particularly devastating, in part because humans have not been exposed to it before, therefore even in genetically diverse populations like ours we had no inherent immunity. What we don’t know in the current situation where increased hygiene is a necessity for Covid-19 prevention, is how this may affect our immune systems in the longer term, and those of our great-great-grandchildren. We are entering the era of the unknown.

As part of Health Squared’s sustainable, member-centred approach to healthcare funding, it was the first scheme to cover Covid-19 tests irrespective of the result, thus encouraging responsible testing behaviour early on to help prevent community spread. The scheme will also cover the Covid-19 vaccine in full for members on all benefit options.

“Even with early detection and every precaution in place, a highly contagious virus like the novel coronavirus is still likely to spread wherever people interact. Ultimately, this may be necessary to bolster vaccination efforts to reach population immunity, because RNA viruses tend to mutate more readily and naturally-acquired immunity appears to offer protection against a range of variants.”

Christiaan Barnard Memorial Award honours top trauma surgeon

Mon, 10 May 2021 05:56:49 GMT

Prof Jacques Goosen and his wife Marieta

Countless lives saved by surgeon’s hands and shared expertise

An extraordinary contribution to the advancement of trauma medicine and a career’s worth of lives saved were recently acknowledged with the awarding of Netcare’s highest honour to renowned Gauteng trauma surgeon, Professor Jacques Goosen.

“Over many years, Prof Goosen has placed his exceptional surgical skill and tremendous insight into trauma at the service of patients, saving countless lives from often catastrophic injuries,” says Dr Richard Friedland, chief executive officer of Netcare.

“It is our privilege to present Prof Goosen with the Christiaan Barnard Memorial Award, as a tribute to the outstanding contribution he has made throughout his illustrious career, spanning some four decades in both the private and public sectors.“

Founded in 2011, the Christiaan Barnard Memorial Award pays tribute to doctors who practice at healthcare facilities within the Netcare Group and who have demonstrated leadership in their specific field while contributing to the advancement of the medical profession.

“I am truly honoured to accept this Christiaan Barnard Memorial Award from the people of Netcare, an organisation which lives by respect, dignity and compassion, an ethos of true caring that is intrinsic to the Group under the leadership of Dr Richard Friedland,” Prof Goosen said in accepting the award at a ceremony held recently at the University of the Witwatersrand (Wits) in Johannesburg.

“While I accept this award on behalf of others, I dedicate it to the patients and their families who say, ‘Thank you, doctor,’ not only in the moment of recovery, but also in the moment of ultimate grief.”

Prof Goosen attained his MBChB through the University of Pretoria in 1971, and in 1978 specialised in general surgery as a Fellow of the College of Surgeons of South Africa. After eight years in private practice in Welkom, he was appointed head of the surgical department at the Ernest Oppenheimer Hospital.

He served as a senior specialist in the Wits trauma unit of the Johannesburg General Hospital, now Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), where he continued his academic work and helped train other surgeons, many of whom came from around the world to learn from him, in specialised trauma techniques. In 1998, Prof Goosen started his long association with Netcare at the trauma unit of Netcare Milpark Hospital as a specialist surgeon on a part-time basis.

From 2003 until 2012, Prof Goosen was the principal surgeon and head of the trauma unit at CMJAH. Since 2007 he has been an Adjunct Professor with Wits University, building South Africa’s capacity in trauma medicine.

In 2006 he was appointed director of the trauma unit at Netcare Union Hospital where he also practised as a specialist trauma surgeon. He was instrumental in developing systems that saw the hospital accredited as a level one trauma centre by the Trauma Society of South Africa – one of only four private facilities in the country to have achieved this. From 2008 to 2020, he also served as director of Netcare Mulbarton Hospital’s trauma unit.

“Achievement is never individual, but at all times the result of contributions by others. I accept this award on behalf of my friends at Netcare, in particular at Netcare Milpark, Netcare Union and Netcare Rehabilitation hospitals and Netcare 911,” Prof Goosen said.

He expressed appreciation to the general manager of Netcare Union Hospital, Esme Abrahams, and a special thanks to Mande Toubkin, Netcare’s general manager of emergency, trauma, transplant and corporate social investment, whom he described as “the heart of trauma, emergency, disaster, and transplant healthcare in South Africa”.

“Above all, thank you to Marieta, my wife and partner, who keeps my feet on the ground,” Prof Goosen said. He also paid tribute to his colleagues in trauma medicine and other disciplines who work so closely together, united in their purpose of saving lives.

Professor Goosen remains a staunch supporter of Advanced Trauma Life Support (ATLS), South Africa, since 1992 when he started instructing, and served as Chairperson from 1998 to 2002. He was also a key member of the Strategic Review Committee for the World Health Organization’s Department of Violence and Injury Prevention. For four years until 2007, he served as Chairperson of the Trauma Society of South Africa.

“One’s career passes rapidly from achievement, to service, to reflection. Over many years, one experiences deep satisfaction from seeing young people uncover their hidden talents, realising how good they really are, and surpassing the achievements of their mentors,” said Prof Goosen, who has invested decades in training other medical professionals.

“There is no need to fear for the future. It is in the hands of a critical mass of people who see the spirituality of our world, who choose to treat their fellow man as they wish for themselves; and accept their own fallibility.”

Group medical director of Netcare, Dr Anchen Laubscher, presented Prof Goosen with the Christiaan Barnard Memorial Award, and warmly congratulated him on his numerous achievements, thanking him for his immense contribution to medicine.

“The dedication Prof Goosen has demonstrated in pursuit of preserving human life has earned him international respect and the lifetime gratitude of many thousands of patients and their families. He has been incredibly generous in sharing his expertise and building quality trauma care. He is indeed a most worthy recipient of the most prestigious award with which we can present him, the Christiaan Barnard Memorial Award.”

Don’t take a chance, malaria can be prevented

Fri, 30 Apr 2021 05:17:42 GMT

Sub-Saharan Africa has some of the highest malaria rates in the world, and even within our own borders, the health risks posed by this mosquito-borne illness cannot be taken lightly, especially for those at risk of more severe illness. A pharmacist from South Africa’s largest national courier pharmacy discusses the preventative measures to consider before visiting a malaria area.

“This year World Malaria Day is marked on Sunday, 25 April, an apt reminder of the dangers of malaria particularly for us in Africa, where more than 90% of the world’s malaria illnesses and deaths are recorded according to the World Health Organization [WHO],” says pharmacist Joy Steenkamp of Medipost Pharmacy.

The mosquito may be small, but it is regarded as the world’s deadliest animal because it can transmit illnesses to humans, including malaria which kills an estimated 400 000 people globally per year.

What is malaria?

“Malaria is an infection caused by the tiny Plasmodium parasite, which can be transmitted to humans if they are bitten by a parasite-infected female mosquito. Although malaria is often a mild illness with non-specific symptoms such as fever, headache, and upset stomach, it can progress to become a severe illness that may even be fatal. In some cases, malaria complications can leave the person with lasting health problems even after they have recovered from the illness,” she says.

Who is at risk?

“There are a few high-risk areas within South Africa. If you are travelling to certain parts of Limpopo, Mpumalanga and KwaZulu-Natal, it may be necessary to take measures to prevent malaria. Medicines for prevention are known as chemoprophylaxis and are even more important during summer between September and May, when malaria tends to be more prevalent,” Steenkamp says.

“Pregnant women, children under the age of five, and people who are HIV positive may be at increased risk for malaria and should particularly be cautious when visiting malaria areas.

Preventing malaria

“In malaria-endemic areas, prevention strategies, such as insecticide-treated nets (ITNs) are used, and potential vaccines are being studied in trials. For people planning to visit malaria areas, it is important to plan ahead, as prophylactic medicines available without prescription often need to be started one to two days before travelling and taken daily without interruption while in the malaria area and for a further seven days or more afterwards,” Steenkamp says.

