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27 December 2021 | Story André Damons | Photo Supplied
Prof Stephen Brown, Principal Specialist in the Department of Paediatrics and Child Health in the Faculty of Health Sciences at the University of the Free State (UFS), and his team are taking life-saving medical care to young patients in the rural parts of the Free State.

Paediatric heart specialists hope that an outreach initiative started back in 2016, allowing them to travel to rural areas in the Free State to diagnose heart defects in babies early, would grow and expand to other rural areas and provinces. 

Every year, more than 40 babies in the rural areas of South Africa may die as a result of an undiagnosed heart lesion, because everyone assumes that they have respiratory problems when they actually have critical congenital heart disease – up to 85% of which is curable, says Prof Stephen Brown, Principal Specialist and Head of the Division of Paediatric Cardiology  in the Department of Paediatrics and Child Health in the Faculty of Health Sciences at the University of the Free State (UFS).

Prof Brown, who is also a paediatric cardiologist at the Universitas Academic Hospital, says a life-saving collaboration initiative between the UFS, the Mother and Child Academic Hospital (MACAH) Foundation, and the Discovery Fund started five years ago to help curb the death of young patients due to congenital heart disease, and to make services more accessible to rural communities.

Hundreds of patients seen annually  

“We initiated an outreach programme due to the fact that some patients found it difficult to get transport to our central hospital. Since the Free State is considered rural, there are long distances to travel. Our concept was that we should take the service to grass-roots level to make it more convenient for the parents and caretakers.

“We partnered with MACAH, and since early detection of congenital heart disease makes a big difference, it fits in nicely with MACAH’s first 1 000 days drive. Due to the hard work of Tertia de Bruyn, we were given the opportunity to come into contact with Discovery. Dr Daniel Buys (UFS Department of Paediatrics and Child Health) and Rudolph Pretorius (echocardiography technician) did a lot of the initial paperwork and motivation,” says Prof Brown.  

According to him, a mobile echocardiography apparatus was donated by the Discovery Foundation via MACAH, which is crucial for doing this outreach work. The machine looks like a laptop and can be transported in a carry case.  

“We see between 170 and 250 patients on an annual basis. The service is obviously confined to secondary hospitals, and we started doing the Mofumahadi Manapo Mopeli Hospital in Qwaqwa and the Bongani Regional Hospital in Welkom. It has since expanded to the Dihlabeng Regional Hospital (Bethlehem) and the Pelonomi Secondary Hospital in Bloemfontein. Since initiation in 2020, Pelonomi has seen on average 40 children per month receiving a heart sonar. COVID-19 has had a major impact on our work,” says Prof Brown. 

First 1 000 days in any child’s life determine their trajectory for life

Prof André Venter, Chairman of the MACAH Foundation, says one of the main commitments of the MACAH Foundation in central South Africa is their passionate belief that the first 1 000 days in any child’s life determine their trajectory for life. Says Prof Venter: “We should do everything in our power to ensure that this 1 000-day journey is as optimal for each child, including conception, pregnancy, birth, and health during the first two years of life.”

“As Chairman of the MACAH Foundation, I am sincerely grateful to pioneers such as Prof Brown and his team in Paediatric Cardiology for their excellent outreach initiative, but also to the Discovery Fund who shared our vision and that of Prof Brown’s team and was willing to make this very generous donation. I am so proud of and so grateful to all of you,” says Prof Venter.

According to him, this has not only helped to make infant cardiac screening in the rural areas a reality, but also to make it a world-class service.   

The importance of the partnership for rural areas  

Prof Brown says in his experience, this initiative is greatly appreciated, as he and Dr Buys do the clinics and heart sonars personally. “The families find this fantastic, since they can have direct interaction with their cardiologist, which allows for better communication and adds a personal touch. When they come to Bloemfontein for further assessment – their faces light up when seeing a familiar face.”  

“It also helps with treatment and management at their local institution. I also find that the doctors in the hospitals appreciate it tremendously – they find it easier to phone and ask for advice. It brings the ‘fancy tertiary physicians’ to a human level with whom they can interact. It also alleviates a lot of stress for the physicians, and they can show/ask advice re difficult cases,” says Prof Brown.  

By doing outreach, Prof Brown concludes, they have learned so much about the communities and the importance of being accessible, as patients appreciate having direct interaction with the professor. The doctors and staff have also been enthusiastic and supported them tremendously at all the hospitals. The students from Cuba have joined Prof Brown and his team when visiting their hospitals, and they can spend some dedicated clinical teaching time together.

