UHC people’s consultation for South Africa in 20 July 11:00-13:00

UHC people’s consultation for South Africa in 20 July 11:00-13:00

On 20 July 2021, the SA NCDs Alliance is co-hosting and coordinating a people’s consultation on universal health coverage (UHC). This is especially for you if you use government health services.

The South African version of UHC is called “national health insurance” or NHI. But are we talking about the same thing? There are some big differences. What do you think?

The event is a virtual focus group lasting 2 hours with 30 participants.  You can only participate if you apply. We want to hear your voice especially if you are part of a vulnerable or hard-to-reach group that uses public or government health services. So you need to complete that application form and showing us why your participation is important.

Apply to join the conversation here

  •  People who are left behind or have trouble having their health needs met before or during COVID-19?
  • Civil society participants, breakout group facilitators or note-takers.

We want to make sure that we hear from you, the people, and especially if you are in that “seldom heard” and vulnerable group. We can help a few selected participants with data package to participate on the day.

The event forms part of the United Nations Civil Society Engagement Mechanism (CSEM) for UHC2030 efforts to gather South African insights on the state of UHC.  Your views will be inputted into the UN State of the UHC Commitment Report for publication at the end of 2021 (around UHC Day 12 Dec). Here is the 2020 State of the UHC Commitment Report.

An excellent and relevant reference just published by WHO is Voice, agency, empowerment: Handbook on social participation for UHC 2021

COVID-19 deaths not cut by hydroxychloroquine

COVID-19 deaths not cut by hydroxychloroquine

Hydroxychloroquine does not reduce deaths from COVID-19 and may even cause unwanted damage, recent studies have found. According to the new Cochrane Review, the drug probably does not reduce the number of people needing mechanical ventilation.

“In addition, they note that no new trials of hydroxychloroquine or chloroquine for treating COVID-19 should be started,” the South African Medical Research Council (SAMRC) said on Tuesday. The findings are contained in the study published by authors based in India, South Africa, and the United Kingdom, who undertook the systematic review of studies that used chloroquine or hydroxychloroquine for treating or preventing COVID-19 disease.

It is also likely that hydroxychloroquine caused more unwanted effects than placebo in the trials undertaken. I think this underlines the importance of ensuring that we have reliable evidence even in an emergency situation like this pandemic where there is public pressure for rapid treatments and prevention options.   

Dr Tamara Kredo, Cochrane South Africa, SAMRC

“They searched for studies that examined giving chloroquine or hydroxychloroquine to people with COVID-19; people at risk of being exposed to the virus; and people who had been exposed to the virus,” the SAMRC explained. According to the SAMRC, the public demand for a COVID-19 cure fuelled speculation that the drug might be effective based on unreliable research that did not meet the inclusion criteria of this review.

“The then US President Trump declared chloroquine a ‘game changer’ about a year ago, leading to global demand and confusion. The research community rapidly organised large trials, which demonstrated no evidence of an effect, and these trials are summarised in this review.”

The Council said the review authors included 14 relevant studies of which 12 were studies of chloroquine or hydroxychloroquine used to treat COVID-19 in 8 569 adults. Meanwhile, the two studies focused on whether hydroxychloroquine prevents COVID-19 in 3 346 adults who had been exposed to the virus but had no symptoms of infection. This included research from different countries, four in China and one each from Brazil, Egypt, Iran, Spain, Taiwan, the United Kingdom and North America and a global study in 30 countries.

According to the local author from Cochrane South Africa, Tamara Kredo, this review offers conclusive evidence that hydroxychloroquine has no impact on clinically important outcomes for both the prevention and treatment of COVID-19.

Senior author, Dr Tom Fletcher, said: “The review should put a line under using this drug to treat COVID-19. But some countries and health providers are still caught up in the earlier hype and prescribing the drug. We hope this review will help these practices end soon”. This Cochrane Review was co-ordinated by the Cochrane Infectious Diseases Group (CIDG), which has its editorial base at Liverpool School of Tropical Medicine (LSTM).

Cochrane South Africa (SA) is an internal research unit of the SAMRC and is part of the global, independent Cochrane network of researchers, professionals, patients, carers and people interested in health. Cochrane is a non-profit organisation that prepares and disseminates information on what works and what does not in healthcare. These reviews enable policymakers, health service providers and the public to make informed decisions about healthcare.

SA’s health data ranking

SA’s health data ranking

The SCORE for Health Data Technical Package represents the most comprehensive strategies and interventions for strengthening country health information systems. First launched in August 2020, it is a one-stop solution to improve the availability of timely, reliable and comparable health data to track progress towards the Triple Billion targets and health-related Sustainable Development Goals.

SCORE is the first time that all elements comprising an optimum health information system – Survey, Count, Optimize, Review, Enable – are captured in a single, harmonized package.

