Chris Hani Baragwanath Hospital

'Unstoppable wave of child mortality'

Published by: 
Health Systems Trust

HIV is the main driving force behind South Africa's high child death rates and unless there is a concerted effort to put child survival strategies in place the country faces an "unstoppable wave of child mortality”,’ paediatricians have warned.

Speaking at the national AIDS conference in Durban, Professor Nigel Rollins head of the Department of Paediatrics and Child Health at the University of KwaZulu-Natal, said South Africa was one of nine countries where child mortality was increasing.

Rollins had already warned earlier this year that "PMTCT fatigue” had set in and that multitudes of children were getting needlessly infected.

Aids vaccine trials to go ahead

South Africa is expected to begin it's first Aids vaccine trials at the end of September, following the approval by the Medicines Control Council (MCC) of a second HIV preventative vaccine candidate. The trials will form phase one of three trials that could take seven to 10 years to complete. The most recently approved vaccine candidate, named HIVA.MVA, was designed by the University of Nairobi in Kenya and the University of Oxford in the United Kingdom. Phase one human trials of the vaccine candidate have already have been completed in Kenya and the UK and are underway in Uganda. The trials are sponsored by the nonprofit International Aids Vaccine Initiative (IAVI). In June, the MCC gave approval for a phase one trial of AVX101, designed by the US biotechnology firm AlphaVax Inc. The trial will be conducted by the HIV Vaccine Trials Network of the US government's National Institute of Allergy and Infectious Diseases. A Phase One trial of AVX101 was recently completed in the US. The trials of HIVA.MVA and the AlphaVax candidate are separate, but will be conducted at the same sites: the Perinatal HIV Research Unit (PHRU) of the University of the Witwatersrand at the Chris Hani Baragwanath Hospital in Soweto and the SAAVI HIV Vaccine Research Unit at the Medical Research Council in Durban. Professor James McIntyre, Principal Investigator for the Aids vaccine trial sites in South Africa, said: South Africa's research community has linked hands with researchers cross three continents-Europe, North America and Africa-in the global effort to find a vaccine against Aids. There is no risk of either HIVA.MVA or AVX101 causing HIV infection or Aids. Neither vaccine candidate contains HIV or any substance from HIV infected individuals. A preventive vaccine would be given to people who are HIV negative, to prevent HIV infection. IAVI's HIVA.MVA and AlphaVax's AVX101 employ different vaccine design strategies. HIVA.MVA uses a vaccine strategy called modified vaccinia Ankara, a variant of the basis for the smallpox vaccine. AVX101 uses a carrier for it's vaccine called the Venezuelan Equine Encephalitis alphavirus vector. By studying different vaccine design strategies at once, rather than one at a time, South Africa will help reduce the time needed to identify which is the most effective, said Dr Seth Berkley, President and CEO of IAVI. In the search for an Aids vaccine, speed is of the essence. A preventive vaccine is our best hope to end the spread of an epidemic that infects 15,000 men, women and children around the world every day, Dr Berkley said. The Phase one trials will initially enroll roughly 50 volunteers each. Their aim is to test safety and gather preliminary data on the ability of the vaccine candidates to stimulate the immune system. By conducting the HIVA.MVA and AVX101 trials side by side, South Africa will help gather data to address how an AIDS vaccine may be able to combat the varying subtypes of HIV that are circulating. IAVI's HIVA.MVA is based on subtype A, which is common in east Africa. AlphaVax's AVX101 is based on subtype C, the subtype most common in South Africa. Ideally, a single Aids vaccine will be highly effective against all subtypes of HIV, said Dr. Wayne Koff, IAVI's senior vice president for Research and Development. Preliminary indications are that both of the vaccine candidates currently approved for testing in South Africa hold promise for meeting this goal, but only human trials will tell us for sure. (Source: Sapa, Business Day, 26 August 2003)

University launches AIDS research facility

The growing need for a wider African research response to the HIV/AIDS pandemic has led to the creation of a virtual institute at one of South Africa's leading universities. The concept of the University of Witwatersrand AIDS Research Institute is not to duplicate existing initiatives, but to coordinate research into the disease among the university faculties, Professor James McIntyre, founder of the institute, said at the launch on Tuesday. The institute will not employ any researchers. Instead, it will connect research projects such as the HIV/AIDS Perinatal Clinic at Chris Hani Baragwanath hospital and the Centre for Health Policy in Johannesburg to foster interdisciplinary research. Research teams will work on various project themes, including basic biomedical research, prevention interventions, and social, economic and political issues. Research into policy development and implementation will also be conducted by the university. More details on the institute: (Source: Integrated Regional Information Network, 15 May 2003)

