Paediatric surgeons have started a charity to raise funds to improve facilities for sick children at Chris Hani Baragwanath and Charlotte Maxeke Johannesburg Academic Hospital. Picture: SUPPLIED
Paediatric surgeons have started a charity to raise funds to improve facilities for sick children at Chris Hani Baragwanath and Charlotte Maxeke Johannesburg Academic Hospital. Picture: SUPPLIED

BECAUSE of a lack of resources for state hospitals, Chris Hani Baragwanath in Soweto is often criticised publicly for overcrowding, understaffing, and lengthy waits for critical operations.

So it is disarming when Jerome Loveland says: "It’s a wonderful place to work. When you come to work here, you make a difference every single day."

The care has improved dramatically in the paediatric surgery department since Loveland and his colleagues set up a charity dedicated to saving the lives of sick children, improving their care and modernising the facilities.

Surgeons For Little Lives identified a range of ways, he says, to make a hospital stay less scary and more successful.

The level of care given to young patients and their families at big, underfunded state hospitals can be quite basic, which means it takes longer to recover after surgery, and complications are more likely to set in.

Since Surgeons For Little Lives was launched in May 2015, its biggest venture has been raising R20m to build a paediatric clinic with sleepover facilities at Chris Hani Baragwanath, so parents from out of town can stay with their children and help them heal.

The current clinic is in an asbestos prefab structure with two rooms, which is "socially and ethically unacceptable on every level", Loveland says.

The hospital’s main catchment area is Gauteng, but extends into KwaZulu-Natal, and the Free State, and often the children are admitted for months.

"Their mums have nowhere to stay, so they either drop the child off and maybe visit at weekends, or at their own cost they find accommodation in the community," Loveland says.

"We have incorporated a parental sleepover facility so mums, dads, or grannies can apply to lodge here and contribute to the care of their kids."

Having the parents on site will decrease the stress for them and their children, and they can help by doing the laundry and easing the burden on the nurses, who do try to be motherly when parents are not available.

THE charity is working with the Gauteng health department and GlaxoSmithKline on the project, with the clinic due to open by August 2017. The double-storey building was designed by private hospital group Mediclinic to achieve world-class standards of care and privacy for 2,000 outpatients and 300 in-patients a month, with twin-bedded rooms upstairs for 24 parents.

Loveland is the head of paediatric surgery at Wits University and oversees the paediatric surgery teams at Chris Hani Baragwanath and Charlotte Maxeke Johannesburg Academic Hospital. "It’s a phenomenal unit — we are the biggest paediatric surgery training centre in the country and probably in Africa," he says.

He turns down job offers to work in better-equipped and -funded hospitals. "You don’t get to make the same difference as you do coming to work here," he says.

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LOVELAND is based in large, pleasant rooms at Chris Hani Baragwanath shared by four consultant paediatric surgeons, eight trainees, and eight junior doctors. They oversee 80 children’s beds, including a burns unit and neonatal wards. The team is heavily involved in research, with about 30% of their time spent at the university.

"The international aim is one paediatric surgeon per 500,000 population, and in SA it’s about one per 1.2-million, so we are well short," he says. His team should be doubled to provide ideal care, he says, but it’s enough to provide a functional service.

The lack of government funding is unfortunate but unavoidable. "We all know how strained the finances are, and with the best intentions in the world they don’t have the financial capacity to support us to the level that the children fully deserve," he says.

"All major First World children’s hospitals are run in conjunction with charities, because the state never has enough resources to provide infrastructure and capacity to run these units in the way they ideally should be. Bara is just another example — we run very good services, but there are limits to what they can provide us, so we thought we’d start a charity."

It took 18 months to get Surgeons For Little Lives off the ground with four paediatric surgeons, a doctor who is also a businessman, and people with expertise in finances and marketing.

Several projects have been completed, including recruiting mothers to come in every Monday to help the nurses with jobs such as changing nappies, and encouraging people to donate baby-grows and toothbrushes.

Artist Jan Rech volunteers to visit twice a week for four hours at a time to draw with the young patients.

"A lot of them are here for a long time without their parents, so Jan works with the same children over the weeks, and it’s amazing to watch how they open up and how this art contributes to their psychological rehabilitation," Loveland says.

"It’s a very important project with a massive impact, but a very small outlay from a financial perspective."

Another small but thoughtful idea is to give every young patient an admission pack containing a baby-grow or pyjamas, a facecloth, toothbrush and toothpaste, and a towel, so they feel welcome.

A discharge support system will soon be introduced, with a volunteer who calls the parents a few days after a child is discharged to check how they are doing.

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ELLEN Ngcongo runs the charity’s support services and liaises with people or companies that want to donate time or money.

The charity is also planning to build a new dedicated theatre for paediatric burns surgery. Children currently share a theatre with adults, which raises the risk of cross-infection. A play area will also be built.

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Charlotte Maxeke Hospital has also benefited, with funds used to repair essential surgical equipment and buy other vital equipment.

"We set ourselves targets and we have exceeded our expectations," Loveland says.

As chairman of Surgeons For Little Lives, Loveland has increased his administrative burden, which was already large as the head of the Wits department. He spends about 70% of his working hours performing surgery, and tackles the paperwork at night or at weekends.

He acknowledges that he doesn’t spend enough time with his own children, aged 11 and eight, although he makes a big effort to do so.

Thousands of other children need his attention too, however. Fortunately, his work usually has a happy outcome.

"Our department isn’t tragedy," Loveland says. "You have a massive positive impact on the children you treat every day, so while we do lose some, the vast majority leave here healthy to go and carry on living their lives," he says.

"Our successes are brilliant. You have to balance the sadness with the happiness, and on balance we provide a lot more happiness, and go home happy ourselves."