Mediclinic Pietermaritzburg brings expert care to rural communities

Posted on 10 September 2019

Mediclinic Pietermaritzburg takes a bold new step in public-private partnership.

When Mediclinic first embarked on an ambitious partnership with local provincial hospitals to provide pro bono surgeries for patients on state waiting lists, those procedures were concentrated in the Western Cape. Last year, Mediclinic expanded the initiative to work with local health departments in the Free State, KwaZulu-Natal, Limpopo and Gauteng.

Now, Mediclinic Pietermaritzburg is taking this innovative public-private partnership one step further, by identifying qualifying state patients in far-flung rural Ladysmith, Kokstad and Appelsbosch communities, and working with local government hospitals to get them the care they need.

Dr Muhammed Firoze Essa, an ear, nose and throat surgeon at Mediclinic Pietermaritzburg who was involved in performing the surgeries, and who has played a lead role in coordinating the partnership, explains that for him, these surgeries are personal.

“I was head of the ENT clinical unit at Greys Hospital for about eight years. At the time it was a challenge, and a learning experience: as a department head you can no longer simply function as a surgeon who operates all day. You must learn to understand the logistics of your patients – you must know who they are, and appreciate their reality. I find great joy in helping these patients. The difference surgery makes for them, and the smiles on their faces: this is why we are here.”

On Saturday, 31 August 2019, 32 young patients received much-needed pro bono ear, nose and throat surgeries at Mediclinic Pietermaritzburg, as one of the latest legs of the partnership between the KwaZulu-Natal Department of Health and Mediclinic.

As with previous public-private initiatives between Mediclinic and the public sector, these surgeries utilise spare capacity available in our surgical theatres to support the long waiting lists experienced at public hospitals. What is new with this set of procedures, however, is that Mediclinic will not only be assisting the local state hospital to shorten their surgical waiting list, but also assisting patients from far-flung rural areas.

The 32 young patients who were treated were from Greys Hospital in Pietermaritzburg, and Ladysmith Provincial Hospital, about 160km to the north.

“Here at the ear, nose and throat clinical unit at Greys Hospital, we see patients from all over this part of KwaZulu-Natal – elective and emergency cases,” explains Dr Senast van Wyk, Head: Clinical Unit, ENT at Greys Hospital. “Because of the vast number of patients, we unfortunately do not have time to operate on all of them. We use our limited theatre to treat patients who need life-saving procedures – cancer patients, for example, or small children with urgent issues, such as airway obstruction, which usually develop into life-threatening problems very quickly.”

The result: many children who require surgery to improve their quality of life may wait for months or years for much-needed surgery.

“Infection of the tonsils and adenoids is very common in young patients, but excruciatingly painful. These kids can’t swallow, so they can’t eat,” says Dr Raksha Takoordeen, a paediatrician at Mediclinic Pietermaritzburg, who performed pre-operative assessments on the patients. “But our main worry is when these infections recur regularly.”

Usually, adenoid glands and tonsils work together in trapping and expelling germs that come in through the mouth and nose. But when they become enlarged, due to infection or allergies, they obstruct the back of the nose and restrict airflow. This means there is less oxygen making its way to the lungs, and the heart has to compensate by working harder.

This causes strain, says Dr Takoordeen, and over time, leads to pulmonary hypertension – which cannot be treated. “Once you reach that stage, there is no going back. In young children, if those enlarged adenoids are not treated, it can have a severe impact on growth and development. It becomes worse and worse, and your quality of life deteriorates.”

Mediclinic is proud to be involved in these public-private partnerships, says Dr Mvula Yoyo, transformation executive: Mediclinic SA. “This is a long-term strategy, where we offer our spare theatre time and consumables, and a team of doctors, nurses, anaesthetists and staff members volunteer their time and services. We work closely with local government to understand their challenges and assist where appropriate. All of this brings great value to the community.”

“We are grateful for this partnership,” says Dr Logandran Naidoo, medical manager: Greys Hospital, “as it contributes significantly to alleviating the demand for elective ENT surgery placed on Greys Hospital. Ultimately, our patients will benefit, so it is highly appreciated.”