MESSAGE FROM THE CEO

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volume 1

y e a r 2 0 11

HCT CAMPAIGN . . . . . . . . . 3

WORLD KIDNEY DAY . . . . .

DIARRHOEA SEASON

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T y g e r b e r g A c a d e m i c H o s p i ta l N e w s l e tt e r N u u s b r i e f van T y g e r b e r g A k a d m i e s e H o s p i taa l Ma r c h / Maa r t 2 0 11

MESSAGE FROM THE CEO The excitement of the 2010 Soccer World Cup is behind us and 2011 has dawned with some of that excitement being continued as we watch the Cricket World Cup on television, with all South Africans hoping that the Proteas will be the winners. Let us continue with this winning spirit at Tygerberg Hospital and collectively breathe that same ‘gees’ we exhibit in the sports arena into our daily activities at Tygerberg Hospital as we continue to provide quality healthcare to the patients who put their trust and hope in this institution in their quest for wellness. My appeal to staff at the end-of-year function last year was for each staff member to join me in taking ownership of Tygerberg Hospital and to ensure that each of us individually and collectively ensure that our workplace, this refuge for patients is safe, neat and clean and that we truly improve not only the patient’s experience but also improve our interactions with each other so that we can perform better and remain a centre of excellence.

My focus as CEO for 2011 will be on: Visibility: There will be scheduled visits to service areas by the management team and I will host a Staff Indaba. Client Centredness: Improving the patient’s experience remains the mainstay of our everyday function, I will actively promote teamwork and foster the improvement of relationships within teams and across teams. Responsiveness: I have the commitment from the Management Teams that matters requiring attention will be responded to appropriately and expeditiously. Relationships: I will continue to build on strengthening our strategic partnerships and seek new partnerships were appropriate. I trust that 2011 will be a year filled with new achievements and service excellence. I am also looking forward to the Tygerberg Hospital Open Day to be held on the 17th March 2011, providing another opportunity for us to engage with the public on the role and work of Tygerberg Hospital. Dimitri Erasmus

TYGERBERG WATCH

Inside this issue we will be introducing quarterly Xhosa lessons. The introductory lesson will be “getting acquainted”. Looking forward to hear you practise Xhosa with each other as well as with our patients. For example, Molo means Hallo/Hi. The purpose of the lessons is to explore other languages. We will keep it simple so that everyone will be able to converse. Enjoy !!!

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OPENING OF NEWLY RENOVATED G5

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he opening of the newly renovated ear, nose and throat (ENT) ward G5 was held on 26 January. Speaking at the event, head of the unit Prof James Loock praised the staff for remaining motivated even though they previously worked in an environment which was not conducive to work in. He also thanked the Signal Hill Rotary Club who contributed to the renovation of some of the rooms in G5. The proceeds from a bazaar by the Theatre’s Nursing Staff also contributed towards the renovations of the ward.

Above: Ms Sharon Hoffman (right) handing over the proceeds of the bazaar to Ms Modeline Elliot

Above: Ms Jessica Naga & Ms Charlotte Arries in one of the rooms renovated with the money donated by the Signal Hill Rotary Club

The doors leading to the newly renovated G5

END OF YEAR FUNCTION

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n 8 & 9 December the TBH staff were treated with a end of year function which was sponsored by the Hospital Facility Board. This event is a gesture from the TBH management that expresses their appreciation of the staff’s hard work during the year. It also provides a relaxed atmosphere where the staff members can interact freely away from their workstations. The master of the ceremony was the well known Cape Town comedian, Solly Philander, who had the crowd in stitches. Also present at the event was the CEO, Dr Dimitri Erasmus, who thanked the staff for their commitment and dedication throughout the year. The Zamar band provided the entertainment. A light lunch was served. Above: TBH staff enjoying their lunch at the party. From left: Mr Adam Loff, Mr Desmond vd Linde, At the end of the event the staff went back to work Mr Ronald Layman, Ms Noleen Lewis & Ms Pauline Haywood knowing that their hard work does not go unnoticed.

