Paraphrasing the nostalgic and political folk song by Pete Seeger, embellished and sung by many other famous artists, South Africa can ask 'Where have all our (medical) graduates gone'? And why have they gone?
To the Editor: I appreciated the editorial on the decriminalisation of drugs, which argued that psychoactive drugs are part of human antiquity, that world-wide attempts to 'clean up' the drug scene have been counterproductive, that the 'war' on drugs has failed, and that attempts to root out drug barons and supply routes has hiked prices and destabilised political systems rather than achieving the noble aim of drug eradication. With subtle reference to human hypocrisy, Professor Van Niekerk points out that official acknowledgement of the futility of drug wars is political suicide. He makes the sobering observation that tobacco and alcohol are in the top half of the ranking scale of human harm and yet these drugs are legal. He implies that decriminalising the others will go a long way toward relinquishing the lucrative control of drug dealing from the barons to the State, which could put the money to better use.
To the Editor: The editorial in the SAMJ questioning whether it is time to decriminalise drugs refers. The Central Drug Authority (CDA) produced the South African Position Paper on Cannabis in 2004; however, the document was never made public or released. The Position Paper builds a case for prohibition on a 'public health' basis and ostensibly represents the government's position regarding cannabis.
To the Editor: The scope of technologies for health extends from technologies that provide a direct benefit to health (such as molecular genetics, biological technologies, pharmaceuticals and medical devices) to those that support health system functions (such as telecommunications, information technologies, devices for environmental protection and food technologies)
To the Editor: The Southern African Human Genome Programme (SAHGP) is a ground-breaking national and regional initiative that aims to unlock the unique genetic character of southern African populations. Through generous support from the Department of Science and Technology (DST), the SAHGP was officially launched on 27 and 28 January 2011.
Africa's debilitating quarter share of the world's disease burden, with just 3% of the globe's health workers and 1% of its finances, is to be tackled through a unique international partnership involving a top South African NGO. Aimed at improving quality, access and affordability and beginning with sub-Saharan Africa, the partnership will upgrade health care facilities by offering a quality improvement framework and incentivised performance-based loan mechanisms. At the same time the majority low-income patients will be offered pragmatic subsidised voluntary private health insurance via a prepayment scheme.
Hospital and health care managers and administrators will in future be measured against mandatory core standards and judged on outcomes, with little place to hide and less room to shift responsibility, the country's new standards certification chief warned last month.
In spite of UN-sanctioned air 'support' and pin-point strategic bombing to reduce civilian casualties, Libya's rebel fighters remain relatively easy targets for Gaddafi's ground forces because of their 'chaotic and aimless leadership'.
A combination of stigma, ignorance of reformist laws and health care facilities that offer abortion services being 'unidentifiable' mean that 43% of designated facilities today fail to provide first-trimester pregnancy termination services.
The National Committee for Confidential Enquiries into Maternal Deaths (NCCEMD), which since 1998 has produced triennial reports of maternal deaths in South Africa, has identified the increasing rate of haemorrhage during and after caesarean section (CS) as a problem. Obstetric haemorrhage is the third most common cause of maternal death, accounting for 491 of the total 3 959 deaths in 2005 - 2007, but constitutes one of the most avoidable causes of maternal death, over 80% of cases being thought to be 'clearly avoidable'.
The arguments in the paper by Dhai et al. may be summarised as follows: Since childbirth may take place by vaginal delivery or caesarean section, a choice must be made and consent to vaginal delivery is as necessary as consent for caesarean section. Dhai et al. affirm the patient's right to choose, together with the observation that the safety of vaginal delivery may be limited in the public sector. Rising caesarean section rates and the differences between public and private sector rates are noted. They argue that sound ethical and legal principles should be used in determining mode of delivery. The right to choose is enshrined in the process of informed consent, which requires full disclosure. This includes the possibility that the labour ward may be inadequately staffed. Dhai et al. state that informed consent and respect for patient autonomy are an 'ethical and legal imperative'; furthermore, they argue that failure to obtain consent may be construed to be assault. They also cite the Consumer Protection Act, which stipulates that consumers have a right to the performance of services in a manner and quality that persons may be entitled to expect.
South Africa, home to the world's largest population of people living with HIV (5.7 million), experienced a measles outbreak that started in late 2009. There was a stepped increase in cases of measles, with the highest incidence reported in March 2010. By September 2010, more than 17 000 new measles cases had been reported to the National Institute of Communicable Diseases since January 2009. A mass vaccination campaign from mid-April to early May 2010 resulted in a significant decline in new measles cases.
The most recent major source on medical migration from South Africa is this study by Peter Arnold. The book is thoroughly researched with an extensive literature review, and it is profusely illustrated with graphs and figures.
The first edition of the Woordeboek van Afrikaanse Geneeskundeterme appeared in 1979, and has seen 8 reprints. The phenomenal increase in knowledge over the past 30 years necessitated a revision - hence this updated, extended, explanatory and bilingual Woordeboek vir die Gesondheidswetenskappe/Dictionary for the Health Sciences. This edition was revised under the supervision of Professor J de V Lochner (Stellenbosch University), with the assistance of at least 30 experts over the entire spectrum of the various medical disciplines.
Jac or Jacques or Jack, as he was known to his many friends, was born on 6 June 1945 in Frankfort, in the then Orange Free State. The son of a family practitioner, Dr Simon Padley Morrison, Jac grew up on a farm in Northam district, north of Pretoria.
To the Editor: It has been estimated that globally about 38.6 million people were infected with HIV by 2005, with about 5 million of them living in South Africa (SA). The World Health Organization estimated that 4.7 million people living in sub-Saharan Africa urgently needed antiretroviral therapy (ART). In that year SA implemented prescribed minimum benefits (PMBs) for HIV/AIDS in the private health care sector. Despite the increased availability and affordability of ART in SA, only 60 000 people were receiving ART through medical aid schemes by mid-2005.
Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province.
Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia.
Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour-coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed.
Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practice. Preventive systems and precautionary measures should be put in place to reduce drug administration errors.