CHRIS HANI BARAGWANATH HOSPITALThe Biggest Hospital In South Africa.Chris Hani Baragwanath Hospital Departments
Department of PaediatricsHead: Prof John M. Pettifor (Chief Paediatrician)OverviewBed numbers (excluding surgical and surgical specialties):
Total paediatric beds408 Basic StatisticsAnnual admissions to the general paediatric wards:
Since 1992 there has been a 28% increase in admissions to the general paediatric wards. This increase has been associated with an almost three fold increase in the in-hospital mortality over the same period. HIV/Aids is solely responsible for this increase in workload and the increase in in-hospital mortality. HIV/Aids is now responsible for over 40% of admissions to the general wards, and for over 50% of admissions in the infant and toddler age group. Neonatal ServiceAnnual delivery rates and admissions to the neonatal unit:
Emergency & Outpatient ServicesIt is gratifying to see that, despite the increase in the number of admissions to the general paediatric wards, the number of patients being seen in our emergency service has remained relatively constant at just under 45'000 per annum. 29% of these are seen after normal working hours or on weekends. Five and a half thousand children were admitted to the short-stay wards in 2000. This facility does prevent serious overcrowding in the general paediatric wards. Some 20'000 children attended the subspecialty paediatric outpatient services during 2000. The service continuous to provide specialist care for referrals from a large part of South Africa and the neighbouring countries. DevelopmentsSeveral improvements to the paediatric facilities have taken place over the past year. Goldfields of SA very generously donated funds to build a completely independent outpatient facility for paediatric haematology/oncology under Dr Linda Wainwright. The facility not only has consultation and counselling rooms but also play rooms, procedure rooms and a day ward. The interior decorating was partially done by the wives of the directors of Goldfields. The department is very grateful for their contribution to the welfare of the sick children at Chris Hani Baragwanath! More recently, the Department has developed a separate outpatient facility for older children suffering from HIV/Aids. This section, run by dr Tammy Meyers, is situated in the old Harriet Shezi Hall, which was revamped and converted into consultation, procedure and waiting rooms. Funds for the upgrading came from generaous donations from a number of private enterprises. Dr Tiziana Aduc organised the renovation of the isolation cubicles in each of the wards. The cubicles have been repainted in bright colours, television sets provided and toy boxes filled. Funds were provided by a number of sponsors including the Carl & Emily Fuch Foundation. Ambulatory Paediatric ServiceThis division provides a 24 hour emergency and daily sick service as well as subspecialty outpatient clinics. The latter provides outpatient diagnostic and management expertise for tertiary care referrals. As part of it's service the department staffs a Gastro-enteritis Unit, also known as the Drip Room. This unit was started in the 1950's to address the problem of dehydration caused by diarrhoea. Since it's inception the concept has been copied by numerous hospitals and clinics throughout the country. The facility provides for the rehydration of dehydrated infants and young children, under the care of the children's mothers. During their stay in hospital the mothers are taught about the importance of fluid replacement, continued breast feeding and the feeding of older infants during episodes of diarrhoea. The ambulatory service is also responsible for a short-stay ward which cares for infants and children who are too sick to be treated or investigated as an outpatient, but who do not warrant admission to the acute paediatric wards. In the shortstay ward the basic care of the patients are provided again by their mothers, supervised by the nursing staff. Some statistics from the ambulatory services:
Impatient ServiceThese facilities provide a total of 223 beds. The diagnoses of the children admitted reflect the health problems of developing communities in many parts of the world. Nutritional problems, and those related to infectious diseases, account for the large majority of the admissions. Over the last 7 years the number of children admitted annually have increased from 4'500 to over 5'600. MRC / University Mineral Research UnitThe unit, which is housed in the Department of Paediatrics, was established in 1985 under the directorship of Professor John Pettifor. The unit's research interests are focused on metabolic bone disease of particular relevance to the people of South Africa. The major directions include the pathogenesis and management of osteoporosis in adults, and the factors influencing peak bone mass and bone loss. Further, the role of dietary calcium intake in the pathogenesis of metabolic bone diseases in children - in particular Ricketts - is being investigated. The unit, which consists of an 8 bedded research ward, laboratories and offices for staff, is funded by grants from the South African Medical Research Council and the University of the Witwatersrand. The staff are employed by the Gauteng Health Department. Paediatric Haematology and Oncology ServiceThe paediatric Haematology/Oncology service was started in 1975. In 1989 the Goldfields Foundation sponsored the upgrading of ward 44, to provide a specialised Children's Haematology/Oncology Clinic. The clinic contains 18 beds for inpatients, a 4 bed day ward, out-patient clinic area, treatment room and doctors offices. Numerous other donations have contributed towards making this unit a bright attractive home from home, especially for long stay patients. Volunteers continue to provide play-therapy for the children. The service expanded rapidly, and in 1993 the Goldfields Foundation sponsored the renovation of ward 43. This added another 25 inpatient beds to the service. The unit is therefor able to provide comprehensive care for the children and their families. Both medical and nursing staff have remained fairly constant, thus providing continuity of care, a vital for the children's wellbeing. At present approximately 140 new patients are seen per annum, as well as children on maintenance chemotherapy, and long-term follow-up of survivors. An outreach programme, which involves a service to outlying areas and hospitals, continues to be very successful. It provides a Family Counsellor that is being funded partially by the Anglo American de Beers Chairman's Fund and CHOC (a parent body of the Children's Haematology/Oncology clinics of Johannesburg and Chris Hani Baragwanath Hospitals). Clinical research is encouraged and work is being done on Rhabdomyosarcoma, Retinoblastoma and Osteogenic Sarcoma. Neonatal UnitIt provides neonatal care for the Maternity hospital and Soweto clinics. There are twelve intensive care unit beds, 25 -30 high care beds (supposed to be 18 only - over 100% occupancy rate) and 100 low care beds. The unit catered for 18'395 deliveries in the hospital and a further 11'000 deliveries at the clinics last year. Seven thousand babies are referred to us and about half of those are admitted. The hospital deliveries have increased by 3'000 since 1998. The unit is starting a Kangaroo Mother Care Unit in ward 40. The unit aims to also start a self-help group for mothers of these premature babies. Nursing staff, allied medical disciplines and mothers who have had premature babies, will be involved. Would you welcome additional information on this site? Send your request.
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