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TBH HCT CAMPAIGN A mass HIV Counselling and Testing (HCT) campaign was launched at TBH in November. This campaign came as a result of the National Health Minister’s call to have 15 million South Africans tested by the end of June 2011. At TBH this campaign acts as a starting point to prevent the spread of the HIV virus, as well as facilitating access to anti retroviral treatment. The campaign also serves to promote safer sex and the promotion of a healthy lifestyle. This entails supporting people to follow healthy lifestyles irrespective of their status and increasing number of people who seek advice on a healthier lifestyle. At TBH the HCT campaign is headed by the infectious disease clinic with the support of Life- line. From November 2010 to January 2011, 800 people were tested. This shows the commitment of the community in trying to combat this preventable disease. The TBH Infectious Disease Clinic has reached a stage where it realized that its efforts need to be increased if it wishes to reach its target of 5 000 people tested by the end of June 2011. Henceforth the blitz campaign whereby it will market the HCT campaign vigoriously with energy and enthusiasm. This took place during March. Two areas have been identified where the testing will take place on a daily basis. Life-line will once again join forces with the TBH infectious Disease Unit in mobilising the patients and visitors for testing.

Testing will be offered on a daily basis from Monday to Friday from 08h00-16h00, on the 8th floor at the Internal Medicine Department and on the 1st floor at the Emergency Services (Old Resus). An extra service will be offered on Saturdays from 09h00-16h00 on the 1st floor at the Emergency Services (Old Resus). A special after hour service will be offered on Friday 18th March and Saturday 26 March from 16h00-22h50 on the 1st floor at the Emergency Services (Old Resus).

WORLD KIDNEY DAY

Mrs Mara Majiedt

The Renal Unit celebrated World Kidney Day with an open day on 10 March. The Department of Health’s MEC Theuns Botha, was one of the guest. The programme started with an informal lecture by Prof Davids. Visitors were encouraged to live healthy lifestyles. They were also taken on a tour through the Renal Unit. The visitors were also given in depth information on how the different dialysis function.

Above: Department of Health MEC , Theuns Botha, speaking to Mr Christopher Visser, who is a patient at the Renal Unit.

Far Left: Staff of the Renal Unit From left to right: Ms Dawn September, Dr Yazied Chothia, Ms Eveline Varrie, Ms Rosie Wlash, Ms Jacqueline Holes, Mr Ferzil Francis, Ms Jennifer Juta



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CHILDREN’S CHRISTMAS PARTY

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he annual Tygerberg Children’s Hospital Christmas Party was held on 26 November. The party was well attended by 400 children. The purpose of this party was to give the hospitalised children at Tygerberg Children’s Hospital (TCH) a Christmas party that they will not forget and to enable them to be part of the Christmas festivities even though they are away from home. Some of the entertainment included the clown Larni Jabulani, the face painter Fiesta and the magicians Ryan Jones, Matthew Ross and Sam Spiller. Coca Cola supplied coke and jumping castles for the children. The children and their caregivers received beverages and snacks. Each child also received a gift.

Above: Father Christmas (Mr Lefifi) with some of the children who attended the party

Tygerberg Children’s Hospital would like to thank all the sponsors for their contributions which made the event possible.

Far Right : The Children with some of the sponsors

CEO BALL The 3rd annual CEO Ball was held on the 12 November. The theme colours were blue, maroon and gold. The ball was well attended and the patrons danced late into the night. All proceeds of the ball goes to TBH Facility Board. This year’s ball will be on 11 November. Keep your diaries open!!!