When visiting malaria areas, it is also advisable to try to avoid being bitten by mosquitoes as far as possible. “Cover up by wearing long-sleeved shirts, long pants and sleeping with a mosquito net to help reduce your chances of being bitten. Mosquito repellents can also help, but pregnant women should be cautious to ensure any measures are pregnancy-safe before using them.”

Some malaria prophylactic medicines are available without a doctor’s prescription. Self-care products such as these are available from https://shop.medipost.co.za/ , where you can chat to our friendly online agents about the products we have in stock and register for convenient delivery to any address in South Africa. Delivery is free on purchases over R350, and when combined with monthly chronic medication orders.

“Your pharmacist will advise if you are a suitable candidate for malaria prevention as these medicines may interact with certain chronic medication, such as blood thinners and certain medications used for HIV and tuberculosis. Furthermore, pregnant women would need to consult with their doctor to determine the need for malaria chemoprophylaxis.”

People registered with Medipost Pharmacy’s chronic medication delivery service or self-care medication online shop, have free access to telephonic clinical advice from pharmacists and pharmacist’s assistants in their preferred official South African language.

This service is available from Monday to Friday, 08h00 to 17h00, and Saturdays between 08h00 and 12h00 for advice regarding dosage, possible side effects or interactions and other queries relating to medication dispensed by Medipost Pharmacy.

“Although we are all concerned about the Covid-19 pandemic, we cannot let our guard down when it comes to other major health concerns – especially preventable illnesses such as malaria. Do not take a chance if you are travelling to a malaria area, even this late in the season,” Steenkamp concludes.

Popping the myths around schizophrenia

Fri, 30 Apr 2021 05:03:44 GMT

The time to focus on a frequently ignored illness that impacts the lives of thousands of people has arrived. Schizophrenia is difficult for the person diagnosed with it and their loved ones, in addition, the number of myths surrounding the diagnosis can exacerbate their difficulties, contributing to a negative mindset.

Here are some of the common misconceptions about schizophrenia.

Myth: Schizophrenia means a split personality

Fact: While the name schizophrenia is derived from Greek and means ‘split mind’, it doesn’t mean split personality. Schizophrenia can change the way a person thinks by altering the way they feel and respond to certain situations. This change happens as their emotions fluctuate from day-to-day and the lack of a logical thought process.

Myth: People living with schizophrenia are always dangerous or violent

Fact: On the contrary, people living with schizophrenia are more likely to harm themselves or become victims of violence as opposed to harming others.

Myth: People living with schizophrenia always hallucinate

Fact : The most common symptoms of schizophrenia include low motivation, dulled emotions, rambling speech and the inability to express emotions. While hallucinations are one of the symptoms, they do not affect all people living with schizophrenia.

Myth: Schizophrenia runs in the family

Fact: While schizophrenia can be inherited, it’s not always the case. Should someone in your family be diagnosed with schizophrenia, it doesn’t mean you will have it as well.

Here are some more facts about schizophrenia

On average, people living with schizophrenia have a reduced life expectancy by up to 18 years.
Because of the severity of schizophrenia, up to 50% of people living with the disorder attempt suicide.
Schizophrenia ranks in the top 10 causes of disability in developed countries.
The onset on schizophrenia and its symptoms begin between the ages of 15 to 30.

While schizophrenia impacts the lives of people in several ways, it’s important to learn more about the disorder and not believe the myths and misconceptions. Visit schizophrenia24x7.co.za, a resourceful website packed with reliable information on treatment options and coping strategies.

Some treatment options for schizophrenia can include,

Oral medication which must be taken daily.
Monthly injectable which is administered by a doctor.

Remember, with the right monthly treatment, psychosocial support and interventions from close friends and family, people living with schizophrenia can go on to live stable and productive lives.

Do what you can

In working together, we can break the stigmas about schizophrenia and assist people living with the disorder to live a fulfilled life.

Medical schemes must shoulder responsibility in broadening healthcare access

Fri, 23 Apr 2021 08:32:50 GMT

Josua Joubert

Meeting new needs in challenging times

Emerging from the toughest economic year in the country since the Great Depression with a devastating 7% contraction in GDP in 2020, times are tough for South Africans.

Josua Joubert , CEO and Principal Officer of CompCare Medical Scheme , considers how a medical scheme can broaden access to quality healthcare at this challenging moment in history.

“For average households, affordability and lasting value have in the last year shot to the very top of the priority pile, if they were not there already. This is particularly true with regard to healthcare, which – with the ongoing impact of Covid-19 – is now more important than ever before,” he says.

Joubert points out that there remains a great deal of work to be done in ensuring the healthcare needs of all South Africans are met, but in the meantime there is a trend towards healthcare consumers doing their utmost to keep their healthcare cover intact.

“Medical schemes with a good balance of experience and foresight are addressing needs in segments of the market that have previously been overlooked. Quite simply, these individuals deserve better healthcare access. CompCare has therefore taken the stance of ‘waste not, want not’ with benefit options specifically formulated to make rands go further.

“For example, our efficiency discounted (ED) option offers exceptional value by partnering with Netcare hospitals and Dis-Chem pharmacies. This can amount to as much as 25% of the normal contribution rate for a similar plan, a difference that can, for many, make or break the decision to sign up for healthcare cover. Similarly, the majority of our preventative benefits – which provide for every stage of life – are paid from scheme risk and not from day-to-day benefits, assisting to preserve member savings more effectively,” he asserts.

Joubert notes that flexibility is another pertinent factor when it comes to access, particularly for employer groups where one of the greatest challenges is finding the right provider to affordably cover several different staff bases without compromising on quality. “CompCare can solve this problem, with an option for everyone from the lowest-earning employee to the top-ranking executives, all within one scheme.

“And, while the ability to seek quality preventative care and treatment for one’s physical wellbeing is paramount to a good quality of life, mental health should be of equal importance. CompCare’s emotional wellness benefit, which is available free of charge on all options, provides a 24-hour helpline with trained clinical professionals, together with a referral for face-to-face counselling when required.

“As one of the country’s top-rated medical schemes, we take seriously the responsibility to provide healthcare cover that offers truly meaningful benefits for even the tightest of healthcare budgets. We pledge to continue reaching further than ever before to improve healthcare access, now and into the future,” Joubert concludes.

Growing inclusion non-negotiable for SA healthcare

Fri, 23 Apr 2021 08:25:03 GMT

Teshlin Akaloo

NetcarePlus fills important market gap to remove barriers to quality care

Quality healthcare and the peace of mind it provides can only be sustainable if it is made accessible to more South African households. To this end, Netcare, one of the country’s leading private healthcare providers, is expanding healthcare funding options available in South Africa to address the affordability barrier still faced by many individuals and families.

“Quality healthcare should be inclusive and yet the financial pressures that many employed people are facing means that private healthcare is simply out of their reach,” says Teshlin Akaloo, managing director of Netcare’s Innovative Products division, which is launching innovative new products under the NetcarePlus brand.

“Access to quality healthcare when a person most needs it protects livelihoods and longer-term health. The NetcarePlus brand, encompassing financial services and other products, has been established to serve the need for innovative healthcare solutions to fill the affordability gap.

“This new and affordable way for South Africans to get private healthcare will be supported by a range of innovative products to enable employers and individuals to purchase healthcare services as and when required. These products can either serve as stand-alone options for those who are uninsured or as a practical add-on to existing cover.”

New accident and trauma cover

Etienne du Toit, general manager: product & marketing for NetcarePlus adds that in addition to the primary healthcare GP consultation vouchers launched in July 2020, NetcarePlus has identified a market need for hassle-free access to private emergency and trauma care.

“Netcare has partnered with Hollard as the underwriter for its latest product offering, NetcarePlus Accident and Trauma Cover, aimed at broadening access to this critical service. We believe the peace of mind that comes with having made provision for such unexpected eventualities should be attainable by as many people as possible,” says Du Toit.

“Hollard is South Africa’s largest privately owned insurance group, with an outstanding track record and partnership business model and we are pleased to be associated with such a strong and reputable insurance brand.”

