Public Health Medicine meets Veterinary Medicine

By Dr Sikhumbuzo A Mabunda

I am sure my fans must have been wondering if I am still alive, well rest assured I have survived. After the “eye opening” day yesterday with Home Based Care Workers and the reptile park we went on to learn more about the interaction between Humans - Domestic animals - Wild animals. This unfortunately came at a prize, a huge prize! We had to be on the road from 04:30 am, just to go see cows being dipped! i Yho yho yho!

Dr Greg Simpson (the Veterinary doctor) had 5 veterinary students with him, 3 final years from the University of Pretoria (Onderstepoort) and 2 were third year students from the Netherlands. As much as we don’t often think about it, there are lots of diseases transmitted between humans and animals (whether wild or domestic), these are therefore grounds for Public Health Medicine to partner up with veterinary medicine using a public health approach in addressing ill health arising from this interaction.

Just like Human Health promoters, the veterinaries also address farmers to educate and prevent ill health either to the animals or to humans. We then experienced the cattle being inspected, calves being tattoed, wounds cleaned, blood drawn from both the neck and tail of a cow and Fidele even auscaltated a cow.

We then moved to the Hluvukani clinic to show the veterinary students the setup of a Primary Care Health Centre and the possible challenges experienced.

After this we then went to the Hluvukani Animal Health Clinic to meet Lucy (the 3 legged calf with “failure to thrive”/ also abandoned). We had a tour of their operating theatres and pharmaceutical area. We had a lecture from Dr Greg to contextualise the importance of these two professions working together in the promotion of wellbeing.

Quality Assurance (QA)

 At 11:30am when we got to Tintswalo hospital for the QA talk we were already into our 8^th hour of our working day. We were impressed with how well this man (Mr Peter Ngobeni) understands the health system and the challenges the hospital faces. He also knows the weaknesses and strengths of the methodologies used to measure the Domains and Priority areas from the National Core Standards (NCS).

It was so emotional for all of us to say our goodbye to Thembi our hostess and the Wits Rural Health organiser. She has really excelled and was very accommodating and understanding.

We met the cattle herders and farmers at 6:00 in deep rural Mpumalanga.
It was amazing to see everyone so early and so organized so far off the beaten track.

Greg Simpson meeting with the farmers

Veterinary students first catching and then weighing and tagging the calfs - something like a mini rodeo

University of Pretoria Veterinary School:
http://web.up.ac.za/default.asp?ipkCategoryID=50

Tintswalo hospital:
http://www.tintswalohospital.org/

Agincourt Health and Demographic Surveillance & Malaria Control Programme

By Charlyn Goliath

All excitedly the group departed to Agincourt and after traveling for a few kilometres we were stopped by the traffic cops. We received a “R3 000.00” ticket, payable at any traffic officer along the road. What an eventful start to the day!

Our arrival at the Agincourt
Health and Demographic Surveillance Unit

Agincourt Health and Demographic Surveillance System (HDSS) is a project of the MRC and Wits Rural Public Health and Transitions Unit within Agincourt. The need for the project was identified in 1992 when there was very little information available on the health status of rural populations. The HDSS is a longitudinal population registration system that monitors demographic dynamics in a geographically defined population. It is an integrated field and computing operation, designed to manage the longitudinal follow up of individuals, households and residential units and related demographic and health outcomes within the site.  

Ryan Wagner the project manager gave us an overview of the HDSS project. 

Ryan Wagner

Activities structure

Bush Buck Ridge study area map 

Demographics

Field trippers listening attentively

A Learning, Information dissemination and Networking with Communities (LINC) unit was started in 2004 to assist with maintaining community networks. Audrey, the manager of the LINC unit, gave an overview of the LINC programme.

We visited a site office of the HDSS to get a better understanding of what happens with the census forms once completed.

Afterwards the “public health cencus workers” took out their hats and hit the road with the data collectors to do a household cencus. This provided the group insight into the information that is being collected and processes that is followed.

Census awareness

En route to the census 2012 field office

The team learning about the census in the field office

Thembi from the Wits Rural Facility was like our
mother during the field trip

Community visit with the census field workers

Sorted out census forms

On the left are 4 census data capturers

Ryan showing us the filing room

We had a wonderful lunch prepared by locals from the community.

Agincourt AHPU:
http://www.agincourt.co.za/

After lunch we departed to learn more about the Malaria Control Programme of the Bushbuckridge Sub-district. Mr Alpheus Zita gave us an overview of the programme. There has been an increase in imported cases of malaria due to migration patterns in this sub-district. Tintswalo hospital, a district hospital in this region, was the highest reporting facility for 2011/12.

Spray operators from the local community are used for the vector control programme. Spraying is done once a year in dwellings and twice a year in lodges and game reserves. The environmental impact of DDT was highlighted during the presentation. Surveillance work is being done by case investigators and these case investigators visit health facilities to collect malaria notifications for reporting purposes and follow-up on patients in the communities.

The presentation was followed by a demonstration of the spraying. Muthei has decided to give up her day job and become a spray operator.

Malaria control programme office.
Please note the water container in the background

Contrary to what it looks like (a bomb) this is the life saving pressurized container
that is used for residual spraying 

Sikhumbuzo operating the residual spraying container
Muthei supervising

Spray demonstration

Malaria fairy Dombo...

Kruger National Park

Up with the birds and left the camp just before 6.  Our guest, Steve from Rhodes university, was ready with a backpack and water bottle.  At Kruger National Park Orpen gate we paid and within 5 minutes from the gate we saw three lazy lions sleeping unaware of the tourist commotion while digesting their last meal.  We were speculating wether this was in fact 'natural' and about chances that they were tranquilized and placed there to satisfy the camera burdened Chinese tourists.  

Before 11:00 we saw and array of wildlife ranging from impala, wildebeest and kudu to rhino and elepant.  In between many fascinating birds were identified ranging from malachite, pied and giant kingfisher to different types of vultures harassing eachother to get the tastiest parts of a rotting carcass.   

For lunch we had to fend off a semi tame and vervet monkey trying to steal our food before we enjoyed our sandwiches.  On the way out we enjoyed tea and coffee at Skukuza rest camp.  At the gate of the Wits Rural Facility we met up with Charlyn Goliath who joined us from Stellenbosch University, Robin Dyers who went back to Cape Town for the weekend and Alicia Aziz a student from the US planning to do some health systems and history research in the area.  Our braai plans failed because of rain…

South African National Parks - Kruger:
http://www.sanparks.org/parks/kruger/