Operation toyi-toyi

In theatre H35 at Johannesburg Hospital, surgeons were performing a delicate life-saving heart operation.

Twelve-year-old Sowetan Siphamandla Mbatha was undergoing an operation - sponsored by The Star - to remove part of the membrane around his heart.

Just metres away, striking nurses dressed in red and black waved placards and toyi-toyied in the corridors outside.

The public sector strike, now in its fourth week, has severely disrupted hospitals and schools across the country. At Johannesburg Hospital, the effect was clear.
The bins in the basement parking lot overflowed with rubbish while the floors of the hospital - usually shiny clean - were grubby and littered with dirt.

Cooldrink cans and chocolate wrappers lay scattered on the hospital benches. Buckets full of medical waste lay undisposed.

Armed soldiers - brought in to maintain order and keep the hospital running - swept floors and helped non-striking workers attend to patients. None of the non-striking hospital staff wore uniforms.

A staff member who spoke to The Star said a nurse had been assaulted by striking colleagues in the hospital corridors.

Posters stuck along the wall alerted people that the hospital was only seeing to emergency cases until the strike ended.
At the hospital's "green block", just metres from the operating theatres, about 10 striking nurses sang revolutionary songs and stomped their feet.

One placard, among the many they hoisted, read: "Manto don't think it's over. There is secondary rejection and you'll back our hands back off" - in reference to the health minister's liver transplant performed at the hospital three months ago.

On Wednesday, Cosatu was expected to meet to discuss the government's final wage offer of 7,5 percent. The unions initially demanded a 12 percent increase but revised their demands to nine percent last week.

Meanwhile, oblivious to Tuesday's protests at Johannesburg Hospital, surgeons operated on Siphamandla. Just four months ago, Siphamandla was an active 12-year-old boy. He played soccer for hours on the streets of Zola in Soweto, went to school, studied hard and helped out around the house.

But in March, his mother, Zuzile, watched her son's health deteriorate.

"At first I thought he just had a cough, and took him to the clinic for a check-up. They did not know what was wrong, and after x-rays, referred me to (Chris Hani) Baragwanath Hospital," she said.

There, doctors discovered that he had a condition known as constrictive pericarditis, where the heart's outer membrane, the pericardium, prevents the heart from beating normally.

Siphamandla's heart couldn't fill up with enough blood to pump to the rest of his body. Because of this, his body, including his lungs, swelled up with excess water. He needed surgery.

Johannesburg Hospital, which performs all state heart surgery in the region, has a waiting list of 300 children, and all the doctors at Bara could do was drain off the excess fluid from his lungs. This helped for a while, but when his mom took him for a check-up last week, his condition had worsened and urgent surgery was needed.

The Boikanyo Foundation, set up by the Golden East Round Table Association and Johannesburg Hospital to raise money to help ease the massive backlog of children on the surgery waiting list, heard about Siphamandla's case.

Last month, the foundation paid for open-heart surgery on five-month-old Kgaotsang Goretetseng, who was born with a hole in her heart. After the surgery, The Star donated R100 000 to the fund. It was with this money that the foundation was able to provide Siphamandla with surgery.

On Wednesday, a team of surgeons led by Krubin Naidoo and Kathy Vanderdonck waited as Siphamandla was wheeled into theatre H35.

Back at the children's ward, his mother sat anxiously where his bed had stood.

"I am very excited about this. I just want my old Siphamandla to come back so that he can once again live a normal life," she said.

At 1.45pm, surgeons cut through Siphamandla's chest. Fifteen minutes later, his beating heart was exposed. Using a variety of clamps and surgical tools, the surgeons stripped the pericardium, allowing the heart to beat freely.

A boy his age should have a pericardium between half a millimetre and a millimetre thick. Siphamandla's pericardium was 8mm.

Three hours later, the operation was complete and the surgeons closed his chest.

Dr Murray Davidson, a member of the Round Table association and part of Johannesburg Hospital's cardiothoracic department, said the foundation hoped to help many more children in need of surgery.

"This hospital has all the skills; what the foundation is doing is funding an additional ICU bed where children will recover and for disposable equipment used in the theatre.

"This partnership with the hospital means that the surgery costs far less than it would at a private hospital," he said.
source:www.int.iol.co.za