CHRIS HANI BARAGWANATH HOSPITAL

The World's 3rd Biggest Hospital, in South Africa.

Chris Hani Baragwanath Hospital Departments

Department of Paediatrics

Head: -currently unspecified- (Chief Paediatrician)

Overview

Bed numbers (excluding surgical and surgical specialties):

  • General Paediatric beds: 164
  • Admission beds: 10
  • Subspecialty: Heamatology/Oncology: 43
  • Subspecialty: Cardiac/Neuro: 16
  • Subspecialty: Renal (dialysis): 2
  • Metabolic: 8
  • Short-stay beds including GE Unit: 40
  • POPD (temporary): 5
  • Neonatal ICU: 12
  • Transitional car (high care): 18
  • Wards 66 & 67: 50
  • Ward 40: 40

  • Total paediatric beds: 408

Basic Statistics

Annual admissions to the general paediatric wards:

Year 1992 1993 1994 1995 1996 1997 1998 1999 2000
No 4'404 4'464 4'670 4'838 5'319 5'599 5'197 5'312 5'645
Deaths % 3.9 4.2 4.8 5.5 6.1 7.3 7.8 9.2 9.1

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.

Ambulatory Paediatric Service

This 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.

Impatient Service

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.

MRC / University Mineral Research Unit

The 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 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 Service

The 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.

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 Unit

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.

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