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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 part of project aimed at producing third-generation biofuels from microalgae in Germany
2016-05-09

Description: Novagreen bioreactor  Tags: Novagreen bioreactor

Some of the researchers and technicians among the tubes of the Novagreen bioreactor (Prof Grobbelaar on left)

A researcher from the University of the Free State (UFS), Prof Johan Grobbelaar, was invited to join a group of scientists recently at the Institute for Bio- and Geo-Sciences of the Research Centre Jülich, in Germany, where microalgae are used for lipid (oil) production, and then converted to kerosene for the aviation industry.

The project is probably the first of its kind to address bio-fuel production from microalgae on such a large scale.  

“The potential of algae as a fuel source is undisputed, because it was these photoautotrophic micro-organisms that were fixing sunlight energy into lipids for millions of years, generating the petroleum reserves that modern human civilisation uses today.  However, these reserves are finite, so the challenge is marrying biology with technology to produce economically-competitive fuels without harming the environment and compromising our food security.  The fundamental ability that microalgae have to produce energy-rich biomass from CO2, nutrients, and sunlight through photosynthesis for biofuels, is commonly referred to as the Third-Generation Biofuels (3G),” said Prof Grobbelaar.

The key compounds used for bio-diesel and kerosene production are the lipids and, more particularly, the triacylglyserols commonly referred to as TAGs.  These lipids, once extracted, need to be trans-esterified for biodiesel, while a further “cracking” step is required to produce kerosene.  Microalgae can store energy as lipids and/or carbohydrates. However, for biofuels, microalgae with high TAG contents are required.  A number of such algae have been isolated, and lipid contents of up to 60% have been achieved.

According to Prof Grobbelaar, the challenge is large-scale, high-volume production, since it is easy to manipulate growth conditions in the laboratory for experimental purposes.  

The AUFWIND project (AUFWIND, a German term for up-current, or new impetus) in Germany consists of three different commercially-available photobioreactor types, which are being compared for lipid production.

Description: Lipid rich chlorella Tags: Lipid rich chlorella

Manipulated Chlorella with high lipid contents (yellow) in the Novagreen bioreactor

The photobioreactors each occupies 500 m2 of land surface area, are situated next to one another, and can be monitored continuously.  The three systems are from Novagreen, IGV, and Phytolutions.  The Novagreen photobioreactor is housed in a glass house, and consist of interconnected vertical plastic tubes roughly 150 mm in diameter. The Phytolutions system is outdoors, and consists of curtains of vertical plastic tubes with a diameter of about 90 mm.  The most ambitious photobioreactor is from IGV, and consists of horizontally-layered nets housed in a plastic growth hall, where the algae are sprayed over the nets, and allowed to grow while dripping from one net to the next.

Prof Grobbelaar’s main task was to manipulate growth conditions in such a way that the microalgae converted their stored energy into lipids, and to establish protocols to run the various photobioreactors. This was accomplished in just over two months of intensive experimentation, and included modifications to the designs of the photobioreactors, the microalgal strain selection, and the replacement of the nutrient broth with a so-called balanced one.

Prof Grobbelaar has no illusions regarding the economic feasibility of the project.  However, with continued research, optimisation, and utilisation of waste resources, it is highly likely that the first long-haul flights using microalgal-derived kerosene will be possible in the not-too-distant future.

Prof Grobbelaar from the Department of Plant Sciences, although partly retired, still serves on the editorial boards of several journals. He is also involved with the examining of PhDs, many of them from abroad.  In addition, he assisted the Technology Innovation Agency of South Africa in the formulation of an algae-biotechnology and training centre.  “The chances are good that such a centre will be established in Upington, in the Northern Cape,” Prof Grobbelaar said.

 

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