This insurance product guarantees stabilisation at the scene of an accident or trauma event and Netcare 911 transportation to a contracted private hospital. Another important benefit is that it also includes access to unlimited in-hospital treatment for up to 90 days for accident and trauma related medical care.

The package will include, among others, associated services following from an accident or trauma event, for example pathology and radiology and 24-hour trauma counselling services. The cover also includes regular lump sum payments if the accident or trauma event results in the person being hospitalised for two days or more. Completing the picture, assistance with Road Accident Fund claims are also included, where needed.

Recognising the fact that consumers prefer to have a choice as to how and where they buy, the product is available through intermediaries as well as a user friendly and secure online application platform – https://bit.ly/3fg9p4F – where individuals can get a quote and activate their accident and trauma cover. NetcarePlus GP vouchers can also be purchased on this platform.

“We are pleased to be a part of this innovative answer to reducing the funding challenges many South Africans grapple with. NetcarePlus products offer a unique mechanism providing reassurance that access to private healthcare is secured before it is needed,” says Besa Ruele, CEO: Hollard Life Solutions.

“Hollard is a solutions-driven insurer and we partnered with NetcarePlus to find gaps that exist in the market and resolve them with imagination and innovation, so we can create positive and enduring change for South Africans. This partnership will ensure that we enable more people to create and secure a better future for themselves and their family members because of the unique design of this product range,” Ruele explains.

NetcarePlus Prepaid Procedures

“The NetcarePlus Prepaid Procedure product intends to provide an affordable solution for certain medical procedures at an all-inclusive cost. These procedures are performed at certain Netcare hospitals by a few surgeons and at prescribed times, and the price we charge includes all costs related to the procedure and not just the cost of the hospital stay,” says Du Toit.

“The COVID-19 pandemic has highlighted the urgency of closing the affordability gap through creative models that are workable for South Africa’s dynamic economically active population. In making new funding mechanisms available to provide financial certainty around private healthcare costs, it will be possible for many thousands more South Africans to enjoy the benefits of quality healthcare in the private healthcare setting,” Akaloo asserts.

“By packaging the necessary quality care with affordable payment solutions to deliver peace of mind in an end-to-end service, NetcarePlus’ prepaid products encourage earlier, timeous intervention and treatment.

“A growing national network of healthcare professionals underpins the NetcarePlus offering, connecting them with a growing client base, which also contributes to expanding their practices.

“Quality healthcare helps people live their full potential. More South Africans can now affordably take care of their health and be prepared for emergencies through innovative solutions such as those offered by NetcarePlus through the extended Netcare ecosystem,” Akaloo concludes.

Note: The NetcarePlus Accident and Trauma product is underwritten by The Hollard Insurance Company Limited (Hollard), a licensed non-life insurer and an authorised financial services provider. This cover is not a medical scheme, and the cover is not the same as that of a medical scheme. This insurance product is not a substitute for medical scheme membership.

Finding it hard to focus?

Mon, 19 Apr 2021 15:26:49 GMT

Tips from a healthcare specialist on improving concentration

Have you ever forgotten why you walked into a room, incorrectly filled out a form or missed an important deadline? Problems with concentration can affect people of any age and can lead to outcomes varying from the insignificant to the severe. Fortunately, according to Amanda Kuhn, an occupational therapist in the COPE therapy team at Akeso Pietermaritzburg, there are a number of effective ways in which you can bolster brainpower and overcome this type of mental hurdle.

“Just as we consider the health of our bodies, we need to consider the health of our minds,” asserts Kuhn. “There are several important factors within our control that contribute to our cognitive ability. There can, however, also be underlying causes leading to attention span issues, which may require very specific diagnosis and treatment. It is therefore advisable to take stock of what you are experiencing if you have concerns about your concentration.”

Do I have a problem with concentration?

Kuhn cautions that just one or two of the below behaviours could indicate a need to introduce constructive measures:

Being easily distracted or restless
Inability to think clearly or solve problems
Forgetting recently acquired information
Difficulty in completing tasks timeously
Making careless mistakes
Inability to sustain attention and ensuing impulsive behaviour
A lack of motivation and energy

Occupational therapist, Amanda Kuhn

Tips on improving concentration

Kuhn recommends starting with creating a balanced lifestyle and controlling external factors as far as possible.

1. Get enough sleep

“Quality sleep is vital to good concentration and general health. Adults need seven to nine hours per night, teens around ten hours and young children even longer. Too little or too much sleep will leave you feeling tired, so it’s important to find the right balance for yourself.

Include: Blue screen filters if you work on a computer; non-caffeinated beverages at night; a bedtime routine – it can take 30 minutes to one hour to fall asleep.

Exclude: Watching TV or using a computer or cell phone before bedtime; heavy meals and caffeine in the evenings.

2. Maintain a healthy diet

“Managing sugar levels helps to keep your brain energised and alert. Eat moderate, healthy portions regularly throughout the day. People struggling with this may wish to consult a registered dietician.

Include: Plant oils, fish oils and nuts – all excellent for the brain; plants and fruits – these provide vitamin C, magnesium, zinc and calcium, which are important for concentration.

Exclude: Processed foods, which do not provide the sustained energy needed to beat that mid-afternoon slump.

3. Exercise regularly

“An active lifestyle is vital for maintaining good health all round. Exercise stimulates dopamine – an important neurotransmitter in the body that helps one to focus – and oxygenates the body, allowing you to focus more clearly. Again, balance is important – studies have shown that continuous physical training for more than 60 minutes a day can cause increased release of stress hormones, negatively impacting concentration levels.

Include: Daily moderate exercise and regular desk breaks; children doing homework in the afternoons may need to get up and move around between homework tasks or every half hour.

Exclude: Sitting in the same position for hours at a time – get up and move around at least every hour.

4. Practice mindfulness

“Learning how to bring your attention back to the present is one of the best ways to control focus and set aside distracting internal thoughts.

Include: Focused breathing exercises – concentrate on your breathing while you breathe in slowly and deeply through the nose and slowly out through the mouth, three or four times while paying attention to the flow of the air and the movement in your chest or abdomen. This is a practice you can do anytime, anywhere.

5. Do brain games

“Give your brain a workout and sharpen concentration by stimulating memory and the reasoning, logic part of the brain.

Include: Memory games, visual or verbal; logic games such as Sudoku, puzzles, word games; games of strategy and problem solving, such as crosswords, chess, Bridge and similar activities.

Exclude: Overuse of screens – certain digital games can be excellent for exercising logic and memory but too long in front of a screen is bad for your health. Set an alarm for 20 or 30 minutes as a reminder to stop.

6. Manage your workspace

“The environment in which you work plays an important part in your ability to focus.

Include: Good ambient lighting; a comfortable room temperature; sound cancelling headphones if you struggle with noise or white noise in the background if you battle to concentrate in silence.

Exclude : Distracting noises or music; headache-inducing artificial light.

7. Reactivate your brain

“When a concentration slump does hit, get up and move around. Some people find it helpful to play with a stress ball while thinking, while others like to chew. Keep healthy snacks at hand in such cases,” advises Kuhn.

Underlying causes

“Concentration issues can point to an underlying condition that requires further investigation. For example, a person’s ability to focus can be impacted by depression or they may be struggling with an undiagnosed condition such as an attention deficit disorder,” explains Kuhn.

“There may be physiological causes such as neurochemical imbalances of cortisol, serotonin or dopamine, which impact concentration ability. Ageing diseases such as dementia or Alzheimer’s are often red flagged with diminishing concentration and memory.

“Anxiety disorders also impact a person’s thinking ability, as racing thoughts create an internal distraction. Stress management is integral to regaining focus, as when you are stressed your body goes into survival mode making it hard to reason and concentrate,” asserts Kuhn.

Stress and concentration in youngsters

Kuhn encourages parents and teachers to be mindful of the correlation between stress and poor concentration in children and teens. “Many children feel a great deal of pressure to perform well at school. Pushing children hard to succeed can have the opposite effect to what is desired, as high stress levels inevitably impact their ability to focus.

