December 3rd marks the 50th anniversary of the first human-to-human heart transplant by Prof Chris Barnard. But the disparity of treatment across the country threatens to undo the gains made since Prof Barnard’s first surgery in 1967.

This is according to Cardiologist and President of the South African Society of Cardiovascular Intervention (SASCI), Dr Dave Kettles, who was speaking at a seminar organised by heart transplant recipients Ray Hartle and Ali Koekemoer at Life St Dominic’s Hospital. Dr Kettles was joined by a team of cardiology specialists who discussed the prevalence and treatment of heart disease in SA.

“Geographic injustice”

Dr Kettles said based on the Statistics SA mortality reports, the incidence of cardiac disease among South Africans is growing; unlike in developed countries. It’s estimated that 225 people die of heart disease every day, 80% of these deaths could be prevented. Dr Kettles called for improved detection, prevention and treatment of non-communicable diseases (NCDs). However, he noted that the country suffers because there are only 200 cardiologists to treat the total population, whereas a country like Brazil has 8,000 cardiologists for its population of 180 million.

In East London, a state patient cannot have an angiogram or have a cardiac operation. The entire Eastern Cape Province is served by only two cardiologists in the public sector hospitals. Dr Kettles noted that while Capetonians may get a transplant as a state patient, in East London very few people can be treated for their heart attack, suffering substantial long-term damage as a result.

“Let’s celebrate by all means, but let’s wake up as well to the unacceptably low standard of care offered to our population, and the resultant loss of life,” said Dr Kettles.

Decline in heart transplants

Despite the growing incident of heart disease, the number of heart transplants being conducted in South Africa’s public sector is declining. Over the past 50 years Groote Schuur Hospital has performed 537 transplants. However, current numbers show a decline at less than five operations a year. This is according to Cardiothoracic Surgeon at the University of Cape Town and Groote Schuur Hospital, Dr Tim Pennel, who said the transplantation programme is gradually being taken over by the private sector.

Heart transplant surgeon at the Christiaan Barnard Memorial Hospital, Dr Willie Koen, said that historically, many heart donations had come from the Eastern Cape, but that he had seen a fall-off in recent years.

Dr Pennel says heart transplantation can’t be approached in an isolated manner and called for better co-operation between the public and private healthcare sectors.

“Life Healthcare and the state hospitals have been engaging for a number of years and have assisted each other in a small way in the provision of certain cardiac interventions and renal care,” said Life Healthcare Eastern Cape Regional Manager, Bruce Janssens. Janssens concluded by saying that  the treatment of cardiac ailments and disease was a key component of the group’s strategic vision in the Eastern Cape.

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