Above: Some of the patrons that were at the ball Far Left: The CEO Ball partygoers showing their dance moves on the floor Far Right: The CEO Dr Dimitri Erasmus with Mrs Sharon Erasmus 4

WORLD KIDNEY DAY Across the world more than 500 million people, or about one adult in ten, have some form of chronic kidney disease (CKD). World Kidney Day was celebrated worldwide on the 10 March. The aim has always been to raise awarenes about the importance of our kidneys- and to spread the message that kidney disease is common, harmful and treatable. This year the theme was Protect your kidneys and save your heart. It highlights the importance of CKD as a major risk factor in the development of heart disease and strokes. The most important causes of CKD are diabetes, high blood pressure and infections, including HIV. We are facing an epidemic of CKD, partly because of the massive increase in the number of patients with diabetes. Sadly the developing world is going to bear the brunt of this epidemic, with limited resources, both financially and in terms of manpower, with which to respond. The most serious consequences of having CKD is the development of heart disease, strokes or complete kidney failure, also called end-stage kidney disease. If the disease is detected early, treatment is available to stop or slow down further deterioration. However, because kidney disease is often “silent”, it can be present for many years and is often at an advanced , irreversible stage by the time the patient becomes ill. It is therefore important that you be screened annually for kidney disease if any of the following risk factors are present: if you are over the age of 50, if you have or had heart disease or a previous stroke, diabetes, high blood pressure or family members with kidney disease, or if you are HIV positive or obese. Screening is quick and cheap, and consists of checking your blood pressure and doing a dipstick test of your urine to check for the presence of protein or blood. If abnormalities are found, additional tests will be needed, including a blood test to measure kidney function.

as the filter. The patient runs a two-litre bag of special fluid into the abdomen. The toxins in the body which are not being cleared by the malfunctioning kidneys are then transferred into this fluid, which is drained and replaced four times a day, seven days a week. This is done by the patient at home. A transplant is the best option for quality of life and costeffectiveness but we are limited by a serious scarcity of kidney donors. The All Black rugby Jonah Lomu is probably the best known kidney transplant patient. On average we do about 20 to 25 kidney transplants per year at Tygerberg

If early CKD is diagnosed, the treatment benefits the kidney as well as the heart. It includes healthy eating with less salt intake, exercise, maintaining a healthy weight, not smoking, good blood pressure and blood sugar control, and control of cholesterol levels and medication to reduce the amount of protein in the urine. For some patients whose kidneys have failed completely, dialysis is a procedure which can replace some of the functions of the kidney. Because this therapy is extremely expensive, we can only accomodate a few patients. Haemodialysis involves connecting a patient to a sophisticated machine, removing blood from the patient and filtering it with the machine before returning it to the body again. This treatment takes four hours, and patient require it three times a week for the rest of their lives, or until they have a kidney transplant. This is the most common type of dialysis, and requires a complex infrastructure of dailysis machines, expensive consumables and special chairs for the patients, and highly trained staff, including technicians and nurses. Peritoneal dialysis is an alternative method where the membrane lining the abdomen (the peritoneum) is used

Hospital. Most of the kidneys are supplied by living donors, usually spouses or other family members. Dr Andre van der Merwe here at TBH has established a technique for removing the kidney from the living donor using laparoscopic surgery, also called keyhole surgery. This method allows the much faster recovery of our donors, shorter hospital stays and quicker return to work. We have had good media coverage of this innovation. Professor MR Davids



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FAREWELL

Above: From left: Mrs Joseph, Dr Carter & Ms Theron

On 24 November the Nursing Department hosted a farewell party for the two Deputy Nursing Managers. Mrs Joseph was a Deputy Manager of the Obstetrics & Gynaecology, CSSD & ICU. She retired after 39 years of service. Ms Theron who was a Deputy Nursing Manager for the Emergency Services, Surgeries & OPD retired after working at TBH for 38 years.

Above: Mrs Welma van Deventer, an Administration Clerk, retired after 23 years at TBH

Far Right: The 3 retiring staff of Nursing Department. From Left to right: Mrs Joseph, Ms Theron, Mrs van Deventer with their gifts Above: Mr Khotso Nondabula, Assistant Director of Physiotherapy Department retired on 30 September

GOODBYE & GOOD LUCK !!!