Download the South African report 2013-2018

Share Ben’s story through the Patch Academy

Angie, Abigail, Anton and Benjamin Hawkes 

To mark International Childhood Cancer Day Patch SA is spreading its digital wings by opening its online learning platform. The Patch Academy provides accredited CPD certificate courses on aspects of children’s palliative care especially relevant for South Africa. Are you a health care provider working in South Africa? The courses are open to doctors, nurses, social workers, psychologist, pharmacists, therapists and in fact anyone who wishes to learn how to provide palliative care to babies, toddlers, children and adolescents. The courses are accredited by The Colleges of Medicine of South Africa.

Ben and the Hawkes’s inspiring story

Anton and Angie Hawkes gave permission for the use of this story and image. This is not just Ben’s story but that of the whole family.

Benjamin Hawkes was just 10 years old when he was diagnosed with osteosarcoma (bone cancer) and over the next ten months, he underwent chemotherapy, limb salvage surgery and radiation therapy. A clear PET scan at the end of this arduous treatment was cause for celebration, but two months later it was found that the cancer had metastasised and was invading Ben’s lungs.

More aggressive chemotherapy and many difficult weeks in hospital followed, leaving Benjamin weak and uncomfortable with an open-ended drain inserted into his lungs. At that time the oncologist took Ben’s parents, Anton and Angie, aside and told them that there really wasn’t anything more they could do for Benjamin other than sending him to a different hospital for radiation that could extend his life for a short time.

It was and will always be one of the toughest and most difficult moments in our lives. We sat with Ben and told him the truth – something we had agreed on from the start – and his little face fell as he asked, ‘So I’m going to die?’ I replied: ‘Yes, my boy…’ We then told him that it was up to him what he wanted to do next. We could move him to a different hospital for more radiation or we could go home. Ben may have only been 11 years old but he answered, ‘I promised that I would beat this cancer and I did, but it came back and I’m just so tired. I just want to go home.’

Anton and Angie Hawkes

Surprised at their choice and reminding them that Benjamin would likely die within a few days without further treatment, Anton and Angie honoured their son’s wishes and with very little assistance arranged to collect the medical supplies and equipment needed to take him home. 

Palliative care in action

Through a series of chance events, Anton received a phone call the next day recommending they contact Umduduzi Hospice Care for Children, a charity organisation that provides palliative care to children and families in hospitals and in homes in and around the greater eThekwini district. (The word ‘umduduzi’ is the isiZulu word for ‘the comforter’.) When Ben’s health seemed to improve and he outlived the 3-day prognosis from the oncologist, a concerned Anton found Umduduzi’s details online and sent them an email at midnight.

At 8 a.m. we received a phone call from Dr Julia Ambler from Umduduzi and she was at our house at 1 p.m. that same day.

Dr Ambler introduced herself to Ben. He instantly liked her because she spoke to him as an adult, never pinched his cheeks or rubbed his head, something Ben really hated. Over a cup of coffee, we had the first honest chat about palliative care, what we could expect and a conversation about death. The most notable thing to come out of this chat was that one should never give timelines about the passing of a loved one, as we found out with Ben living at home with us for almost another seven weeks. Dr Ambler advised us on what to expect in the dying stage, discussed extra pain medication to ensure Ben would be pain free as much as possible, and how we were all coping emotionally. 

Ben continued to surprise us and we went on to have outings to our local beach kiosk, Crocworld and we even managed to go to the movies to watch one of Ben’s favourite sequels, ‘Guardians of the Galaxy II’. But more importantly, he was at home in his own bed with his mom, dad, sister, dogs, his guinea pigs, and his Lego.

Ben finally died peacefully at 2 a.m. in his bed at home surrounded by all those who love him…. mom, dad, his sister Abigail and dogs Teddy and mNini.

Anton and Angie Hawkes, Pennington, KwaZulu-Natal

Passionate advocates for “special time”

Having known very little about children’s palliative care before their son’s cancer diagnosis and the experience of his final weeks, Benjamin’s parents have since become passionate advocates for it.

There is a definite need to reach out to and educate doctors, medical practitioners and families about the benefits of palliative care; how important the last bit of dignity and sense of peace it brings for patients and families alike. Having the support of someone who understands what you are going through and reassuring you that you are doing the best you can do for your child, is invaluable.

Those last 7 weeks we had with our son was the most terrifying, heart wrenching, but most special time and having the support of Umduduzi, helped us immensely.  The grief of losing a loved one never goes away and I know, two years on, that we still shed a tear almost every day but sharing Ben’s final moments at home as a family was, and always will be, very special.

Anton and Angie Hawkes

Children’s palliative care in South Africa

Patch SA is the national charity that supports the development of hospice and palliative care services for children like Benjamin and for all children with any type of life-threatening or life-limiting illness or condition and their families.

Despite the National Policy Framework and Strategy on Palliative Care being ratified in 2017, it has yet to be implemented and there is an enormous gap in the provision of education on children’s palliative care for medical and allied health care providers. Education in the basic elements of paediatric palliative care would ensure that children like Benjamin and his family would receive good palliative care from the time of his diagnosis, and not just in the last weeks of life.

Dr Michelle Meiring, Patch Chair, pediatrician, palliative care specialist