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14 December 2022 | Story André Damons | Photo André Damons
Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health being presented to the acting Chancellor by his supervisor Prof Stephen Brown.

A lecturer from the University of the Free State (UFS) says the need to improve the care of seriously ill children is a vital part of reducing preventable deaths and diseases, and this led him to investigate the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness. The study was done for his PhD thesis. 

This forms the basis for the PhD thesis of Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health, called, The Development and Validation of Predictive Models for Paediatric Critical Illness in Children in Central South Africa using Artificial Neural Networks. His thesis reports the development and testing of several machine learning models designed to help healthcare workers identify seriously ill children early in a range of resource-limited settings. Combining a systematic literature search and Delphi technique with clinical data from 1 032 participants, this research led to significant progress towards implementable models for community health workers in clinical practice.

Care for critically ill children is a mission and calling 

Dr Pienaar graduated with a PhD specialising in Paediatrics on Monday (12 December) during the Faculty of Health Sciences’ December graduation ceremony. It took him three years to complete this degree. His supervisor was 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 UFS. Prof Nicolaas Luwes and Dr EC George were his co-supervisors. 

“I have been working in paediatric critical care since 2019 and see the care of critically ill children as my mission and calling in life. At the outset of the project, I was interested in approaches to complex phenomena and wanted to investigate new methods for tackling these in healthcare. 

“I have been interested in technology since childhood and in collaborating with other disciplines since I joined the university in 2019. Machine learning seemed like a great fit that could incorporate these interests and yield meaningful clinical results,” explains Dr Pienaar the reason why he chose this topic for his thesis.

He hopes that, in time, this work will lead to the implementation of integrated machine learning models to improve care and clinical outcomes for children in South Africa. From a scholarship perspective, he continues, his hope is that this work draws interest to this field in clinical research and encourages a move towards incorporating these new methods, as well as skills in areas such as coding and design in the armamentarium of a new generation of clinicians.

Medicine chooses you

According to Dr Pienaar, he always had broad interests, of which medicine is one. “I am very grateful to have found my way in medicine and am humbled and privileged to be allowed to walk with children and their families on a difficult and important journey. I believe this profession will choose you and put you where you are needed if you give it time and are prepared to listen.”

He describes graduating as a complicated ending to this period of his life and the beginning of a next chapter. He was humbled by the graduation ceremony. 

“It was wonderful to graduate with undergraduates and postgraduates in my profession – I felt great pride and solidarity joining these new colleagues and specialists in taking the oath. I am certainly relieved, proud, excited, and happy. I am also very grateful to the university, my promotors, colleagues, friends, and family for supporting me through this process. I must confess, it is also slightly bittersweet, I loved working on this and do miss it, but look forward to the next exciting project. 

“I would like to thank my Head of Department, Dr (Nomakhuwa) Tabane, my supervisors, my family and friends once again. I would also like to acknowledge and thank the National Research Foundation (NRF) as well as the University of the Free State for their assistance with funding this research.”

News Archive

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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