When Prof Steven Matshidza, Head of the Department of Orthopaedics at the University of the Free State (UFS), talks about his outreach work and making a difference in patients’ lives, it’s clear why he and his department have won several awards over the years for their work in rural communities.
Their outreach work in Limpopo was even acknowledged by President Cyril Ramaphosa on a visit to the province in September 2020, the Health Professions Council of South Africa (HPCSA), as well as by Dr Zweli Mkhize, former minister of health.
Since starting with their outreach work in Limpopo in 2016, they have done more than 2 000 orthopaedic operations in that province and more than 600 in Free State. During the same period, Prof Matshidza and his department won six awards from the Limpopo provincial government, the South African Medical Association (SAMA) and the Rural Doctors Association of Southern Africa (RuDASA) special award.
Prof Matshidza is joined on the outreach project by colleagues from UFS, Sefako Makgatho Health Sciences University, University of Pretoria, Wits, and the University of Limpopo as well as private orthopaedic surgeons, anaesthetists, medical officers, interns and nurses.
How it started
Earlier this year while doing outreach work in the province, Prof Matshidza and his dedicated team performed the first successful robotic-assisted knee-replacement surgery at Botlokwa level one district and rural Hospital which is the first of its kind in Limpopo. Dr Phophi Ramathuba, Limpopo’s Health MEC, described this surgery as a major achievement and milestone as part of the ongoing Rural Health Matters Campaign, aimed at reducing surgical backlogs in rural and remote hospitals.
However, says Prof Matshidza, the awards are not what motivates him to keep going. Outreach is his passion. “I love it. It’s an addiction,” he says.
Prof Matshidza started his outreach project in 2016, shortly after moving from Limpopo to Bloemfontein to take up a position at the UFS. He got a call from Dr Ramathuba who asked him to move back to Limpopo. “I said ‘no, I can’t because this (his work at the UFS) is more national duty I am doing’. However, I can help in three ways. We can do outreach to try and tackle the numbers of patients waiting on surgery, I can help recruit doctors for them and finally, I will assist in training specialists.”
The project started with four orthopaedic surgeons who would visit the province for a weekend every four months to do operations at one hospital. It soon expanded to other hospitals in other districts of the province and became a multispecialist project with specialists in other fields from other universities also volunteering their time.
According to Prof Matshidza, the biggest number of doctors involved over one weekend was 22, working in seven theatres. They operated on 101 patients.
“Other specialists include urology, obstetrics and gynaecology, pediatric surgery and general surgery. This programme is now at such that people want to do it. Its amazing how they want to be involved. They want to volunteer their time as we do not get paid.
“We fly there on Friday, do operations the whole of Saturday which sometimes goes on till 2am. On Sunday, we work a half-day and fly back early Monday morning. We do it now on a monthly basis,” says Prof Matshidza.
Passion
There are now discussions for the team to create this model in other provinces and even perhaps render these services in Zimbabwe.
Prof Matshidza says they also do outreach work in the Free State at the Mofumahadi Manapo Mopeli Regional Hospital, in the Thabo Mofutsanyana District, in Kroonstad, Botshabelo District Hospital as well as the Albert Nzula Hospital in Trompsburg. They have operated on over 650 patients in already.
“I do it because outreach is my passion. Outreach is an integral part of me. It is just something I have to do. I love it. Doing outreach is where I feel I am complete; I am a surgeon. I don’t need to worry about how many students didn’t attend class or fail class. That’s the place where I focus only on the patient. Nothing else matters. I also use that opportunity to teach our senior registrars.
“Doing outreach also means you are operating in areas where you don’t normally work, you are operating on people that would otherwise have to wait years for operations. The good that came out of this is that when we started the outreach, that place only had two orthopaedic surgeons for whole province. Now there are more than 12, of which half took part in the outreach,” says Prof Matshidza.
According to him, the outreach work helps to tackle the huge backlogs of patients waiting for these operations in public hospitals. There is currently a shortage of orthopaedic surgeons in the country especially in rural areas. Every year, says Prof Matshidza, almost 30 orthopaedic surgeons are trained nationally, which is not nearly enough.
“One of the challenges is that rural areas suffer the most as some of the younger surgeons do not want to work in these areas because they want to settle in the towns. The second challenge is that we have a violent society which means there are a lot of trauma injuries, car accidents or interpersonal violence. This creates a backlog which the system can’t cope with.”