CHRIS HANI BARAGWANATH HOSPITAL

CHRIS HANI BARAGWANATH HOSPITAL - Overview

The Chris Hani Baragwanath Hospital is the 3rd largest hospital in the world, occupying around 173 acres (0.70 km2), with approximately 3,200 beds and about 6,760 staff members.

The facilities are housed in 429 buildings with a totalsurface area of 233,795 m2.

Approximately 70% of all admissions are emergencies,including approximately 160 victims of gunshot wounds per month. Accident, emergency and ambulance represent the busiest services, counting over 350 daily patients. Every year, about 150,000 inpatient and 500,000 outpatient cases are registered.

The Department of Ophthalmology, the St John Eye Hospital,has 111 beds and counts about 50,000 patients per year.

Approximately 6,000 patients per year are treated in theMaternity Hospital. The hospital is in the Soweto area of Johannesburg, SouthAfrica. (Soweto was a separate municipality from 1983 to 2002, when it was amalgamated to the City of Johannesburg.)

It is one of the 40 Gauteng provincial hospitals, and isfinanced and run by the Gauteng Provincial Health Authorities. It is a teaching hospital for the University of the Witwatersrand Medical School, along with the Charlotte Maxeke Johannesburg Academic Hospital, Helen Joseph Hospital and the Rahima Moosa Mother and Child Hospital.

This site's purpose is to make the Chris Hani Baragwanath Hospital easy to find and contact and to give the visitor the most important information about it (not managed by the government).

The Chris Hani Baragwanath Hospital strives to:

• Achieve the highest level of patient care basedon sound scientific principles and administered with empathy and insight.
• Train our work corps to be the best equipped andmotivated to serve the sick and injured.
• Maintain and defend truth, integrity and justicefor all, at all times, to the benefit of patients, staff and the community.

Centers of Excellence

Internal Medicine

The Department of Medicine include subspecialties of Cardiology, Neurology, Nephrology, Pulmanology, Endocrinology, Rheumatology, Haematology and Infectious Diseases.

Admissions: 3,000 per month

Admissions have risen by 40% over the past 5 years, largely as a result of the HIV/Aids pandemic. The death rate of admitted patients exceeds 10%.

The Department of Medicine continues to offer quality care to the community of Soweto, and is dedicated to excellence in teaching and research. The major crisis now and in the future is the Aids pandemic.

Cardiology Unit

The division of Cardiology is a large busy unit treating approximately 15000 outpatients and 4000 inpatients annually. The spectrum of pathology is vast covering congenital, ischaemic, valvular and hypertensive heart disease. A section of electrophysiology has been developed with the capability of doing diagnostic EPS studies, conventional and biventricular pacing and implantation of ICD's. Interventional procedures including angioplasty, stents and mitral balloon valvuloplasties are routine. The unit has a strong echocardiography capability with state of the art equipment to perform transthoracic and transesophageal studies.

Teaching and training forms a large component of the cardiology units work both at undergraduate and postgraduate level.

Cardiac training is provided to foreign to foreign doctors from elsewhere in Africa so that they may take valuable skills back home.

The cardiology units work both at prides itself on its research achievement. Numerous presentations and publications are held at international meetings and in prestigious peer review journals, predominantly in the fields of valvular disease, heart failure and hypertension.

In summary, the CARDIAC UNIT is dedicated to providing good clinical care, teaching and relevant basic science and clinical research.

Gastroenterology Unit

The Gastro-enterology Unit was founded in 1975. During the following 25 years the unit has established itself as one of the major gastro-enterology units in Africa.

It is the only centre in Africa where the impact of urbanisation on GIT (Gastro-Intestinal-Tract) diseases have been studied in detail.

Patients in this unit receive diagnostic and therapeutic services comparable to the best offered in the United States or Europe.

