Community service doctors in Limpopo province

No Abstract. South African Medical Journal Vol. 96 (3) 2006: 180-18

Geographical differences in the relationship between total dissolved solids and electrical conductivity in South African rivers

Electrical conductivity (EC) is a useful surrogate for total dissolved solids (TDS). EC is more rapidly and easily measurable with reasonably-priced equipment. However, as an indirect measure EC is subject to uncertainties that are not always apparent to the user. We set out to investigate the relationship between TDS and EC in 144 643 sample results availableon the Department of Water Affairs water quality database. TDS is   calculated as the sum of the major solutes determined by laboratory  analysis and EC is a measurement in a flow cell. The median TDS:EC ratio for 332 high priority sites was 7 mg/.: 1 mS/m. Regional differences  ranged from 4.8 to 8.6. Investigation of 38 of these sites using Maucha diagrams suggested that the differences are related to the dominant  major ions, with sodium chloride waters having a lower TDS:EC conversion factor than calcium bicarbonate waters. The practical application of these findings is that users of EC meters should not simply apply a blanket conversion factor, but need to select an applicable factor for the river  system in which they are measuring.Keywords: conversion factors, electrical conductivity, field instruments, rivers, total dissolved solids, water qualit

Culture, Tradition, Custom, Law and Gender Equality

Culture is like an umbrella under which some people like to hide from rain, and also to shade themselves from the sun. But sometimes you need to fold it.*

Culture, Tradition, Custom, Law and Gender Equality

In August 2011 Advocate Joyce Maluleke, Director in the Gender Directorate of the South African Department of Justice and Constitutional Development addressed the Annual General Conference of the South African Chapter of the International Association of Women Judges held in Potchefstroom on the dangers of harmful traditional practices such as early and forced marriages, virginity testing, widow's rituals, levirate and sororate unions, female genital mutilation, breast sweeping/ironing, the primogeniture rule, practices such as 'cleansing' after male circumcision, and witch-hunting. Although she considers respect for tradition, culture and customs to be part of the South African identity, she argues that cultural practices should be rooted in respect for human rights, democracy and equality. We publish her paper here as an oratio

Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.

BACKGROUND: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. METHODS: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. FINDINGS: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0). INTERPRETATION: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. FUNDING: Medical Research Council of South Africa.Medical Research Council of South Africa