CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
94
AFRICA
cardiac programmes needed to incorporate
care plans into present management
for the future of their patients.
9
Integral
to these plans is the involvement of
patients and parents. Prof Gil Wernovsky
reported on the fundamental shift from
doctor-centred care to a patient-centred
approach, ushering in a new era shared
decision making.
It has been predicted that by the
year 2030, the prevalence of death from
cardiovascular disease (CVD) will have
increased significantly, with the largest
increase occurring in Africa.
10
Clearly,
the perception that CVD is not relevant
to developing countries is erroneous and
needs to be urgently redressed. Several
important plenaries highlighting new
research on tobacco use, hypertension,
obesity and atherosclerosis,
11,12
and
emphasising significant mechanisms in
combating non-communicable diseases
were presented.
13
Paediatric cardiology has undergone
dramatic advances in the past decade and
several of these were showcased in live
transmissions from units in South Africa
and Europe.
14
The possibility to perform
highly technical procedures to repair
conditions associated with diseases such
as RHD and tuberculosis in developing
countries, without the need for cardiac
surgery, is extremely exciting.
In the interventional track, a young
patient with Takayasu’s arteritis (thought
to be associated with tuberculosis) was
given a new lease on life after a stent was
placed in a coarcted segment of the aorta,
while a Namibian boy had a trans-catheter
pulmonary valve implanted. These cases
represented not only a triumph for the
patients, but also the congress and
practitioners, as it was the first African
congress to perform successful live
interventions on paediatric cases.
The need to perform medical
procedures, especially those of high
complexity, safely and accurately is
paramount. Learning about efficiency
and safety from other high-pressure
industries such as Formula 1 racing and
the commercial airline industry will aid
hospitals to improve their outcomes,
decrease errors and increase productivity.
Prof Allan Goldman, convenor of the
Risky Business conference series,
delivered a lecture titled: ‘Heart surgery
is a risky business: how to doing it better
and safer for less’. He concluded that
the new challenge in heart surgery was
enhanced quality of life, better long-term
results and a change in the way we think
and work in order to improve outcomes.
The World Congress attempted
throughout to reinforce the conviction
that children with heart disease
worldwide ought not to be denied the
benefits of medical science. Sessions on
emerging programmes in all regions of
the world highlighted these inadequacies
and discrepancies but also show-cased
examples of successful units in among
others, Angola, Fiji, Cameroon and
Borneo.
Humanitarian efforts were emphasised
with talks fromnetworks and organisations
such as the Global Heart Network and
Children’s Heartlink, which provide
infrastructure, training and capacity
building in order to support units to evolve
into independent centres. Despite these
reports, the failure to treat patients with
congenital and non-communicable heart
diseases in countries in Africa remains an
extraordinary failure in the face of global
resources to address these problems.
Prof Gene Bukhman reminded his
audience during his plenary ‘Starting a
heart programme: lessons from Rwanda’
that extraordinary changes in the health
of the poor were possible in a short period
of time in countries where leadership,
collaboration, equity and planning were
harnessed to improve outcomes. The
Minister of Health of Rwanda addressed
the congress via videolink and reported
that over the last decade, deaths in Rwanda
from HIV, TB and malaria have dropped
by 80%, maternal mortality by 60% and
life expectancy has doubled, at an average
healthcare cost of $55 per person per year.
Innovations in such resource-poor regions
have demonstrated that healthcare can be
both equitable and affordable.
It was the wish of the organisers
that delegates enjoy not only a fruitful
academic experience with colleagues and
faculty but also an enriching cultural
and social encounter within South Africa.
This was most ably provided by excellent
opening and gala ceremonies with music
by Loyiso Bala, the Cape Town Youth
orchestra and choir, and soloists, while
the iconic Johnny Clegg entertained
delegates at a picnic in Kirstenbosch
Botanical Garden. In tune with the social
responsibility facet of the congress,
several crèches and playgroups in Cape
Town benefited from the donation of the
warm winter picnic blankets.
The congress was the premier cardiac
event on the continent of Africa to date,
both in terms of numbers of delegates
and faculty. The scientific content sought
to emphasise current challenges in Africa
and South Africa, thus including private,
public and government sectors in the
important dialogues around finding
sustainable to health system deficiencies.
It emphasised current challenges for
paediatric cardiac care in Africa and
South Africa,
15
and included multiple
sectors in discussing possible solutions
to existing health system deficiencies.
The Deputy Minister of Health opened
the congress while the honourable
Minister of Health of South Africa, Aaron
Motsoaledi addressed the meeting as a
faculty member, on his vision for school
health. The Minister of Health of Rwanda
lectured on ‘Uniting to address paediatric
cardiac disease in Africa’ in addition to
the lecture by the Minister of Health of
Rwanda on uniting to address paediatric
cardiac disease in Africa, the Honourable
Minister of Health of South Africa, Dr
Aaron Motsoaledi was a member of our
faculty and delivered a lecture outlining
his vision for school health in Africa.
Throughout the meeting, the highest
levels of achievements in research and
technological development were balanced
with provocative explorations relevant
to equitable distribution of cardiac care
to needy children everywhere. In this
way, the congress remained true to its
vision to represent the majority of the
world’s children with heart disease, raise
awareness, and ultimately contribute
to improving care for children of all
ages with congenital and acquired heart
disease in all regions of the world.
LIESL ZÜHLKE, MB ChB, DCH,
FCPaeds, Cert Card MPH, Liesl.zuh-
School of Adolescent and Child Health,
Red Cross War Memorial Children’s
Hospital; Department of Medicine, Groote
Schuur Hospital and University of Cape
Town, South Africa; President of the
Paediatric Cardiac Society of South Africa,
President of the 2013 World Congress
Company and member of the local organ-
ising committee of the World Congress
References
1.
Van der Bom T, Bouma BJ, Meijboom FJ,
Zwinderman AH, Mulder BJ. The preva-
lence of adult congenital heart disease,
results from a systematic review and
evidence based calculation.
Am Heart J
