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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

Researcher finds ways to serve justice efficiently
2016-01-07

Description: Prof Monwabisi Ralarala  Tags: Prof Monwabisi Ralarala

Prof Monwabisi Ralarala tackled the serving of justice from a linguistic viewpoint.
Photo: Supplied

In 2012, local and international media was saturated with reports of the Eugène Terre’Blanche murder trial. At the judgment, Judge John Horn read a lengthy extensive document, of which three pages were dedicated to voicing his concern about how police officers distort statements in the process of translation. Considering the fact that statements are the entry points to the criminal justice system, Prof Monwabisi Ralarala’s attention was drawn to the negative impact such distortion had insofar as the administration of justice was concerned. Of the three PhD degrees conferred by the University of the Free State (UFS) Faculty of Humanities at the 2015 Summer Graduation, one was in Language Practice with Prof Ralarala’s name on it.

Prof Ralarala’s research interests in language rights, forensic linguistics, and translation studies led him to use the Terre’Blanche trial as the basis for his second PhD case study titled: Implications and explications of police translation of complainants' sworn statements: evidence lost in translation. The doctoral dissertation focused on police stations in the Xhosa-speaking community of Khayelitsha in Cape Town.

Language and the law

When the victim of a crime approaches the South African Police Services (SAPS), the requirements are that a sworn statement be taken. However, as a prerequisite, the narration needs to be translated into English.  “The process unfolds in this manner: the complainant or the person laying the charges speaks in a language that they understand, and then the police officers translate that information into English because English is still the de facto language of record,” explained Prof Ralarala.

In the process of translation, the original narrative is lost, and so is some of the evidence. “They [the statements] have to be packaged in a certain way, in the form of a summary. As a police officer, you have to discard all the original narrative and create another narrative which is in English,” added the Associate Professor and Institutional Language Coordinator at the Cape Peninsula University of Technology.

Evidence is the basis of any court case and, when it is translated by police officers who do not hold the credentials of professional translators, a problem inevitably arises.

Because police officers are not trained in translation, “Some of the statements are filled with distortions, changing of information all together. In some cases, one would come across a case which was initially an assault but then - through the change and transformation, re-narration, retelling of the story by someone else - it becomes a case of attempted murder.”

Considering that a statement determines a suspect’s fate, it becomes all the more important to ensure that accuracy is upheld.

His internal and external supervisors, Prof Kobus Marais and Prof Russel Kaschula from the UFS and Rhodes University respectively stated that his PhD work has been hailed as a gem by international scholars. “According to one international assessor, he has made an exceptional contribution to the humanities and social sciences in general and to the fields of linguistics and translation studies in particular.”

Reshaping the landscape

According to Prof Ralarala, there are huge gaps in the translated versions of statements which create a problem when a ruling is made. Some of the recommendations put forward in his dissertation to bridge that gap are:

• to review the language policy insofar as the criminal justice system is concerned. The languages we speak are official and constitutionally embraced, and they hold the same status as English, hence they need to be used in criminal justice processes;
• to revisit the constitution and review if the provisions made for the Nguni languages are implemented;
• to supplement paper and pen with technology such as tape recorders. Statements can be revisited in cases where a controversy arises;
• to deploy professional translators and interpreters at police stations;
• to design a manual for police officers which contains all the techniques on how a statement should be taken.
• to enforce constitutional  provisions in order to reinforce the language implementation plan in as far as African languages are concerned .

These recommendations serve to undo or eliminate any perceived injustices perpetuated and institutionalised by current linguistic and formal practices in South Africa's criminal justice system.

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