Wits University medical training

MEDICAL TRAINING IN GOOD HEALTH

Wits-trained doctors, surgeons and specialists are the unsung heroes of health care in South Africa. Wits also leads the way in training a new generation of medical experts at private and public hospitals in Johannesburg.

BY HEATHER DUGMORE

Prof Jerome Loveland, specialist paediatric and transplant surgeon

Playing a pivotal role is the Wits Donald Gordon Medical Centre

(WDGMC), South Africa’s first private teaching hospital, of which Wits University is the main shareholder. Some of the country’s top medical practitioners are doing groundbreaking work here.

“We train specialists and sub-specialists in association with state hospitals, and provide training in sub-specialist disciplines that were not available before in South Africa, such as solid organ transplants and geriatric medicine,” says Dr Sue Tager, neurologist and CEO of the WDGMC since 2008. “The training we offer is critical for South Africa.” Dr Tager says they pride themselves on being able to train in areas not always available in the public sector: “Through this approach we have managed to create more opportunities for doctors to further their expertise in this country. We have also been able to attract specialists back from the private sector and overseas (many of them Wits-trained), to develop their field with us.”

As a teaching hospital the WDGMC has retained a notable number of doctors and specialists who might have been lost to the training environment, moved to private hospitals that don’t do training, or relocated overseas.

Dr Tager explains this directly enhances the quality of health care, as well as the quality of training at Wits and in the public sector environment, adding that there has been an exponential increase in the number of black and women specialists and sub-specialists.

“We are also helping to address the nursing crisis in South Africa, and the WDGMC is involved in the training and skills upgrading of nurses in the disciplines we provide.”

Salaries are a perennial issue, but Tager says research shows that what nurses want most is training.

The WDGMC partners with a number of state hospitals, including the Charlotte Maxeke Johannesburg Academic Hospital (Joburg Gen), Helen Joseph and Chris Hani Baragwanath Hospital (Bara).

“We believe that to maintain high standards of health care, strong partnerships between universities, public and private hospitals and the state are essential.”

She adds that public health care in general is not where it should be and private health care is very expensive: “Across the board, quality health care needs to be available to far more people. Wits and the WDGMC have contributed to more accessible, continuously improving health care and we have maintained a high standard of health sciences education. We are proud of this and we welcome closer collaboration with the National Department of Health.”

Some of the WDGMC’s specialists are:

Professor Russell Britz (Wits-trained; MBBCh 1979) established the liver transplant unit in 2004. It is currently headed by Professor Jean Botha (Wits MBBCh 1990), who returned from the United States in 2012 to establish the paediatric liver transplant unit. The first renal and pancreas transplant in a child in South Africa was performed at the WDGMC in 2008. The medical team included Dr Gary Fetter (Wits MBBCh 1986), Prof Britz and Prof Dokkie Botha (Wits MBBCh 1964). Prof Dokkie is now in his 70s and still assists with surgery.

Professor Jose Ramos (Wits MBBCh 1983) returned from the private sector to head the hepatobiliary surgery unit.

Dr Brent Tipping (University of Cape Town-trained) heads the Geriatric Medicine Unit. In 2008 he started and heads the geriatric medicine division at Wits in association with Helen Joseph Hospital. They train geriatrician registrars and fellows in both the public and private sectors.

Dr Brendan Bebington, who did his postgraduate specialisation at Wits, returned from the private sector to head the colorectal surgery unit.

Dr Charles Sanyika (University of KwaZulu-Natal) is a member of the WDGMC radiology and interventional radiology treatment unit, where he performs unique interventional radiology procedures. Cancer of the liver can be treated through noninvasive means here.

Sir Donald Gordon

Sir Donald Gordon’s R120-million donation to the University in 2002 is the largest single donation ever received by Wits.

Gordon, a Chartered Accountant by profession, founded Liberty Life in 1957 and Liberty International PLC in 1980. In June 2005 he was knighted in recognition of his services to the arts and business. He has an Honorary Doctorate in Economic Science from Wits (1991).

His legacy continues to make a considerable impact in South Africa through the Wits Donald Gordon Medical Centre and the Donald Gordon Auditorium at the Wits School of Governance.

With the funds from the Gordon family’s donation, Wits was able to purchase the Kenridge Hospital in 2002. Mediclinic, the international private hospital group, became a 49.9% shareholder in 2005.

Professor Jean Botha

HEAD OF THE LIVER TRANSPLANT UNIT, WDGMC

“In 2016 we did 25 paediatric liver transplants, 50% from living donors and 50% from donated organs. In the same period we did 70 adult transplants, all from donated organs,” says Prof Jean Botha, who did his MBBCh and general surgery at Wits.

In 2000 he took up a fellowship at the University of Nebraska Medical Centre in the United States to learn how to do liver transplants. He remained there for 12 years, rising to head the living donor liver transplant programme.

“During that time my South African colleagues, including Professor Russell Britz, would go over there, and my partners and I would come to South Africa, where I did the first liver transplant on an adult at the WDGMC in 2004,” he says.

“I returned in 2012 because I always had this desire to come home, and I knew that I could make a difference to many people’s lives here. America was a wonderful experience but you miss home and family.”

On returning in 2012 he established the paediatric living donor transplant programme.

“In living donor liver transplants we use the smallest possible piece of liver from an adult, usually a parent, which we transplant and it then grows. It is a relatively safe operation and we we have done this for 100 children over the past four years. We cannot do this in adults because the piece of transplanted liver would need to be too big. In adults and in children where there isn’t a suitable living donor, we do donor transplants using livers from deceased people.”

Children and adults need liver transplants for a variety of reasons, including biliary atresia, fatty liver diseases, autoimmune conditions, cirrhosis, chronic hepatitis B and alcoholic liver disease.

“We have an 83% one-year survival rate for all our liver transplants in children and 87% in our adults. Once patients get through the first year they have an excellent prognosis for long-term survival. We currently have the same survival rates as international units but we are working towards achieving 90%.”

Over 50% of the unit’s paediatric patients are black and approximately 25% are state patients who have the transplant at the WDGMC at no cost to the patient.

“The state partially contributes towards the cost of state transplant patients. A liver transplant can cost from R500 000 to R1-million and it is extremely important to us that all South Africans, irrespective of whether they are on medical aids or not, have access to our facility.

“We work closely with our colleagues at all the state hospitals in Gauteng and regard ourselves as one big unit. We are here to help as our unit has the resources and human power required for liver transplants, and to train specialists at the highest level. What we urgently need are more liver donors, as we currently have 57 people waiting for liver transplants. If we had more donors we could do so many more transplants.”

Prof Jean Botha Photo: Sandy Maytham-Bailey