You may see an increase in physical activity or in eating in these children, which is a natural response to raise dopamine levels and combat stress. Symptoms could appear to be those of an attention deficit disorder but it can also be the case that it is stress related. All possibilities should be explored, which can require a little time and patience in order to rule out any lifestyle-related issues,” advises Kuhn.

When to seek professional help

Kuhn notes that there is no empirical data about the length of attention span an individual should experience, however any memory or concentration issues impairing a person’s ability to function well should be taken note of. “Anyone noticing concerning changes or struggling to make cognitive improvements may wish to visit their GP, who will be able to help assess the situation and refer to a specialist if required,” concludes Kuhn.

For information about concentration and memory concerns or accessing mental health services or if you are in an emotional crisis, Akeso is here to help. Contact info@akeso.co.z a or visit www.akeso.co.za or www.copetherapy.co.za . In the event of a psychological crisis, emergency support can be reached at 0861 435 787, 24 hours a day.

Kidney disease can strike at any age

Thu, 15 Apr 2021 06:36:35 GMT

Unit leader of National Renal Care Queenstown, Sr Chumani Mbixane, says that people with kidney failure usually need dialysis treatment three times a week for four hours at a time. “We get to know our patients quite well, and we care for each one individually with empathy. NRC Queenstown is still providing dialysis for some of the same patients since our unit opened some 20 years ago,” she says.

Dialysis and ongoing caring support can sustain quality of life for many years

Most people take their kidney health as a given, however kidney failure leaves people reliant on renal dialysis for survival, unless a kidney transplant can be performed. Fortunately, it is now possible for people with end-stage kidney disease to live well for many years with the aid of dialysis and by adopting a healthy lifestyle.

“Many people mistakenly believe that kidney disease is only a problem in older people, however the reality is it can affect individuals at any age,” says Sr Chumani Mbixane, the unit leader of National Renal Care (NRC) Queenstown in Komani in the Eastern Cape.

“Kidney function can often be preserved if the problem is detected before it progresses to end-stage kidney disease and is appropriately managed. For many people there may be no noticeable symptoms at first, therefore regular general practitioner examinations and kidney function tests are recommended,” she says.

“People with high blood pressure and/or diabetes may be at particular risk for developing kidney disease, as are those with family members with kidney disease [hereditary kidney disease], and should make a point of discussing their kidney health regularly with their doctor.”

NRC units nationwide, including NRC Queenstown, support renal patients by providing haemodialysis, and continuous health education suited to each individual’s condition and circumstances. Haemodialysis is a life-saving procedure for people with impaired kidney function or kidney failure. A dialysis machine filters the person’s blood and artificially purifies it as a substitute for the detoxification function usually performed by healthy kidneys. Peritoneal dialysis is another form of dialysis available, involving fluid exchange via a membrane in the patient’s abdomen.

National Renal Care records patients’ progress and outcomes on an ongoing basis as part of benchmarking to ensure quality care that is data driven is provided to patients. These include self-reported health and well-being assessments, which assists the NRC team to focus on the outcomes that matter most for a patient. In 2020, more than 70% of NRC patients nationally reported they felt physically well within expected parameters, although they remain reliant on dialysis. A resounding 89.8% reported good mental wellness, which is integral to overall wellbeing.

“We also have the Health Start programme, which is unique to NRC, where people with early kidney disease are provided with the information they need to preserve their remaining kidney function. When detected early enough, this may even prevent their kidneys from deteriorating and the person may be able to avoid the need for dialysis, or delay it by years,” she explains.

“Individuals with kidney failure usually need dialysis treatment three times a week for four hours at a time. We therefore get to know our patients quite well, and we care for each one individually with empathy,” Sr Mbixane says.

The Queenstown unit, which originally opened in August 2001 with only two haemodialysis machines, has had to relocate several times to larger premises in order to accommodate the needs of its growing patient base. The comfortable, modern facility now has 21 dialysis stations and capacity to dialyse 84 patients per week. Sr Mbixane adds that NRC Queenstown is still providing dialysis for some of the same patients since the unit opened some 20 years ago.

“With the expert guidance of a renal specialist, known as a nephrologist, and following the guidelines for maintaining a healthy lifestyle we provide as part of our service at NRC, it is possible for renal patients to not only survive but enjoy quality of life for decades with end stage kidney disease,” Sr Mbixane concludes.

Advice for keeping your kidneys healthy

Many kidney diseases can be prevented with the following tips from National Renal Care:

Quit smoking: Smokers are three times more likely to have reduced kidney function.
Limit alcohol consumption: This can help prevent heart disease and high blood pressure, which both increase the risk of kidney disease.
Eat a balanced, nutritious diet and maintain a healthy weight: This also helps to prevent diabetes and high blood pressure, major risk factors for kidney disease.
Drink enough water: Six to eight glasses per day this will help your kidneys flush out harmful toxins.
Exercise regularly
Regularly check your kidney health with your general practitioner
Only take medicines and supplements with your doctor’s approval

Romance and schizophrenia: An odd couple

Tue, 13 Apr 2021 05:08:59 GMT

Dating in an era of social media can be daunting. Dating for people living with schizophrenia? Double daunting. This is why many people living with schizophrenia avoid relationships of any kind.

The symptoms of schizophrenia vary from person to person, which is why it’s important to have an open, honest conversation about what someone living with schizophrenia faces. Some of the symptoms include,

Delusional behaviour

False ideas that are often far from reality.

Hallucinations

Visual or auditory hallucinations that are extremely real to the person experiencing it.

Disorganised thinking and speech

Effective communication is often impaired as a person living with schizophrenia, may be unable to have coherent thoughts, let alone a conversation.

Lack of emotions and expression

Commonly known as ‘flat-affect’, a person living with schizophrenia may be unable to express their true feelings through speech or actions. This may result in emotional distance between a couple.

These symptoms impact a person’s ability to maintain meaningful relationships, especially romantic relationships. However, with medical progress in treating and managing the symptoms of schizophrenia, it has become possible to date and maintain long-term, meaningful relationships.

Here are some tips to make it easier for people living with schizophrenia, or interested in dating someone with schizophrenia.

1. Keep expectations in check

Even if a person’s schizophrenia is well-managed and they feel healthy, dating may result in social anxiety. From the beginning, it’s important to make your expectations known to your partner and possibly engage in therapy to better discuss these expectations.

2. Take it slow

Stress is one of the triggers of schizophrenia and makes it difficult to manage the symptoms. Taking it slow is smart when easing into a relationship. Start with low-key activities such as coffee dates, picnics or going for a walk in nature. These activities reduce expectations and give you time to ease into a relationship.

3. Go easy on sexual activities

Many schizophrenia treatment options impact the libido. If your medication results in the inability to get aroused or experience an orgasm, speak to your doctor about other treatment options.

4. Teamwork makes the dream work

For many people living with schizophrenia, dating can be just a dream. But with the right person and open, honest communication, it’s possible. Go to therapy together. It will help your partner learn about your symptoms from the person that knows you best, your doctor. It also empowers your partner with the knowledge to help should a psychotic episode occur.

Dating with schizophrenia is possible, especially with the right treatment such as long-acting monthly injectables to manage your symptoms. After all, a partner’s support can be one more way to live better with schizophrenia.

To learn more about schizophrenia, visit schizophrenia24x7.co.za for helpful resources and tips on living with schizophrenia.

Psoriasis is more than skin deep

Mon, 12 Apr 2021 07:50:59 GMT

People living with psoriasis face the reality of their condition at all times. Red, scaly patches on the skin, the itch that won’t go away, the stares, invasive questions and comments, and the never-ending physical pain.

Living with psoriasis is more than a skin condition. This disease is a daily physical, emotional and psychological battle for one million South Africans living with this chronic disease, and can cause mental stress, anxiety, low self-esteem and depression. On top of this, people living with psoriasis also face social stigma, as the disease is often difficult to hide. The stigma can negatively impact their mental health and can result in people living with the disease, isolating themselves.

