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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

Research into veld fires in grassland can now help with scientifically-grounded evidence
2015-04-10

While cattle and game farmers are rejoicing in the recent rains which large areas of the country received in the past growing season, an expert from the University of the Free State’s Department of Animal, Wildlife, and Grassland Sciences, says that much of the highly inflammable material now available could lead to large-scale veld fires this coming winter.

Prof Hennie Snyman, professor and  researcher in the Department of Animal, Wildlife, and Grassland Sciences, warns that cattle and game farmers should be aware, in good time, of this problem which is about to rear its head. He proposes that farmers must burn firebreaks as a precaution.

At present, Prof Snyman focuses his research on the impact of fire and burning on the functioning of the grassland ecosystem, especially in the drier grassland regions.

He says the impact of fire on the functioning of ecosystems in the ‘sour’ grassland areas of Southern Africa (which includes Kwazulu-Natal, Limpopo, Mpumalanga, the Eastern Cape, and the Harrismith environs) is already well established, but less information  is available for ‘sweet’ semi-arid grassland areas. According to Prof Snyman, there is no reason to burn grassland in this semi-arid area. Grazing by animals can be effectively used because of the high quality material without having to burn it off. In the sourer pasturage, fire may well form part of the functioning of the grassland ecosystem in view of the fact that a quality problem might develop after which the grass must rejuvenate by letting it burn.

Prof Snyman, who has already been busy with the research for ten years, says quantified data on the impact of fire on the soil and plants were not available previously for the semi-arid grassland areas. Fires start frequently because of lightning, carelessness, freak accidents, or damaged power lines, and farmers must be recompensed for this damage.

The shortage of proper research on the impact of fires on soil and plants has led to burnt areas not being withdrawn from grazing for long enough. The lack of information has also led to farmers, who have lost grazing to fires, not being compensated fairly or even being over-compensated.

“When above-and below-ground plant production, together with efficient water usage, is taken into account, burnt grassland requires at least two full growing seasons to recover completely.”       

Prof Snyman says farmers frequently make the mistake of allowing animals to graze on burnt grassland as soon as it begins to sprout, causing considerable damage to the plants.

“Plant roots are more sensitive to fire than the above-ground plant material. This is the reason why seasonal above-ground production losses from fire in the first growing season after the fire can amount to half of the unburnt veld. The ecosystem must first recover completely in order to be productive and sustainable again for the long term. The faster burnt veld is grazed again, the longer the ecosystem takes to recover completely, lengthening the problem with fodder shortages further.  

Prof Snyman feels that fire as a management tool in semi-arid grassland is questionable if there is no specific purpose for it, as it can increase ecological and financial risk management in the short term.

Prof Snyman says more research is needed to quantify the impact of runaway fires on both grassland plant productivity and soil properties in terms of different seasonal climatic variations.

“The current information may already serve as valuable guidelines regarding claims arising from unforeseen fires, which often amount to thousands of rand, and are sometimes based on unscientific evidence.”

Prof Snyman’s research findings have been used successfully as guidelines for compensation aspects in several court cases.

 

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