News Archive

Bloemfontein's quality of tap water compares very favourably with bottled water
2009-08-04

The quality of the drinking water of five suburbs in Bloemfontein is at least as good as or better than bottled water. This is the result of a standard and chemical bacterial analysis done by the University of the Free State’s (UFS) Centre for Environmental Management in collaboration with the Institute for Groundwater Studies (IGS).

Five samples were taken from tap water sources in the suburbs of Universitas, Brandwag, Bain’s Vlei, Langenhoven Park and Bayswater and 15 samples were taken of different brands of still and unflavoured bottled water. The samples were analysed at the laboratory of the IGS, while the interpretation of the analysis was done by the Centre for Environmental Management.

“We wanted to evaluate the difference in quality for human consumption between tap water and that of the different brands of bottled water,” said Prof. Maitland Seaman, Head of the Centre for Environmental Management.

“With the exception of two samples produced by multinational companies at their plants in South Africa, the different brands of bottled water used for the study were produced by South African companies, including a local small-scale Bloemfontein producer,” said Prof. Seaman.

According to the labels, the sources of the water vary from pure spring water, to partial reverse osmosis (as an aid to standardise salt, i.e. mineral, content), to only reverse osmosis (to remove salts). (Reverse osmosis is a process in which water is forced under pressure through a pipe with minute pores through which water passes but no – or very low concentrations of – salts pass.)

According to Prof. Seaman, the analysis revealed some interesting findings, such as:

• It is generally accepted that drinking water should have an acceptable level of salt content, as the body needs salts. Most mineral contents were relatively higher in the tap water samples than the bottled water samples and were very much within the acceptable range of drinkable water quality. One of the bottled samples, however, had a very low mineral content, as the water was produced by reverse osmosis, as stated on the bottle. While reverse osmosis is used by various producers, most producers use it as an aid, not as a single method to remove nearly all the salts. Drinking only such water over a prolonged period may probably have a negative effect on the human physiology.

• The pH values of the tap water samples (8,12–8,40) were found to be slightly higher (slightly alkaline), like in all south-eastern Free State rivers (from where the water is sourced) than the pH of most of the bottled water samples, most of which are sourced and/or treated in other areas. Two brands of bottled water were found to have relatively low pH levels (both 4,5, i.e. acidic) as indicated on their bottles and as confirmed by the IGS analysis. The health implication of this range of pH is not significant.

• The analysis showed differences in the mineral content given on the labels of most of the water bottles compared to that found by IGS analysis. The possibility of seasonal fluctuation in content, depending on various factors, is expected and most of the bottling companies also indicate this on their labels. What was a rather interesting finding was that two pairs of bottled water brands claimed exactly the same mineral content but appeared under different brand names and were also priced differently. In each case, one of the pair was a well-known house brand, and the other obviously the original producer. In one of these paired cases, the house brand stated that the water was spring water, while the other (identical) “original” brand stated that it was spring water treated by reverse osmosis and oxygen-enriched.

• Nitrate (NO3) levels were uniformly low except in one bottled sample, suggesting a low (non-threatening) level of organic pollution in the source water. Otherwise, none of the water showed any sign of pollution.

• The bacterial analysis confirmed the absence of any traces of coliforms or E.coli in any of the samples, as was also indicated by the bottling companies. This is very reassuring. What is not known is how all these waters were sterilised, which could be anything from irradiation to chlorine or ozone treatment.

• The price of the different brands of bottled water, each containing 500 ml of still water, ranged between R3,99 and R8,99, with R5,03 being the average price. A comparison between the least expensive and the most expensive bottles of water indicated no significant difference in quality. In fact, discrepancies were observed in the most expensive bottle in that the amount of Calcium (Ca) claimed to be present in it was found to be significantly different from what the analysis indicated (29,6 mg/l versus 0,92 mg/l). The alkalinity (CaCO3 mg/l) indicated on the bottle was also found to differ considerably (83 mg/l versus 9,4 mg/l). The concentration of Total Dissolved Salts (TDS) was not given on the product.

“The preference for bottled water as compared to Bloemfontein’s tap water from a qualitative perspective as well as the price discrepancy is unjustifiable. The environmental footprint of bottled water is also large. Sourcing, treating, bottling, packaging and transporting, to mention but a few of the steps involved in the processing of bottled water, entail a huge carbon footprint, as well as a large water footprint, because it also requires water for treating and rinsing to process bottled water,” said Prof. Seaman.

Media Release
Lacea Loader
Deputy Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za  
3 August 2009

 

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