What is psoriasis?

Psoriasis is a serious lifelong skin condition, where the body makes new skin cells at an alarming rate, causing the cells to pile up on the skin’s surface. This causes thick, scaly lesions, called plaques.

Psoriasis can affect children, as young as 15-years-old, women and men across all racial lines. And the impact of psoriasis can be devastating to other organs and tissues in the body.

Many people diagnosed with psoriasis are often overweight and have higher cholesterol. These health concerns, coupled with the severity of psoriasis, lead to an increased risk for vascular disease, causing heart attacks, strokes, and premature death, as the inflammation can harm the arteries and veins.

Symptoms associated with psoriasis

Although psoriasis can present on any part of the body, it is most common on the knees, elbows, lower back, scalp, legs, face, palms and the soles of the feet. Symptoms are different for everyone, and can include,

Red patches covered with thick, silvery scales
Stiff, swollen and painful joints
Itching and burning
Dry and cracked skin

Clear skin is achievable

Although there is no cure for psoriasis, people living with this disease don’t have to suffer. Dermatologists can prescribe treatment options that can reduce or eliminate symptoms, bringing much-needed relief to people living with psoriasis. These treatment options can include topical treatments to help prevent the skin from becoming too dry, oral medication, light therapy, and breakthrough biologics that makes it possible for a patient to achieve clear skin.

People with symptoms of psoriasis should seek medical treatment from a dermatologist who will prescribe effective treatment options. Should you need ongoing treatment, enquire with your medical aid to access effective treatment to help achieve clear skin. Remember, effective psoriasis treatment can also prevent other serious health concerns like diabetes or psoriatic arthritis, and help people with the condition live a fulfilled and healthy life.

People living with psoriasis should also educate themselves about this debilitating disease, recognise what triggers cause their psoriasis to flare-up, and then make lifestyle changes to avoid the triggers. The #MoreThanSkinDeep Facebook page is a valuable resource that shares information about the impact of living with psoriasis. Lastly, remember a good skincare routine and healthy lifestyle can help.

CANSA and SACRS launch Colorectal Cancer Awareness & Support

Thu, 08 Apr 2021 04:41:17 GMT

The Cancer Association of South Africa (CANSA) in partnership with The South African Colorectal Society (SACRS) launched its Colorectal Awareness and Support Programme on World Health Day, 7 April 2021. COVID-19 has led to a delay in screenings and treatment as CANSA urges all to make health a priority.

Elize Joubert, CANSA CEO says, “Colorectal cancer affects men and women in South Africa significantly. It’s the 2nd most common cancer among men and the 3rd most common cancer among women (National Cancer Registry 2017). Unfortunately, colorectal cancer symptoms are not always recognised for what they are, leading to misdiagnosis and a more advanced stage of cancer. Our Colorectal Cancer Awareness and Support Programme will help people recognise the signs of colorectal cancer, increase knowledge around screening options to facilitate early detection and help lower the risk for colorectal cancer. We further hope to assist colorectal cancer patients to cope better with diagnosis and treatment by releasing support materials throughout the year, that aims to help them to better understand and access public and private health support services, pain management, stoma products and care.”

CANSA and the SACRS will also advocate with policy makers for a National Colorectal Cancer Policy. The policy should promote the rights of colorectal cancer patients, guide population based screening and public health services related to risk reduction, treatment, care, support and control of colorectal cancer.

Dr Adam Boutall, head of colorectal surgery at Groote Schuur Hospital and the President of the SACRS comments, “The SACRS is looking forward to partnering with CANSA as it launches its colorectal campaign. Early diagnosis of colorectal cancer, improves survival and increasing awareness and education around colorectal cancer is critical to achieving this.”

CANSA Stoma Support

Many colorectal cancer patients have a portion of their bowel and / or colon removed and end up with a permanent stoma. A stoma is an opening on the abdomen that can be connected to the digestive or urinary system to allow waste to be diverted from the body. It can take a while for a patient to adapt to living with a stoma, so it’s important to seek support from CANSA.

“CANSA’s stoma service has an excellent offering of stoma products, accessories and provides patient support. We recently introduced our CANSA Tele Stoma Support Service where online consultations for stoma patients and their families are offered to assist with challenges or stoma queries,” Joubert states.

A stoma patient, living in a remote area, recently responded with thanks, after being assisted through the CANSA Tele Stoma Service with regards to changing the stoma bag and being given advice with regards to treatment of side effects: "You really helped me because I didn't know anything, and the consultation really helped me so much. And now I know at least how to do something and if I need help, I can ask you. Now I have a clue what to do when I have a rash."

Symptoms

It is important to contact CANSA or go to a local clinic or doctor to investigate symptoms. Symptoms of colorectal cancer might present as: a persistent change in bowel habits (including diarrhoea or constipation or a change in consistency of stools); rectal bleeding or blood in stools; persistent abdominal discomfort (cramps, gas or pain); a feeling that the bowel does not completely empty; weakness or fatigue; or unexplained weight loss.

Screening

Identifying the presence of blood in the stool, can help detect colorectal cancer early. CANSA offers faecal occult at home stool test kits (R100), which can be done at home. If the test is positive (visible red line on test strip) for the presence of blood in the stool, CANSA provides a referral letter to request a colonoscopy.

A colonoscopy in symptomatic patients or patients over the age of 50 can detect precancerous polyps in the colon. If these polyps are removed the chance of developing colorectal cancer can be dramatically reduced.

CANSA offers an online Lifestyle Risk Assessment Tool , which helps identify lifestyle factors which could increase cancer risk, and then provides recommendations on how to change behaviour to lower cancer risk. This can also be done at CANSA Care Centres .

(For more information, please contact Lucy Balona, Head: Marketing and Communication at CANSA at email lbalona@cansa.org.za . Call 011 616 7662 or mobile 082 459 5230.)

Arthritis in children: A surprising condition

Tue, 06 Apr 2021 10:09:31 GMT

Early intervention and specialised care key to successful treatment

Winter may be upon us but that has never stopped the children of South Africa from making the most of the outdoors, running around and playing ball games until the sun goes down. However, some children are unable to join in the fun due to a debilitating illness one tends to associate only with the elderly – arthritis.

This disease is surprisingly common among children, with between one and four in every 1 000 being affected. According to Dr Bhadrish Mistry, a paediatric rheumatologist practising at Netcare Mulbarton Hospital south east of Johannesburg, it is difficult to pinpoint these numbers any closer as there are so many undiagnosed cases.

“Due to the misconception that arthritis affects only older people, there are sadly thousands of children suffering from the illness who are not correctly diagnosed and therefore do not receive the proper treatment,” says Dr Mistry. “Misdiagnosis of arthritis in children is truly a tragedy, as it results in unnecessary suffering and often in disability, such as finger and wrist deformities. It can even be fatal.”

Juvenile idiopathic arthritis is an autoimmune disease that can take seven different forms, some of which are less severe and affect less than four joints. Others can be more severe, such as systemic juvenile arthritis, which presents with swollen joints, bad skin rash, fever that comes and goes and can affect certain internal organs. Between 19 000 and 75 000 children are estimated to be living with arthritis in South Africa.

“Currently the youngest patients I am seeing are 15 months and 25 months old. Shortly after starting to walk, the 15-month-old had stopped altogether – that’s when his parents knew something was not right. It turned out he had arthritis in his hip and the pain made him stop wanting to walk, so there was a regression in that milestone,” relates Dr Mistry.

Fortunately, if a diagnosis can be made early, the chances of successful treatment are good and while no cure exists for the disease it can be managed so that the patient’s physical development and growth can continue as it should, and they can enjoy a normal childhood.

