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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

Is milk really so well-known, asks UFS’s Prof. Osthoff
2011-03-17

Prof. Garry Osthoff
Photo: Stephen Collett

Prof. Garry Osthoff opened a whole new world of milk to the audience in his inaugural lecture, Milk: the well-known (?) food, in our Department of Microbial, Biochemical and Food Biotechnology of the Faculty of Natural and Agricultural Sciences.

Prof. Osthoff has done his research in protein chemistry, immuno-chemistry and enzymology at the Council for Scientific and Industrial Research (CSIR) in Pretoria and post-doctoral research at the Bowman-Grey School of Medicine, North Carolina, USA. That was instrumental in establishing food chemistry at the university.
 
He is involved in chemical aspects of food, with a focus on dairy science and technology. He is also involved in the research of cheese processing as well as milk evolution and concentrated on milk evolution in his lecture. Knowledge of milk from dairy animals alone does not provide all the explanations of milk as food.
 
Some aspects he highlighted in his lecture were that milk is the first food to be utilised by young mammals and that it is custom-designed for each species. “However, mankind is an opportunist and has found ways of easy access to food by the practice of agriculture, where plants as well as animals were employed or rather exploited,” he said.
 
The cow is the best-known milk producer, but environmental conditions forced man to select other animals. In spite of breeding selection, cattle seem not to have adapted to the most extreme conditions such as high altitudes with sub-freezing temperatures, deserts and marshes.
 
Prof. Osthoff said the consumption of the milk as an adult is not natural; neither is the consumption of milk across species. This practice of mankind may often have consequences, when signs of malnutrition or diseases are noticed. Two common problems are an allergy to milk and lactose intolerance.
 
Allergies are normally the result of an immune response of the consumer to the foreign proteins found in the milk. In some cases it might help to switch from one milk source to another, such as switching from cow’s milk to goat’s milk.
 
Prof. Osthoff said lactose intolerance – the inability of adult humans to digest lactose, the milk sugar – is natural, as adults lose that ability to digest lactose. The symptoms of the condition are stomach cramps and diarrhoea. This problem is mainly found in the warmer climates of the world. This could be an indication of early passive development of dairy technology. In these regions milk could not be stored in its fresh form, but in a fermented form, in which case the lactose was pre-digested by micro-organisms, and the human population never adapted to digesting lactose in adulthood.
 
According to Prof. Osthoff, it is basically the lactose in milk that has spurred dairy technology. Its fermentation has resulted in the development of yoghurts and all the cheeses that we know. In turn, the intolerance to lactose has spurred a further technological solution: lactose-free milk is currently produced by pre-digestion of lactose with enzymes.
 
It was realised that the milks and products from different species differed in quality aspects such as keeping properties and taste. It was also realised that the nutritional properties differed as well as their effects on health. One example is the mentioned allergy against cow’s milk proteins, which may be solved by the consumption of goat’s milk. The nutritional benefits and technological processing of milk aroused an interest in more information, and it was realised that the information gained from human milk and that of the few domesticated species do not provide a complete explanation of the properties of milk as food. Of the 250 species of milk which have been studied, only the milk of humans and a few domesticated dairy animals has been studied in detail.

Media Release
15 March 2011
Issued by: Lacea Loader
Director: Strategic Communication
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: news@ufs.ac.za

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