'Suffer [let] little children, to come unto me, for theirs is the kingdom of heaven' are lyrics of a Stephen Foster song, and of much older song versions that echo the text in the Bible. Pope Benedict XVI expressed that he was deeply disturbed and distressed over the tales of abuse of children in Ireland. The Murphy Report, an Independent Commission of Investigation, examined more than 300 abuse claims in the Archdiocese of Dublin between 1975 and 2004. It reported that instead of being concerned for the victims of the abuse, the Church was more concerned about 'the maintenance of secrecy, the avoidance of scandal, the protection of the reputation of the church and the preservation of its assets'.
To the Editor : The Choice of Termination of Pregnancy (CTOP) Act instituted safe, effective, affordable and acceptable methods of fertility regulation for women. Universal access to reproductive health services is available through the district health services.
To the Editor : I want to reassure members of the Medical Protection Society and readers of the SAMJ that the surprise new government regulations on indemnity will not diminish our longstanding and strong commitment to the South African medical and dental professions.
To the Editor : We refer to the paper by Okwi et al. Cost benefit analysis of screening for sickle cell disease (SCD) using different methods cannot be done in isolation, and the following are important principles to take into account.
To the Editor : In response to Professor Rayner's letter to the SAMJ, I would like to point out that Discovery Health was able to resolve the case before it was published in your journal. Professor Rayner has indicated to us in writing that he would have withdrawn his letter to you, had it not been too late to do so.
Beleaguered public hospitals and clinics, due for a quality assurance 'make-over' and continual monitoring in advance of the much-vaunted National Health Insurance (NHI), may emerge little better in spite of strenuous government efforts.
The Constitutional Court has reserved judgment in what could be a watershed case for lung-diseased former miners, epitomised by a sick Eastern Cape man who is challenging an archaic legal framework that enabled his lay-off for just R16 000.
Appeals last month by the Treatment Action Campaign (TAC) to eTV's 'sense of ethics and morality' to enable the canning of a 22-minute commercial programme that promotes demonstrably fatal faith-healing were studiously ignored, the organisation claims.
Self-tests for HIV in South Africa are currently unregulated. Gaps in law and policy have created a legal loophole where such tests could effectively be sold in supermarkets, but not in pharmacies. At the same time, South Africa lacks an effective regulating mechanism for diagnostic tests, which brings the quality and reliability of all self-tests into question. The authors argue for greater access to, and availability of, quality HIV self-tests. This strategy will encourage regular HIV testing, allay fears about stigma and confidentiality when testing in public facilities, and decrease the costs associated with traditional voluntary counselling and testing, and is likely to lead to earlier diagnosis and treatment of HIV.
While there are no specific protocols for dealing with reports of sexual abuse of children, the Criminal Law (Sexual Offences and Related Matters) Amendment Act of 2007 (Act No. 32 of 2007) clearly stipulates that, in the event of a report of sexual abuse by a child or any other person of the abuse of a child, the relevant person has the legal (statutory) obligation to report such abuse to the police; and that it replaces previous legislation where reporting could be done to a social worker or the police. According to the Child Advocate, a disclosure by a child (specific child, specific offender) is sufficient to require such reporting.
The remaining sections of the Children's Act and the Children's Amendment Act came into effect on 1 April 2010, thus completely repealing the Child Care Act. The provisions of the Children's Act dealing with the capacity of children to consent to HIV testing and to access contraceptives have been in effect since 1 July 2007. The Children's Act now allows sufficiently mature children of 12 years of age to consent to medical treatment, and to consent to surgical operations with the assistance of their parent or guardian. The provisions allowing consent to termination of pregnancy by girls of any age in the Choice on Termination of Pregnancy Act are not affected by the Children's Act.
The Facts: Obsessive-Compulsive Disorder is an easy-to-read book which aims to provide a general overview of obsessive compulsive disorder (OCD) and offer basic information describing the symptoms, causes and popular theories explaining OCD.
It is encouraging that since 1994 the South African government has worked hard to create legislation and policy that place equality, human rights and justice at the centre. This is the case for health, education, social development and the legal system. However, it is a depressing reality that in many (if not most) cases, those charged with implementing the transformative changes in society have failed due to a host of reasons. Lack of skills coupled with unwillingness to consult with those working at the coalface has resulted again and again in poor planning, inappropriate interventions and a waste of valuable resources. Nowhere is this truer than for the provision of psychiatric and mental health services for our communities.
To the Editor : Couples should be included in HIV prevention research, but their recruitment in southern Africa is challenging given high levels of migration and non-cohabitation. We describe the recruitment strategies and experiences of a pilot study in rural South Africa. With the aim of recruiting 20 couples at mobile voluntary counselling and testing (VCT) caravans and community venues, 75 index partners were screened with an average of 4 additional contacts required to schedule interviews. Recruiting and interviewing couples is feasible, but requires substantial resources.
To the Editor : Vuvuzelas are a new experience for non-South African soccer fans, and for their physicians. We describe the first case of a vuvuzela-induced thyroid cyst. A 42-year-old man presented with acute painful swelling of the neck and difficulty in swallowing. An ultrasound scan confirmed the clinical suspicion of a thyroid cyst with a volume of 2 ml (Fig. 1). The cyst was successfully emptied by fine-needle aspiration (Fig. 2) and the patient was immediately free of complaints. On being asked whether he had raised heavy weights or pressed strongly, he responded that he had blown a vuvuzela during a recent World Cup soccer game.
Background. Globally, a significant 'mental health gap' exists between the major burden of mental and substance use disorders and the provision of psychiatric and mental health services. As a signatory to the UN Convention on the Rights of Persons with Disabilities, South Africa has committed itself to transformation aimed at ending the inequities that characterise mental health service provision and 'closing the gap'.
Methodology. Budget allocations over a 5-year period to 6 psychiatric and 7 general hospitals in KwaZulu-Natal (KZN) are compared and current numbers of psychiatric beds and psychiatric personnel in that province are contrasted with the numbers required to comply with national norms.
Results. The mean increase in budget allocations to public psychiatric hospitals was 3.8% per annum, while that to general hospitals over the same period was 10.2% per annum. The median cumulative budget increase for psychiatric hospitals was significantly lower than that of general hospitals (Mann-Whitney U-test, p=0.001). No psychiatric hospitals received specific funding for tertiary services development. KZN has 25% of the acute psychiatric beds and 25% of the psychiatrists required to comply with national norms, with the most serious shortages experienced in northern KZN. There are 0.38 psychiatrists per 100 000 population in KZN.
Conclusion. Inequitable funding, inadequate facilities and significant shortages of mental health professionals pervade the mental health and psychiatric services in KZN. There is little evidence of government abiding by its public commitments to redress the inequities that characterise mental health services.