Dr Priya Ambaram, a paediatric rheumatologist practising at Netcare Waterfall City Hospital in Midrand, Johannesburg, explains that arthritis in its most basic form can be described as pain, swelling and limitation of movement of a joint. “Common symptoms may include a swollen joint, intermittent fevers and skin rashes, and fatigue and body aches. However, it is often a change in behaviour in a child that may indicate a problem. Parents may note that their child is limping, or not using one of their legs, for example.

“It is important to remember that children are not small adults – they do not communicate in the same way. An adult will usually be able to discuss pain in a detailed way. Children will often deny they are in pain but may be irritable, have trouble sleeping or play less. Sometimes quite specific changes can occur, such as an alteration in handwriting, which may indicate problems in the fingers or wrist joint,” she says.

Dr Ambaram points out that children are not only unlike adults mentally and emotionally, but physically too in that their bodies are constantly changing as they grow and develop. It is for this reason that specialist doctors are required to attend to their medical needs. “Many people find it hard to believe that children can have arthritis or that there are even paediatricians who specialise in the treatment of this,” she relates.

Indeed, there are at present only nine paediatric rheumatologists in South Africa, three in Gauteng, one in KwaZulu-Natal and five in Cape Town. Of these, three practise at Netcare facilities, namely Dr Bhadrish Mistry, Dr Priya Ambaram, and Dr Kate Webb, who practises at UCT Private Academic Hospital in Cape Town. There are two training programmes available – one at the University of the Witwatersrand and one at the University of Cape Town – nevertheless, there is a severe shortage of paediatric rheumatology specialists and services for children locally. It would also appear that many sufferers are not diagnosed due to a lack of awareness about the disease affecting children.

Dr Ambaram asserts that arthritis in children can often be missed if a thorough examination of the musculoskeletal system – that is the muscle, bone and joint – is not performed. “It is important for the attending healthcare professional to enquire about joint stiffness or limping that is worse in the morning or after periods of inactivity, as this suggests inflammatory arthritis.

“Arthritis can affect a single joint or multiple joints, it can be acute lasting for less than six weeks, or chronic, extending beyond six weeks. There are many factors that can lead to the onset of arthritis in children. A common respiratory tract infection can trigger arthritis in one or multiple joints. If the inflammation in the affected joint does not subside, as it should, this is a concern. Conditions such as a malignancy, connective tissue disease and certain genetic conditions can also play a part in triggering arthritic inflammation. If juvenile arthritis is suspected, prompt referral to a paediatric rheumatologist will be necessary,” she notes.

Treatment varies depending on the type of arthritis as well as the period of time the child has been suffering. Dr Mistry explains that non-steroidal anti-inflammatory medication is used to provide some relief for the pain and discomfort while disease modifying anti-rheumatic drugs (DMARDs) are used to treat the arthritis itself. Treatment would usually begin with conventional DMARDs, which are highly effective in many cases. Should this not be effective then biologic DMARDs would be required, which are very costly. In the case of systemic arthritis, biologic DMARDs are the first line of defence due to the severity and duration of the disease. Good nutrition is also very necessary whilst taking medication and furthermore supports the body in fighting negative growth.

“The sooner the child can receive treatment the better the chances of a positive response and a remission from the arthritis. Even as little as six months without treatment can result in damage, so time really is of the essence. Once in remission, we always have to watch for flare-ups which can be brought on by the many unavoidable triggers. However, if we can control the disease early on there is a good chance for the child to have totally normal development,” explains Dr Mistry.

“Watching a child deal with the pain or discomfort caused by arthritis is something no parent wants to experience. Children are adaptable and they quickly change their behaviour to avoid activities that have become difficult for them. As soon as you relieve the pain they blossom again. It is amazing to see the progress these little ones can make when they get the care they need early on,” he concludes.

Children suffering from arthritis are not alone and can reach out to Arthritis Kids South Africa, a support group for sufferers of the disease and their families. Visit arthritiskids.co.za or email admin@arthritiskids.co.za for more information.

KeyHealth Medical Scheme curatorship confirmed

Thu, 01 Apr 2021 05:33:06 GMT

The journey of restoring governance at KeyHealth Medical Scheme continues. This follows the curatorship confirmation by the High Court of South Africa on 25 March 2021, in a judgment by Honourable Judge Kollapen.

The Scheme had been placed under provisional curatorship on 16 September 2020, through an order by Honourable Judge Kubishi, and the erstwhile Trustees had brought a reconsideration application.

“This confirmation of curatorship underscores efforts which are already in motion to restore governance at KeyHealth, for the protection and benefit of its members,” said Dr Sipho Kabane, the Registrar of Medical Schemes.

Curatorship is an intervention put in place by the Medical Schemes Act (131 of 1998) that empowers the Registrar of medical schemes to protect members’ interests and assets, where necessary. It involves the removal of the Board of Trustees (BoT), and the appointment of a Curator to take full management of a scheme and rectify the identified issues.

KeyHealth Medical Scheme was placed under curatorship following non-compliance with several regulatory aspects of the Medical Schemes Act. Specifically:

The irregular appointment of the Chief Executive Officer, contravening its scheme rules;
Irregularities in the election of some of the scheme’s Trustees;
The composition of the BoT when effecting the removal of implicated Trustees – including conflict of interest and violation of the Code of Conduct of Trustees;
The implementation of a discriminatory incentive structure against new older members in favour of new younger members.

In addition to non-compliance, other governance problems were also identified. For instance:

The long tenure of the existing BoT;
Interference by external parties in the scheme;
Divisions within the BoT as a result of dysfunction in the governance structure.
The Curator’s role and mandate is to, amongst others, restore overall effective governance of the scheme, facilitating the proper election of a new BoT to oversee its affairs, whilst ensuring continued servicing of members and beneficiaries of the scheme.

To access the ruling, click here .

It’s home at last for SA’s first COVID-19 lung transplant patient

Wed, 31 Mar 2021 11:23:37 GMT

Dr Paul Williams, pulmonologist intensivist (left) and Dr Martin Sussman, cardiothoracic surgeon, who both practise at Netcare Milpark Hospital, admire baby Kuhle as her proud mother, Mbali and father, Sizwe look on.

‘All is well’ for Mbali and Baby Kuhle

An air of celebration surrounded 27-year-old Mbali Mbatha, as she was wheeled out of Netcare Milpark Hospital amidst applause from doctors, nurses and hospital staff who had come to wish her well when she recently left the facility to start what would be a very different life than what she led before.

Not only did the young mother from Winchester Hills in Johannesburg leave hospital with a three-month-old baby daughter – whom she met for the first time just a few weeks before – but she also left with a newly transplanted lung, having overcome one of deadliest viruses of the 21st century.

A 113-day COVID-19 journey

Mbali’s COVID-19 journey started more than 113 days prior on 23 November 2020, when the severely ill expectant mother was hospitalised in an effort to safeguard both her and her unborn child. Mbali’s condition however deteriorated and by 1 December her obstetrician was left with no choice but to deliver her baby at 30 weeks via emergency C-section.

Mbali credits this as one of the first in a series of major medical decisions that would have life-saving consequences not only for baby Kuhle, which means ‘all is well’, but also for her.

“I was shocked when the doctor told me that he needed to prepare for a C-section and operate immediately. When I realised that I would not be able to carry full term I was devastated. I phoned my husband, Sizwe who calmed me down and said I must let them take the baby out as it would be best for us. All I remember is the cold, it was terribly cold in the operating theatre. I felt so alone – my husband could not be with me. It was a very distressing experience, as I did not even see the baby... I gave birth to my little girl and I passed out,” recalls a tearful Mbali.

Dr Paul Williams, pulmonologist intensivist at Netcare Milpark Hospital relates the next steps: “Mbali was brought to Netcare Milpark Hospital, shortly after she had her baby. She was in serious danger as both her lungs were affected from top to bottom with pneumonia and she was not extracting oxygen from the air. We immediately had to escalate her treatment to a more sophisticated form of care than what would generally be needed by most patients with COVID-pneumonia.”

