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27 December 2021 | Story André Damons | Photo Supplied
Prof Stephen Brown
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

Moshoeshoe - lessons from an African icon - by Prof Frederick Fourie
2004-11-03

(The full text of the article that appeared in City Press and Sunday Independent)

Our understanding of history informs our understanding of the present. No wonder the contestation over historical figures in South Africa’s past is so fierce and so divisive.
The question is: could it be any other way? I would like to think that it could; that black and white South Africans, across linguistic, cultural, religious and other divides, can develop a shared appreciation of our history – at least with certain periods and personalities as a starting point.

One such personality whose legacy I believe offers a possible platform for unifying our still divided country is King Moshoeshoe, who lived from 1786 to 1870, and is acknowledged as the founder of the Basotho.

King Moshoeshoe is the topic of a documentary that has been commissioned by the University of the Free State as part of its Centenary celebrations this year. It is part of a larger project to honour and research the legacy of Moshoeshoe. The documentary will be screened on SABC 2 at 21:00 on November 4th.

Moshoeshoe rose to prominence at a time of great upheaval and conflict in South Africa – the 19th century, a time when British colonialism was entrenching itself, when the Boer trekkers were migrating from the Cape and when numerous indigenous chiefdoms and groupings were engaged in territorial conquests. It was the time of the Difaqane, a period when society in the central parts of the later South Africa and Lesotho was fractured, destabilised and caught in a cycle of violence and aggression.

In this period Moshoeshoe displayed a unique and innovative model of leadership that resulted in reconciliation, peace and stability in the area that later became Lesotho and Free State. It made him stand out from many of his contemporaries and also caught the attention of his colonial adversaries.

Such an evaluation is not a judgment about which model of leadership is right and which is wrong, or which leader was better than another; but merely an attempt to explore what we can learn from a particular exemplar.
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Historians point to the many progressive leadership qualities displayed by Moshoeshoe which he used effectively in establishing the Basotho nation and in defending it.
First, there is his humanism and sense of justice worthy of any great statesman. Confronted by a situation in which cannibals murdered and devoured his grandfather, Moshoeshoe chose not to take revenge. Instead he opted to rehabilitate them and feed them as he believed hunger drove them to cannibalism.

Secondly, there is his skilful alliance-building with his contemporaries such as Shaka in an attempt to neutralize those rivals who were intent on attacking his followers. This is also displayed in the way he sought the protection of the British to keep the Boer forces at bay.
Thirdly, his emphasis on peaceful options is also seen in his defensive military strategy which saw him retreat to a mountain fortress to be able to protect and build a burgeoning nation in the face of the many forces threatening its survival.

Fourthly, there is his remarkable inclusivity and tolerance for diversity which saw him unite disparate groups of refugees from the violence and hunger that displaced them and then weld them into the Basotho nation. He also engaged with French missionaries, inviting them to stay with him and advise him on Western thought, technology and religion.
These are but some of the qualities which belie the notion that all 19th century African leaders were merely marauders and conquerors that gained their ascendancy through violence. Instead Moshoeshoe is a prime example of the human-centred, democratic and pluralist roots of South African, indeed African society.

The Moshoeshoe project that we have initiated (of which the documentary, called “The Renaissance King”, forms but one part) derives from our location as a university in the Free State, a province with a particular history and a particular political culture that developed as a result of this very model of leadership. This province has benefited tremendously from leaders such as Moshoeshoe and president MT Steyn, both of whom many observers credit with establishing a climate of tolerance, respect for diversity of opinion, political accommodation and peaceful methods of pursuing political objectives in the province. Their legacy is real – and Moshoeshoe’s role can not be overstated.
In addition the project derives from the University of the Free State being a site of higher learning in a broader geo-political sense. As a university in Africa we are called upon to understand and critically engage with this history, this context and this legacy.
Besides the documentary, the UFS is also planning to establish an annual Moshoeshoe memorial lecture which will focus on and interrogate models of African leadership, nation-building, reconciliation, diversity management and political tolerance.

In tackling such projects, there may be a temptation to engage in myth-making. It is a trap we must be wary of, especially as an institution of higher learning. We need to ask critical questions about some aspects of Moshoeshoe’s leadership but of current political leadership as well. Thus there is a need for rigorous academic research into aspects of the Moshoeshoe legacy in particular but also into these above-mentioned issues.
While the documentary was commissioned to coincide with the University of the Free State’s centenary and our country’s ten years of democracy, it is a project that has a much wider significance. It is an attempt to get people talking about our past and about our future, as a campus, as a province and as a country – even as a continent, given the NEPAD initiatives to promote democracy and good governance.

The project therefore has particular relevance for the continued transformation of institutions such as universities and the transformation of our society. Hopefully it will assist those who are confronted by the question how to bring about new institutional cultures or even a national political culture that is truly inclusive, tolerant, democratic, non-sexist, non-racial, multilingual and multicultural.

I believe that the Moshoeshoe model of leadership can be emulated and provide some point of convergence. A fractured society such as ours needs points of convergence, icons and heroes which we can share. Moshoeshoe is one such an African icon – in a world with too few of them.

Prof Frederick Fourie is the Rector and Vice-Chancellor of the University of the Free State

* The documentary on “Moshoeshoe: The Renaissance King” will be screened on SABC2 on 4 November 2004 at 21:00.

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