The Paediatric Surgical Department in East London provides the surgical care and treatment for most of the children in the Eastern Cape Province. We provide surgical care for newborns and infants with complex urological and gastro-intestinal conditions, children with cancer, trauma including burns and more routine conditions in older children.
Serving one of the country's poorest provinces is however a major challenge. Budgetary constraints affecting the Health Sector mean that our facilities and equipment are, in many respects, not of a high standard.
Therefore we need some equipment urgently:
- Adequate resuscitation equipment suitable for babies and children of all ages. As we often treat very sick children in our wards, we need proper equipment to manage babies and children who go into cardiorespiratory arrest, so we can save more of them. At present our resuscitation equipment is not adequate.
- A good, reliable dermatome to harvest skin to graft the burned areas in children who sustained burns, so they can be treated better, have less complications and go home sooner. At present we don't have a suitable dermatome that can achieve this.
For a service such as ours to continue to provide the highest standards of care, there is a need to continually work toward enhancing the skills of all staff involved in this work. These include the surgical and anaesthetic staff; nurses in the ICU’s, wards and operating theatres and supportive staff in disciplines such as dietetics, physiotherapy and occupational therapy. Funding is necessary to permit all categories of staff to attend local courses, workshops and meetings aimed enhancing their skills. In addition we have 3 major projects.
A). Surgical skills laboratory. There is a need to further develop the surgical skills laboratory based at the East London Health Resource Centre at which our trainees are able to learn modern surgical techniques and the principles of "Key Hole Surgery" which has become an integral part of pediatric surgical practice. Such a laboratory will offer trainees a comprehensive set of virtual reality exercises, ranging from basic navigation to advanced suturing with exercises of increasing complexity providing ongoing challenges. The principle behind the establishment of the Skills Laboratory has been to allow for the acquisition of surgical skills outside the operating theatre so that a level of competence can be achieved before one operates on children. We anticipate the upgrading our current "basic" laboratory to provide a new Laparoscopic Simulator and two new simple box trainers will cost R1,800,000.
B). Annual Visiting Professorship. We see the need to provide a means for bringing outside experts from South Africa and abroad to East London to enhance the expertise of our pediatric surgical staff. The Visiting Professor will be invited from a local or international centre of excellence and be an acknowledged world authority. The goal is that the visiting professor will work alongside our staff, will lecture, mentor and act as trainer to our trainees. In addition visiting professors will share their experience during surgical procedures and by advising on complex clinical problems on ward rounds and discussions. We would wish this visit to coincide with one our annual South African Paediatric Surgical Meetings to allow the Visiting Professor to meet with the broader South African paediatric surgical community and so bring benefit to more than simply the children of the Eastern Cape. We anticipate that the cost of the Annual Visiting Professorship will be R50,000. per annum.
C). Annual Traveling Fellowship. The Annual Traveling Fellowship would cover the costs of sending one of our junior consultants or senior registrars to a Paediatric Surgical Centre of excellence abroad for a six month period. The intention behind this is to broaden the exposure of the young paediatric surgeon, to allow him or her to gain experience and to learn new skills so that on returning to East London, the Traveling Fellow will be in a stronger position to ensure the continued provision high quality and up to date care to our patients. We anticipate that the Annual Traveling Fellowship will cost R250000. Visiting Professorships and Traveling Fellowships are an integral part of the experience and training at all the established universities in South Africa and our intention is to provide a means whereby this will also become an integral part of the training we offer in the Eastern Cape.
D). Outreach: Peripheral Hospital Support. We are aware of the stress junior doctors working in peripheral hospitals across the Eastern Cape feel in their day to day work but in particular when faced with complex problems such as those often encountered in pediatric surgical practice. Funding is required to allow regular visits of support to these colleagues and also to allow children with problems to be seen initially and at follow up nearer their homes. At present, members of the paediatric surgical team fund these visits themselves.