Cardiothoracic surgeon, Dr Martin Sussman, says Mbali was in extremis and was taken straight from the ambulance into theatre where she was placed on extracorporeal membrane oxygenation (ECMO), which artificially maintains a supply of oxygen to the brain and other vital organs for patients who require either or both respiratory and cardiac support.

“ECMO is essentially an artificial lung. The circuit does the work of the lungs and that is how we kept Mbali alive while she had COVID-pneumonia,” explains Dr Sussman. “While Mbali eventually recovered from COVID-19 her lungs did not recover. One of the complications of COVID-19 is that it sometimes damages the lungs extensively. In Mbali’s case the damage was irreversible. Her only chance of survival was to receive a donor lung.”

A first for South Africa and the African continent?

Commenting on what appears to be a first for South African medicine, Dr Williams, who along with Dr Martin Sussman, led the lung transplant team performing Mbali’s surgery, says lung transplantation itself is a rare procedure for patients with established lung disease such as cystic fibrosis and other conditions. It is done only after all other treatments for lung failure are unsuccessful.

“COVID-19 is a new one for us though. We have had no experience in transplantation with this virus and we are fairly sure that we are the first team in South Africa to do it – perhaps we are even the first team on the African continent. Throughout the world there have been only around 100 lung transplants performed so far for COVID-19 pneumonia at a handful of facilities.”

“To be able to do a transplant on this young woman who is also a mother, was really something special. We did it for her and her baby. Being part of this remarkable team that can make this kind of difference is an immense honour,” notes Dr Williams.

Waking up in hospital after two months

According to Mbali her next memory after delivering her baby was waking up in Netcare Milpark Hospital, many weeks later.

“Some time after I woke up, I was told that I had been in a coma for two months and that I had a lung transplant. In fact, it seemed that there was very little hope I would survive. Had it not been for the exceptional medical care I received and for the lung transplant I would not be here today,” she says.

Despite everything she has gone through, Mbali has left Netcare Milpark Hospital with good memories and much to be thankful for: “The staff are very warm and caring. They ended up feeling like family. The encouragement that the nursing staff and doctors gave me on a daily basis really carried me through. They made me feel like everything was going to be ok.

“I am so thankful to be here today and that I have been given an opportunity to raise my daughter. I am grateful to the doctors and staff of Netcare Park Lane Hospital and Netcare Milpark Hospital. I am particularly grateful to the donor and the brave family for the gift of life, which ensured that I was given this second chance.

“My husband Sizwe has given me so much moral support and encouragement. He only ever had positive things to say. He was a constant source of inspiration throughout my recovery, and he kept telling me that I would walk out of the hospital. During the time that I have been in hospital my mother, Christine has been looking after my baby. While I am sad that I missed out on so much time with her, I am eternally thankful that my mother was there to care for her. More than anything I thank God for saving my life and giving me a second chance at life,” says Mbali.

In closing, Marc van Heerden, general manager of Netcare Milpark Hospital said: “Mbali’s discharge from Netcare Milpark Hospital is a proud moment for us. We are very grateful to the doctors, the nurses, the staff and the donor for giving this family a new chance in life.”

About ECMO

Having identified a tremendous need for the provision of specialised extracorporeal membrane oxygenation (ECMO) treatment, the Netcare Group has established a comprehensive integrated ECMO programme, which in addition to the ECMO rapid reaction transfer teams, has resulted in the establishment of dedicated ECMO centres of excellence at facilities such as Netcare Milpark Hospital, which houses the largest unit of this kind in the country.

In addition to the centre at Netcare Milpark Hospital, Netcare has over the last decade also established adult ECMO centres at Netcare Unitas Hospital in Centurion, Pretoria and UCT Private Academic Hospital in Cape Town. There is also a paediatric ECMO centre at Netcare Garden City Hospital in Johannesburg.

These centres are registered with the Extracorporeal Life Support Organisation [ELSO], which means they are benchmarked against other ECMO centres globally to ensure the highest quality of care. Large numbers of patients who require ECMO support are consequently referred to them from around the country.

International studies have shown that ECMO life support treatments are best undertaken at dedicated ECMO facilities, as they have the necessary expertise, experience and equipment available to successfully provide this form of therapy.

Early referral to an ECMO centre is critical to good outcomes and often to the very survival of patients who, for one reason or another, have failing or highly compromised respiratory or cardiovascular systems. Unfortunately, ECMO treatment in South Africa is still sometimes only called for when it is already too late for patients. They should be referred as soon as other life support systems, such as traditional ventilation, are no longer effectively sustaining the patient.

Mbali Mbatha and her husband Sizwe show off their baby daughter, Kuhle to Marc van Heerden, general manager of Netcare Milpark Hospital.

Triple-check tech for accuracy in knee replacements

Tue, 30 Mar 2021 06:50:38 GMT

Woman and her dog look forward to forest walks again

A clinical psychologist is looking forward to resuming the activities she used to enjoy, after recently becoming the first patient at Netcare Christiaan Barnard Memorial Hospital to undergo a knee replacement aided by advanced navigation technology, using a technique that is a first for South Africa. Coincidentally, one of the patient’s dogs, a bullmastiff named Franki, also had knee replacement surgery not long ago and they have a goal in mind to celebrate their recovery.

“What I am really looking forward to once I am fully recovered is the freedom of going for walks in the forest with my dogs and dancing at a party, once the COVID-19 situation permits of course,” said Lesley Nortje, 62, only three days after her total knee replacement procedure.

“Mrs Nortje’s operation was scheduled three times before, however it had to be delayed each time because there were peaks in COVID-19 infection rates. At last, we were able to do her knee replacement. The delay meant that it could be performed with the aid of this recently commissioned, technologically advanced system,” says orthopaedic surgeon Dr Richard von Bormann, who performed the landmark procedure at Netcare Christiaan Barnard Memorial Hospital in the Cape Town City Bowl.

Balance and comfort

“Our ultimate aim in total knee arthroplasty, or knee replacement surgery, is to recreate a comfortable, balanced joint with stability and a good range of movement. The more accurately we can recreate the patient’s natural anatomy with the prosthetic knee joint in place, the better the knee will function and the better the patient’s comfort will be.”

Dr Von Bormann has undergone special training in the use of the Smith and Nephew’s handheld Navio Robotic Navigation system, which offers additional safeguards at each stage in the operation is planned intra operatively on a three-dimensional (3D) patient-specific map.

“In theatre, the surgeon traces the patient’s knee anatomy and measures the tensions of the ligaments with a mapping tool, which feeds highly detailed information into the system’s computer as a plan for the procedure. A surgical burr technique or a-resection guide is then fitted with fixed navigational reference points, which track movement of the anatomy in real time to enhance surgical accuracy,” Dr Von Bormann explains.

Additional safeguard technique a first for SA

Dr Von Bormann devised a technique whereby he combined this Brainlab Knee Navigation Platform from the CORI Robotic System with the additional safeguard of a Visionaire patient-specific cutting guide as a tool to confirm the accuracy of the Brainlab surgical plan. The manufacturers confirmed that the novel, combined use of the technology was a first for South Africa.

Triple-check technology

“Throughout the procedure, the computer triple checks in real time what the surgeon is doing against the 3D computer-generated map. Instead of relying solely on a pre-surgery MRI scan to design and manufacture patient specific cutting guides for total knee replacement procedures, the computer navigation system provides constant, highly detailed feedback,” Dr Von Bormann says.

While the computer navigation system allows for the surgical plan to be adjusted at the surgeon’s discretion, it automatically confirms the position and accuracy of the bony resections being performed so the surgeon’s designed plan is achieved. A verification tool confirms the accuracy of each resected cut as an additional check, so that the surgeon can make fine adjustments, if needed, before moving on to the next step of the procedure.

“This is especially helpful in knee replacement surgery because the prosthetic knee joint must match the patients anatomy to fit into the space created when the damaged bone surface is removed. The more accurately this can be achieved, the less need there is a need to adjust the ligaments surrounding the joint.”