Above: Amanda Stephens, an Administration Officer left after 21 years of service at TBH. She was promoted to a Senior Administration Officer post at Valkenberg Hospital

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Above: Mr Martin Manuel, an Administration Officer left after 2 years and was promoted to a Senior Administration Officer post at the Metropole Regional Office

TUBERCULOSIS Tuberculosis (TB)is a disease caused by bacteria called Mycobacterium tuberculosis (MTB). It enters the body when microscopic air particles containing the bacteria are inhaled. Most people inhaling the bacteria will, however, not become infected and fortunately the majority of people who are infected will never develop TB. People who are infected but do not develop active TB will not be ill and will only have a positive TB skin test. This kind of infection is called latent TB infection and does not require any specific treatment in the majority of healthy adults. Latent TB infection cannot be transmitted to other people. People that are not at risk of developing TB disease are young children, the elderly and people with poor immune systems. The latter includes people with diabetes or HIV, people who have had renal transplants, or people undergoing cancer therapy. One can either develop TB after exposure to someone else with active TB disease or by the activation of one’s latent TB infection. In most cases TB is curable (the rate is 87%) and the treatment of TB is standardised by the South African Government. The standard treatment includes a combination of four drugs for a minimum of six months. The four different drugs are manufactured as a single tablet. The number of tablets taken depends on the weight of a person.

tests such as a chest X-ray. If you think you may have TB, you must immediately go to your nearest primary- healthcare facility.

Healthcare workers are also at increased risk of exposure to TB, and subsequently also have a higher risk of developing TB infection and disease. The main aspects contributing to developing TB in the workplace are area of work, type Multi-drug resistant strains (MDR/XDR-TB) require of procedure, and the immune state of the prolonged treatment, 1-2 years and longer, and employee. Tygerberg Hospital staff must attend such patients should be referred to specialised the occupational health clinic on the 8th floor TB hospitals or an MDR clinic immediately. In the (C8 West) if they suspect that they have TB. TBH area Brooklyn Chest Hospital and DP Marais Hospital are dedicated TB hospitals. This kind of TB Tygerberg Hopsital’s policy on TB infection is extremely difficult to cure and the medication prevention and control is available on the used to treat it may have severe side effects. intranet of the TBH server and advises one of the areas of high, medium and low risk of exposure to A person who has TB disease may have symptoms TB. It also guides employees with regards to the such as coughing phlegm or blood for two weeks use of masks and other protective equipment to or more, stabbing chest pain, drenching night prevent infection. sweats, loss of weight and loss of appetite. The best way to diagnose TB in adults is to test the sputum for the MTB bacteria. A result should be available within 1-2 days of sending the sputum to the lab. A negative sputum test does not exclude TB entirely and your doctor may want to repeat the tests or may even opt to treat you based on other

Dr Jantjie Taljaard



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ONS HELD Mnr Romeo J Julies, ‘n Sekuriteitsoffisier het ‘n dief op heterdaad betrap wat sagte en harde ware van rekenaars by die Infeksiebeheer Kliniek, op 8 ste vloer, Oos wou steel. Hy het die dief gearresteer en aan die Suid- Afrikaanse Polisie Diens in Parow oorhandig. Baie dankie ook aan Suster Vivien O’ Brien wat die sekuriteit in kennis gestel het van die voorval. Wel gedaan Mnr Julies!!!

LOCNVILLE VISITS G3 On 21 December 2010 the Reach for a Dream Foundation organised a story reading session for the patients of G3. The guests of honour for the day were the Locnville Twins, Brian and Andrew Chaplin. They read a story titled “ A Magical Day for Dreaming” to the children. The story was from a children’s book written by the Reach for a Dream Fundraising Manager, Lara Rosmarin. All the proceeds will be donated to the Reach for a Dream Foundation. This story reading session enforced a culture of reading amongst the patients of G3. The spirits of these patients were uplifted by the Locnville Twins’ visit. Above: The Locnville twins Brian and Andrew reading a story to the children