Job opportunities at RHRU

The reproductive Health Research Unit (RHRU) is one of the foremost South African Research Institutions engaged primarily in research and training in the field of sexual and reproductive health. The RHRU is an academic centre within the University of the Witwatersrand. The Wits Health Consortium (Pty) Ltd, a wholly owned subsidiary company of the University of the Witwatersrand, employs RHRU staff. The Wits Health Consortium (WHC) and RHRU is an equal opportunity employer and adheres to fair recruitment and selection practices. Interested candidates should please send their CV's and clearly marked motivation letter for the position to The Human Resources Department, RHRU, Chris Hani Baragwanath Hospital, P.O. Bertsham, 2013; or fax to (011) 989-9298; or email to Closing Date: 17 April 2003 1. EU Men project: Project coordinator 2. EU Men project: Research intern 3. Senior Project Coordinator: (Training & QI) 1. Project Coordinator: EU Men Project --------------------------------------- The RHRU wishes to recruit an enthusiastic and suitably experienced candidate to join the EU Men programme. This programme aims to conduct research into the reproductive and sexual health of men who are resident in Johannesburg inner city municipal hostels. This will lead to the design of an intervention to improve the health seeking behaviour of hostel residents. The intervention will be implemented by a relevant external organisation. The research design is a pre and post intervention evaluation that seeks to explore the impact of the intervention. Included in the research process will be a series of ethnographic studies of men in the context of hostels in inner city Johannesburg. This will assist in the development of a baseline and post intervention survey. The project coordinator is required to implement the research and assist in coordinating the intervention. This position will be based in Johannesburg at the Chris Hani Baragwanath Hospital. Some essential functions include: * Contribute to the development of the research protocol. * Contribute to the development of research tools. * Contribute to the development and implementation of formative ethnographic research. * Develop the work plan/implementation plan for the project. * Manage and monitor the project expenditure. * Contribute to the development and implementation of the intervention under evaluation in the hostels and surrounding clinics. * Assist in developing and maintaining a comprehensive review of the relevant literature for the project. * Manage the implementation of the survey research by an external organisation. * Write reports and presentations. * Where appropriate, co-author publications with other members of the research team. * Participate in and contribute to the development and achievement of RHRU's corporate goals and objectives * Manage and supervise a research trainee * Provide input and direction to a research survey team. Qualification, experience and personal attributes: * An honours degree in the social sciences (anthropology, sociology, medical anthropology) or clinical/nursing sciences is a minimum requirement. A postgraduate degree or progress towards a postgraduate degree is highly desirable. * Ethnographic or qualitative research experience is imperative and knowledge of public health surveys is desirable. * Knowledge of urban social and health issues would be an added advantage * At least three years experience in management at middle to senior level within a medium to large sized organisation. * Experience in financial and programmatic management and reporting. * Demonstrated writing skills and the ability to produce relevant reports and budgets. * Microsoft Office computer literacy is essential * Experience of working in teams with diverse cultural and professional backgrounds and the ability to communicate sensitively with culturally diverse groups is essential. * Willingness to work in the inner city hostel environment. * A strong commitment to capacity building is essential. * National travel is required. Some international travel might be required. * A driver's licence is essential 2. RESEARCH INTERN (EU MEN PROJECT) ------------------------------------ This exciting position requires a dynamic person to provide support to the EU Men Programme and would be suitable for a candidate wishing to pursue a career in medical research. The responsibilities of this position will include: * Contributing to and assisting the research team with the provision of the research support. * Development of appropriate research questions and research tools * Design and implementation of research studies, data management and analysis, report writing and the dissemination of information. Essential selection criteria: * A Bachelor's degree in social sciences (anthropology, sociology) or nursing. * Experience in project management * Good communication skills both verbal and written * Computer skills essential * Candidates must hold a valid driver's licence. 3. Senior Project Coordinator: (Training & QI) ---------------------------------------------- Main responsibilities * The purpose of this position is to facilitate and organize the RHRU's Research Methods course, short course in HIV Management, Reproductive Health Priorities Conference and Materials development. * The Reproductive Health Research Methods Course * The Priorities Conference * The Short Course in HIV Management * The development of materials for training Key Performance Areas * Planning and forecasting for these courses including budgets * Providing administrative function of the steering committees * Communications and arrangements with participants and facilitators * Logistical arrangements such as venues, transport, ceremonies, advertising, equipment, materials etc * Writing up of necessary reports for donors and internal evaluations of courses * Maintain data bases and communications with participants before during and after the courses. * Training Materials development Qualifications and other Criteria: * Relevant bachelor's degree * High level/ advanced computer skills * Excellent report writing skills * Good financial management * A high degree of organisational skills * Ability to perform numerous tasks/ projects simultaneously * Good problem solving skills * Creative approach to the organisation of functions * Ability to work under pressure and tight deadlines * Excellent interpersonal skills * Must be in a position to travel across the country and thus be in possession of a valid driver's licence and have access to a vehicle.

Long distance op puts SA on medical map

Dr Bob Banieghbal at Chris Hani Baragwanath Hospital in Soweto and Professor Benno Ure at his offices in Hannover, Germany, made use of the latest advancement in surgery - the telementoring system Socrates - to perform the laparoscopic surgery on a two-year-old child on Tuesday. While the operation itself is not unique, the technology used by Banieghbal has once again put South Africa on the medical map. According to Socrates suppliers, it was only the second time that two surgeons from different parts of the globe had used the technology to perform an operation together. Ure, sitting in his office in Germany, was able to advise Banieghbal on the best possible procedure, including where to cut, what to pull and where to stitch. Socrates allows surgeons to participate virtually in procedures taking place in distant operating rooms. How it works: Socrates links surgeons in the operating room with colleagues anywhere in the world. A voice-controlled robotic arm (Aesop) positions and holds an endoscope (a minute camera used to view internal organs) which is inserted into the patient via the navel.Two further incisions are made (the positioning depends on the type of surgery) in which miniature medical instruments are inserted. The surgeon physically present has control over the instruments while both surgeons have control over Aesop, to enable them to have the best possible view of the area being operated on. The surgeons are in contact with each other via TV screens and ISDN telephone lines. The virtual surgeon has a monitor that shows him exactly what is being done, as well as a computer mouse with which he can indicate to the surgeon exactly where to cut or suture. Markings made by the virtual surgeon can be seen on a monitor. Socrates makes it possible for specially trained surgeons to become interactively present wherever needed. Added to this, physicians in rural and remote areas can consult with specialists in emergency situations. The equipment is on short loan to Bara, but Banieghbal is working on ensuring that the hospital keeps it for at least a year. The equipment could cost anything from R600 000 to R1,2-million, he added.