Amongst the achievements of the Bara GIT Unit are:

• Therapeutic: The unit has pioneered the treatment of various GIT disorders in African patients. Facilities for highly specialised procedures in this field are available. Over 2'000 procedures are done annually by the unit.
• Research: Papers in South African and international journals. Over 300 research papers, abstracts and letters have been published on the work being done at Baragwanath. Broadly the works describe the emergence of Western diseases in Africa.
• Teaching: Invitations to lecture abroad. Lectures have been given to prestigious institutions in South America, Europe, Britain and the USA.
• Collaborative studies with leading overseas workers: Eminent international workers, in this field, realise that the clues to the causes of many disease can be obtained by working in liaison with Bara.
• South African Gastro-enterology Society: The importance of Chris Hani Baragwanath in the South African setting, is reflected by the fact that Prof I Segal was elected Life President of the Society.
• African Institute of Digestive Diseases: The importance of the establishment of this institution, during 1997, can best be assessed in the words of Prof I Boucher, President of the World Organisation of Gastro-enterology: "The establishment of a Postgraduate Institution for the training of gastroenterologists in the continent of Africa will be a giant step forward in the promotion of the speciality of gastroenterology in that continent and, ofcourse, should do a great deal to improve the standard of postgraduate gastroenterological practice."

Psychiatry Unit

Patients with a wide spectrum of psychiatric disorders are assessed and managed by the staff. The multidisciplinary team (doctors, nurses, psychologists, occupational therapists, social workers) is essential for the care of patients, taking into account biological, psychological and social aspects.

The psychiatric nurse is recognised as a vital contributor to the care and treatment of the mentally ill. The Psychology Department offers stress management and relaxation training for staff in the hospital, as well as the community. The psychiatric multidisciplinary team strives to deliver a high level of psychiatric care to patients in spite of the serious constraints it has to contend with. Underlying this professionalism is a belief in giving patients respect, consideration, understanding and support.

Respiratory Unit

Pulmonary diseases are the most common reason for admission to the medical wards at Chris Hani Baragwanath Hospital. The HIV epidemic has made a major impact in this field as respiratory tract infections account for most admissions amongst immunosuppressed patients.

The general medical staff manages most patients with respiratory illnesses. However, certain inpatients are referred to the Respiratory Unit for specialist opinions and management.

The Respiratory Unit also runs a weekly Outpatient Clinic for selected inpatients, patients referred from other specialist clinics, Community Health Centres and surrounding peripheral hospitals. Most of these patients have severe asthma or various diffuse parenchymal pulmonary diseases. The weekly "walk-in" service, provided for outpatients frequently obviates admission to hospital.

The nursing staff provide an asthma education service at the outpatient clinic and also visit all inpatients admitted with a diagnosis of asthma. Spirometry, and more sophisticated lung function tests, is performed in this unit. Fibre optic bronchoscopy is utilised for diagnostic purposes and is frequently done on an outpatient basis. Patients who qualify for long term domiciliary oxygen are assessed at the weekly Oxygen Clinic.

Obstetrics & Gynaecology

There is a Perinatal HIV Research Unit situated at the hospital. During 1997 Bara was chosen by the UNAids as one of nine sites world-wide where HIV/AIDS research is being conducted in the international search for an Aids vaccine. All pregnant women undergo consented tests for HIV/AIDS, and if found positive are referred to this clinic for counselling and treatment.

The hospital has facilities for sophisticated ante-natal, intrapartum and postpartum care.

Orthopaedic Centre

Orthopaedic specialist clinics eg Cripple Care, are held in the centre during the week. The unit is a registered training centre for students training as Prothetists/Orthotist. An Orthotist and Prosthetist is a highly specialised and skilled member of the medical team, who deals with measuring, designing, manufacturing and fitment of products, to support or replace a part of the human body. This centre is responsible for the supply of Prosthetics (artificial limbs) Orthotics (orthopaedic appliances) and surgical footwear. The unit handles approximately 10,000 patients per year.

Paediatrics

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.

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.

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.