Department of Internal Medicine

Head: Professor K.R.L. Huddle (Chief Specialist)

Professor Ken Huddle completed his medical degree (MBBCh) in 1974 at the University of the Witwatersrand. He successfully completed FCP(SA) during 1979 at the College of Medicine (SA) and obtained a FRCP (London) during 1996.

Special interests include Diabetes Mellitus and Phaeochromocytoma. Prof Huddle is co-editor of a book "Baragwanath Hospital 50 Years. A Medical Miscellany", has written 2 chapters in the book "Diabetes in Africa", is responsible for over 45 publications, teaches both undergraduate and postgraduate students and is an undergraduate and postgraduate examiner at all South African Universities.

Statistics

The Department of Medicine include subspecialties of Cardiology, Neurology, Nephrology, Pulmanology, Endocrinology, Rheumatology, Haematology and Infectious Diseases.

Admissions: 3'000 per month

Admissions have risen by 40% over the past 5 years, largely as a result of the HIV/Aids pandemic. The death rate of admitted patients exceeds 10%.

Bed status:

• General
693

• Admission Unit
50

• Neurology
40

• Renal Dialysis
36

• Coronary Care
14

• Total
833

Staff posts:

• Specialists
45

• Registrars
40

• Medical Officers
13

• Community Service Officers
8

• Interns
27

• Total
133

Projects and Plans

Plan to reduce admissions:

Meetings with the Gauteng Health Department have led to the implementation of a plan to divert level 1 medical cases from Casualty to other hospitals. It is being phased in at present and will, in time, significantly reduce medical admissions. This will lessen the stress on our doctors and nursing staff.

Renal Institute:

Dr Ivor Katz, Head of the Renal Unit, has initiated a plan to create a new Renal Institute at Bara. Negotiations are far advanced for the funding of this project, which will be an excellent example of a private sector/public sector enterprise.

An AIDS Unit:

Dr Alan Karstaedt, Head of Infectious Diseases at Bara, has put forward a proposal for the creation of an Aids unit at the hospital to assist with management of adult patients with HIV/Aids. This will be a centre of excellence which will function as a resource centre for teaching, service, and research. It will be able to develop protocols for management of HIV/Aids patients.

Palliative Care:

Dr Allison Russell has initiated the development of a Palliative Care Unit at Bara. The major focus of this unit is to provide comprehensive care for patients suffering from advanced malignancy and Aids. Trained nursing sisters form the backbone of this unit.

Appointments

• Drs M Tikly and M Patel were appointed Associate Professors in 2001
• Prof M Patel was recently awarded the PV Tobias and Convocation Award for teaching. He was also awarded his PhD
• Dr D Blumsohn was made an Honorary Professor in 2000
• Prof G Modi has been appointed to the Chair of Neurology at Wits in 2001
• Prof M Tikly was awarded a PhD in 2002
• Prof K Huddle was awarded the FJ Milne Department of Medicine Award in 2001 for distinguished teaching and service
• Dr M Hopley was awarded a MMed in 2002
• Prof D Saffer was awarded an Exceptional Service Medal by the Faculty of Health Sciences in 2002

Education continues to be a high priority. Approximately 40 nursing sisters in training for the Critical Care Nursing Diploma rotate through the ICU each year.

Registrars from Anaesthesia, Internal Medicine, O&G and Surgery rotate through the Unit for 2 or 3 months at a time, and this time is recognised by both the College of Medicine of SA and the Health Professions Council of SA. In addition, the Unit currently has five Medical Officers on its staff. Registrars and Medical Officers are involved in the day-to-day care of both adult and paediatric patients. During their time here they gain valuable experience in managing ventilatory and inotropic support, the initiation and use of invasive monitoring, the supervision of haemodialysis and rational use of antibiotics and nutritional support.

An active teaching programme is in place, and registrars and MO's are supervised in the preparation of talks and presentations.

Furthermore, the Unit has received accreditation for Critical Care subspecialty training, and the junior consultants employed in the unit are working towards such accreditation.

Dr Rudo Mathivha, Director of the Unit, has, in the last year, received several invitations to lecture at international critical care conferences. In the past year the unit has also hosted several international undergraduate elective students, and continues to benefit from the presence of Dr Remy Toko, a consultant paediatrician from the Congo.

General

The Department of Medicine continues to offer quality care to the community of Soweto, and is dedicated to excellence in teaching and research. The major crisis facing us now and in the future is the Aids pandemic. We shall strive to play a meaningful role in assisting the many desperate people who suffer from this scourge.

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