The computer navigation system helps to ensure the tension of the ligaments is recreated to provide the person’s natural balance in their new prosthetic knee’s function. If the ligaments are too tight their range of motion would be restricted, and the person would feel discomfort. If the ligaments are not tight enough, however, the knee could be unstable.

A holiday accident and years of discomfort

Mrs Nortje says that over the years she had injured her knee several times, most notably on a visit to Italy some 12 years ago. “To celebrate my 50th birthday I had planned a walking trip in Italy but soon after we arrived, I damaged some ligaments on my knee. It was quite painful, and so instead of a walking holiday we were ‘forced’ to make the most of our time there enjoying Italian cuisine and drinking in the beautiful scenery instead,” she recalls.

Over the years, her knee also deteriorated from osteoarthritis, compounding her discomfort. Initially more conservative treatments were prescribed, including physiotherapy and injections, but as the condition of her knee became more severe Mrs Nortje was no longer able to do the things she formerly loved.

“I have been struggling for years, and for the last few years I have not been able to walk my dogs in the forest or undertake any activities I previously enjoyed. I had not been looking forward to the prospect of a knee replacement, but it got to a point where I was in a lot of pain and it was compromising my quality of life.

“As a clinical psychologist, I was fortunate that my difficulty walking did not affect my ability to work, but it is a bit disheartening to always be in pain and to be compromising your lifestyle because of your knee. In the end it became an absolute necessity for me to have the total knee replacement.”

Road to recovery for Mrs Nortje, and her dog

“My dog, Franki, also had knee problems and local veterinarian Dr Gray performed two separate back knee replacement operations a few months before my operation, and she required lots of care and confinement in her recovery but is now doing well. We are both looking forward to getting back to our walks in the forest, and it will be a great milestone in both of our recoveries,” she adds.

Dr Von Bormann says that with the appropriate physiotherapy, Mrs Nortje should be able to start resuming normal activities such as going for walks within three to six months. “On the very first day after total knee replacement surgery, the patient stands. On the second day, they walk a short distance with crutches, and by the third day they start climbing stairs as part of the physiotherapy.”

“At first it was very scary to think of walking on my new knee, but I am amazed that I am already on my way to regaining the use of my leg. I walked all the way down the passage on crutches by the second day, and by the end of the week I was back home. The hospital staff have been great, and I had a sea view from my bed so I could watch the ships,” Mrs Nortje says.

General manager of Netcare Christiaan Barnard Memorial Hospital, Dr Louis van der Hoven, congratulated Dr Von Bormann on the procedure. “We are grateful to Dr Von Bormann for the time he has dedicated to mastering this new system, which puts the benefits of this advanced technology and his immense surgical expertise at the service of our community.”

Lesley Nortje and her dog Franki are both recovering from knee replacement operations and are looking forward to going for forest walks together again. Mrs Nortje was the first patient at Netcare Christiaan Barnard Memorial Hospital to benefit from new advanced navigation technology and a first-for-SA technique.

Learning to live with bipolar disorder

Fri, 26 Mar 2021 10:29:00 GMT

With early intervention and a holistic approach, you can live a fulfilled and fruitful life

While general awareness about mental health issues has grown significantly in recent years, certain conditions requiring very specific diagnosis and treatment can remain under the radar, with devastating effects for those individuals affected.

One such mental health condition is bipolar disorder, which is being recognised this World Bipolar Day on Tuesday 30 March. According to Dr Viresh Manilal Chiman, a psychiatrist practising at Akeso Parktown, if diagnosed early and treated using a holistic approach, bipolar disorder can be managed with life-changing improvements for the individual and their family who would otherwise be “struggling against a tidal wave of adversity”.

The South African Depression and Anxiety Group (SADAG) states that over four million people in South Africa are living with bipolar disorder. With such a large portion of the population known to be suffering from this condition and many more individuals probably remaining undiagnosed, Dr Chiman asserts that greater awareness of the illness and its management could make a world of difference for those affected.

What to look out for

“There are multiple factors leading to bipolar disorder including genetics, structural brain changes, inflammatory markers and neurochemical abnormalities. Observing the individual’s thinking, mood and behaviour is a necessary part of the diagnostic process, as it is important to assess the phase a patient is in during an episode and whether there may be any associated psychotic symptoms. Individuals may, for example, experience a depressive episode, a manic or hypomanic episode, or a mixed episode,” explains Dr Chiman.

A depressive episode usually consists of low mood, an inability to take pleasure in usually enjoyable activities, a change in sleep patterns and appetite, feelings of guilt, hopelessness and worthlessness, being indecisive and having suicidal thoughts. If these symptoms are present for a period of two or more weeks, it may indicate bipolar disorder.

A manic episode on the other hand includes the following symptoms for a period of one or more weeks: elevated or irritable mood, increased activity, being more talkative than normal, having racing thoughts or flight of ideas, socially inappropriate comments or behaviour, a decreased need for sleep, grandiose thoughts, being easily distracted, impulsive or reckless behaviour and increased or compulsive sexual behaviour. Hypomania is similar to mania but with less intensity, lasting for at least four days.

In a mixed episode, the individual experiences a rapid alteration of hypomanic or manic symptoms and/or depressive symptoms.

Am I at risk?

According to Dr Chiman, a family history of depression or bipolar disorder is the main risk factor. “Major stressful life events may bring on or perpetuate an episode, while not adhering to medication and treatment can cause a relapse. People may present with symptoms that look like mania but are actually secondary to another medical condition, alcohol or substance use. An accurate diagnosis is therefore all important.”

The different forms of bipolar disorder

“The term bipolar disorder in fact refers to a group of brain disorders that take the form of three conditions, namely bipolar I, bipolar II and cyclothymic disorder,” notes Dr Chiman.

Bipolar I – a manic-depressive disorder that can be with or without psychotic features
Bipolar II – alternating depressed and manic episodes
Cyclothymic disorder – a cyclic disorder of depressive or hypomanic symptoms present for more than 50% of the time for a minimum of two years.

Bipolar depression refers to an individual with known bipolar disorder who is going through a depressive episode.

Coping strategies

Early diagnosis is key to managing bipolar disorder. Once diagnosed, a patient needs to:

Learn to understand their illness and to recognise the warning signs and patterns
Be compliant with treatment which will include both psychotherapy and medication
Live a balanced lifestyle with manageable stress levels
Identify a support system
Have a plan of action in the event of relapse
Avoid substance and alcohol use

“With a multi-disciplinary, holistic approach, bipolar disorder can be well managed, but it is an illness that affects every aspect of a person’s life and it is therefore important to watch it constantly and not let it take over.

“It is an ongoing process and there will be highs and lows. Medication does have side effects and it is necessary to consider risks versus benefits of any medication decision. Despite these challenges, people living with bipolar disorder can have fulfilled and fruitful lives,” suggests Dr Chiman.

When to get help

Dr Chiman cautions that, if left untreated, bipolar disorder can result in chronic and eventually permanent changes in the brain with impairments to cognitive and decision-making abilities. “Sadly, without management, the condition can result in personal relationships being destroyed, problems in the workplace, financial issues, reckless risk-taking behaviour, a risk of alcohol and/or substance use disorders, criminal behaviour and potential harm to self as well as to others.

“A doctor should be consulted when there are noteworthy shifts in mood and changes in sleep, appetite and energy. A close eye needs to be kept on people with bipolar disorder in times of intense stress or excitement. After several relapses, patients and their loved ones can identify the patterns and should seek help as soon as they notice these signs and symptoms. Having suicidal thoughts can be a complication of certain medications, in which case the patient needs to seek help right away so that the necessary adjustments can be made,” he advises.

An emergency intervention

“Family members, friends and colleagues will often be able to identify mania and other symptoms before the individual in question does and, in those instances, should take the person to their treating psychiatrist or to an emergency department immediately. In certain instances, the mental state of the individual is so deeply affected that they are not able to see the necessary course of action for themselves and may need to be involuntarily committed to hospital under the Mental Health Care Act,” concludes Dr Chiman.