Above From left: Amber Chikombola and Danielle Booysen reading their books 8

Above: Brian and Andrew with G3 staff

THE DIARRHOEA SEASON Preparation for the annual diarrhoea season began in November with health promotion and prevention messages being a priority in the community. Each sub-district prepares with additional talks within clinics and community health centers, with community based workers going door to door and educating people with special flip files highlighting prevention through hand washing and correct food storage of food, and demonstrating the recipe for the oral rehydration solution (ORS)used to prevent and treat dehydration when a child gets diarrhoea. We are now however in the time when pressure on the hospitals peaks with the most number of admissions between February and April and great demand for hospital beds. For the first 3 weeks of February, the Childen’s Hospital had 90 admissions with acute diarrhoea to GGround, the short stay paediatric ward. This compares with 100 admissions in the first 3 weeks of 2010. A drop of 10%. The ward occupancy is also down from 110% to 85%. This is a pattern that is seen across other sub- districts and hospitals in the Cape Town Metro, and is very encouraging that perhaps the preventative and promotional efforts have resulted in a reduction in cases and they are probably being better managed at home with earlier initiation of oral rehydration fluid to prevent dehydration and hence the need for hospital admission. A recent study in the short stay ward, GGround did show that up to 80% of care givers do use ORS compared with a national average of 60% which is encouraging.

We must ensure that the best possible care is provided. We have introduced a discharge checklist to ensure patients are warned of signs when to return, that they know the recipe for ORS and are given a special bottle to prepare it, it is ensured that the immunization and Vitamin A status is up to date, and that all children have their nutritional status carefully monitored at clinics to pick up any growth faltering and intervene. Although the total numbers are slightly down there are still many critically ill children requiring intensive care and ward admission, and doctors and nurses in all the paediatric wards at Tygerberg Children’s Hospital are working very hard. Dr Louise Cooke The “Simple Solution”- Home made Oral Rehydration Salts (ORS)Recipe

Other reasons for the decrease that have been postulated include the introduction of rotavirus vaccine last year. Although there was a period of 6 months when it was not available. The clinics also now have access to oral zinc supplements which is given at the start of an episode of diarrhoea. This should shorten the course and may also contribute to less children requiring admission. The measles outbreak last year with the mass vaccination campaign and administration of Vitamin A, to vulnerable children may have also contributed, as the vaccine is thought to have general immune -modulating effects. However we must still recognise that this is a time where there is high demand on paediatric services, with a high turnover of very sick patients.



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DONATIONS

On 24 January, Tygerberg Children’s Hospital oldest patient, Monique Gabriels turned 19 years old. Monique has been hospitalised since the age of two years. The N1 City House & Home in collaboration with various sponsors organised a birthday party for Monique and her twin brother Modrey. Seen far right with Monique (wheelchair) are her mother Mrs Gabriels and some of the sponsors.

G10, G9, G7, G6 On Christmas Eve the SBV(Standard, Barclays & Volkskas Banks) donated toys, children’s clothing and food parcels to the Tygerberg Children’s Hospital. Seen far right from the left: Ms Ntombi Zweni with baby Ntsiki, Ms Tanya Uppington, Mr Arnold Williams

G10, G9, G7,G6,G5, G3, GGROUND

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On 23 December, the Kuils River, New Apostolic Church donated Christmas presents to the Tygerberg Children’s Hospital. Seen far right are members of the Kuils River New Apostolic Church

G6 On 6 December the Smile Foundation together with Walt Disney Channel, donated Christmas gifts to the children in G6. Seen far right are Father Christmas with Devante and his mom, Ms Adonis. Also seen with them is Sister Khafagy, Unit Manager of G6.

