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22 October 2021 | Story Dr Nitha Ramnath | Photo Rhona Klopper
Donating masks to Rekopane Primary School, were from the left: Alfi Moolman (UFS Directorate: Community Engagement), Sonja Venter-Botes (Bloemshelter), Tina Moleko (Rankwe Primary School), and Michelle Engelbrecht (UFS Centre for Health Systems Research and Development).


The Centre for Health Systems Research and Development (CHSR&D) at the University of the Free State (UFS) recently donated 500 masks to Rekopane Primary School in Botshabelo. This initiative was part of its pledge to donate 100 cloth masks to a previously disadvantaged primary school for every 1 000 of the first 5 000 completed questionnaires that formed part of a study survey examining people’s understanding of information about COVID-19 vaccines. The results of the study will be shared with stakeholders who are responsible for providing information about COVID-19 vaccinations.

It is known that a large number of people globally and in South Africa prefer not to be vaccinated. “There are many reasons for this, and we would like to find out where people are getting information about the COVID-19 vaccination, and whether they are able to understand this information, so that they can make an informed choice about getting vaccinated. We did this by asking people about their own health and COVID-19, where they have heard about the vaccine, if they understood this information, and whether they have had/would have the vaccine or not, as well as the reasons for this,” said Prof Michelle Engelbrecht, Director of CHSR&D. 

While following guidelines such as wearing masks, sanitising hands, and social distancing are important to prevent the spread of COVID-19, a large percentage of the population will need to be vaccinated if we want to control the pandemic in the long term and prevent hospitalisation and severe illness. 

All persons in South Africa aged 18 and older were invited to complete an online survey regarding their perceptions of COVID-19 vaccines. The survey, which was available in the seven most spoken languages in the country, was advertised on social media platforms such as Facebook and Twitter, and on the Moya app.  The survey was open from 1 to 31 September 2021, and the CHSR&D received 10 554 completed questionnaires.  No data was required to complete the survey.

The Department of Basic Education partners decided on the school that would benefit, and the study provided an opportunity to support Bloemshelter, a UFS flagship programme. Alfi Moolman of the Directorate: Community Engagement said that “NGOs are really struggling to make ends meet, and we are delighted that Bloemshelter could provide the masks as one of their income-generating projects.  So many lives are touched for the good. The university is indeed a caring organisation.”


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Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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