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WORLD AIDS DAY The staff of the Infectious Disease Clinic held an Aids Day programme on 1 December as part of World Aids Day. The theme was “We are all responsible”. This theme coincides with the vision of the clinic, to provide quality care to patients by empowering adults and children attending the clinic. Emphasis was place on adherence and positive healthy living. The clinic’s staff, including nurses, counsellors, clerks and housekeepers all partciapted in planning the event. Those in the clinic’s waiting area were the audience. One of the clinic patient’s, Ms Onverwacht, delivered a keynote address to empower other patients to disclose their status and speak out in their communities. She gave a very hearfelt and positive speech. She began with a history of a life before and after being diagnosed with HIV. Her rendition of her life story was inspiring and served as an encouragement for many in the waiting room. They were nodding their heads in agreement and they could relate to episodes in her life. The story of her challenges appealed to the audience because she is a single parent and puts great amount of time and effort into raising her children. She spoke about how she motivates her children to stay positive. Her courage to speak out so openly and honestly about her HIV status, served as a motivation to the staff to continue with endeavours and to focus on educating the patients. The counsellor of the high risk clinic addressed the audience on teenage pregnancy and the risk of contracting HIV through unprotected sex. The message was clear that its everyone’s responsibility to recognise the difficulties that the teenagers are struggling with during adolescence. They must be given guidance and support regarding the bodily changes they go through and be exposed to talks where experimentation with alcohol and drugs is discouraged. Sex education must be available to them and they should be empowered to resist peer pressure and drug and alcohol abuse. Parents must take responsibility to support and guide their teenage children and should take into account that they have many things happening in their life during this period between childhood and responsible adulthood. The schools do assist and so do the religious institutions, but ultimately the young person is the parents responsibility. Then Ms Realta entertained with also performed

Pienaar and her team spiritual dancing. She a solo performance.

The Area Manager, of the unit gave a brief overview of the HCT campaign currently in operation at TBH. The importance of knowing your status was emphazised. The clinics particpating in this campaign are the Obstetrics & Gynaecology, Surgery, Orthopaedic and ENT clinics, who all offer the counselling and testing service from Monday to Friday. The Internal Medicine, respiratory and the diabetic clinics

Above: Staff and patients formed a human chain in the fight against HIV & Aids

Above: Staff releasing ballons during the World Aids Day.

provide the service on Tuesdays and Thursdays. The programme concluded with the staff and patients forming a human chain indicating support for, and unity with one another and that everyone takes responsibility for HIV and Aids. Healthcare workers have the responsibility to provide good quality care according to the policies and guidelines, but patients also have the responsibility to ensure that they maintain good heath by attending appointments, practicing safer sex, gaining insight into their disease and by adhering to their medication. As health workers we will continue to care for the patients and to provide emotional support and information sessions. The intended outcome is that the patients should be empowered and motivated to seek healthcare and to disclose their status to their families to eradicate the stigma in the communities. Mrs Mara Majiedt



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XHOSA LESSONS... Getting Acquainted

Xhosa Molo .............................................................. Ewe ................................................................ Kunjani? ........................................................ Igama ........................................................... Ungubani igama lakho .............................. NdinguDorah ............................................... Ifani ............................................................... Ifani yakho ................................................... Phi? ............................................................... Hlala .............................................................. Uhlala phi? ................................................... sebenza ........................................................ Usebenza phi? ............................................. Mna ............................................................... NdinguPat mna ........................................... Enkosi ............................................................ -ya ................................................................. Ngoku ........................................................... Uya phi ngoku? ........................................... Sikhona ......................................................... Sala ...............................................................

English Hallo/ Hi Hi/ Hallo How are you? Name What is your name? I am Dorah Surname Your surname Where? stay Where do you stay? work Where do you work? I/ me I am Pat Thank you/ thanks going now Where are you going now? We are well remain

MORE DONATIONS N1 City Mall donates to TCH On Friday, 10 December 2010, the N1 City House & Home, in collaboration with ABSA Bank, Texas Spur, Wonderland, Checkers Hyper and the Crazy store donated Christmas gifts to the Tygerberg Children’s Hospital (TCH) The MEC for Social Development, Ms De Lille was a surprise guest and she handed out gifts, sweet treats and vouchers alongside the sponsors. Far right: Little Indiphile Hlubane talking to Father Christmas (House & Home) and to the MEC for Social Development, Ms De Lille

Voluntary Aid Services donates paintings to A8 On 28 February the Voluntary Aid Services donated paintings to A8. Far right from left: Ms Daneline van Greunen, Ms Youe Wally, Ms Sylvia Henry, Ms Flora MacClune, (handing over the gift) Ms Lillian Layman 12 Please forward any contributions to the Communications Department at 021 938 5454/5608 or email Lcpienaa@ pgwc.gov.za