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CB20: World Class

27 September 2009
Carte Blancheโ€™s birthday campaign has delivered again, this time to the Charlotte Maxeke Johannesburg Academic Hospital. A state of the art digital theatre now makes endoscopic surgery on a par with the best in the world. Meet Timothy and Marvin, operated on just weeks ago, whose lives have changed forever.
Charlotee Maxeke

To the untrained eye, any operating theatre looks high-tech. But on closer inspection this equipment is showing its age: a tangle of wires, a mechanical operating table, machines that belong in a medical museum - now all that's about to change.

Bongani Bingwa (Carte Blanche presenter): 'Thanks to the generosity of corporate South Africa this theatre - which has been in use for the last 28 years - is about to be replaced with a state of the art digital hanging theatre, taking paediatric surgery at this hospital well into the 21st century.'

The Carte Blanche 'Making a Difference' campaign is the single biggest charity drive in South African history. We've managed to raise R58-million for paediatric units in six public hospitals, including the Charlotte Maxeke Johannesburg Academic Hospital.

Prof Peter Beale (Paediatric Surgeon): 'Without the equipment to be able to keep up with the rest of the world, we would fall very rapidly behind.'

Professor Peter Beale is Head of Paediatric Surgery. Every day he is faced with difficult cases, like that of three-year-old Carel Lourens. After five months of chemotherapy, the cancerous tumour in this little boy's abdomen has shrunk enough to be removed. Prof Beale believes the impact of the new equipment will be huge.

Prof Beale: 'Thanks to Carte Blanche, we can now compete with Red Cross Children's Hospital in Cape Town and surgery training centres throughout the world.'

The old theatre was stripped and technicians from Marcus Medical installed the new state-of-the-art equipment. Suspended from the ceiling is the latest in high definition technology - two wide screen monitors, a touch screen to capture information, as well as high resolution digital recording equipment. After just a few days the new digital hanging theatre was ready for action.

Dr Jacinta Shung (Anaesthetist): 'This is one of the only ones in the world that you can turn around.'

Dr Jacinta Shung will be training anaesthetists on the new anaesthetic machine which cost R1-million.

Dr Shung: 'The software is new. The ventilator is quite a nice ventilator - so you reach children of all sizes. You can do a 900g baby and you can do a 150kg man on it, whereas before we used to have to change the bellows, and there are lots of things you used to have to change. And we had to get different machines and we ended up working with five or six machines because you use one feature of every machine, because no machine was ideal. This has everything in one.'

Another improvement is the new operating table, which cost R650 000.

Prof Beale: 'Well, this is a state of the art modern operating table, which is electronic and controlled by console - which allows you to alter the shape of the bed, and the level of the bed in many ways. The table we had, had been here for 30 years - and this one replaces that and is also a screening table. In other words, you couldn't take X-rays through it, or screen a patient through it.'

The sponsors, who together contributed over R3-million towards the theatre, were invited to the unveiling and welcomed by Carte Blanche executive producer George Mazarakis.

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George Mazarakis (Carte Blanche Executive Producer): 'We are absolutely humbled by the fact that you've trusted us enough to give us your money and to know that it is going to a valuable place.'

After revealing just how their money had been spent, theatre staff celebrated this new beginning by pelting guests with streamers.

And once the ribbon was finally cut, they gave full voice to their appreciation and excitement.

[Theatre staff sing praise]

Hospital CEO Dr Khaya Mfenyana was also grateful for the donations.

Dr Khaya Mfunyane (CEO - Charlotte Maxeke Johannesburg Academic Hospital): 'It goes a long way in addressing the period we are living in economically. Please keep the good work, you've clearly made a mark on the continent for our hospital.'

One of the first children to be operated on in the new theatre is 13-month-old Timothy Beukes.

Priscilla Beukes (Foster mother): 'Timothy's mum had a stroke after she gave birth to Timothy, and after six weeks Timmy was still in hospital, so we decided to take him. We never really knew what was wrong with Timothy, but we took him home.'

Timothy has cerebral palsy, brain damage and epilepsy. He can't swallow normally and suffers from severe reflux.

Raven Padayachee (Foster father): 'It's been tough. At the moment he's been struggling - crying a lot... really crying with pain.'

The team is going to perform a gastric wrap, which means wrapping his stomach around the lower end of his oesophagus to stop the reflux. The endoscopic surgeon is Dr Bob Banieghbal.

Dr Bob Banieghbal (Endoscopic surgeon): 'We're going to inflate the abdomen with carbon dioxide to make sure we have space to see what we are doing.'

Endoscopic surgery is done through tiny portholes in the abdomen. Using a camera and miniature instruments the doctors can see exactly what they are doing on high resolution screens in front of them.

Dr Banieghbal: 'I'm going to insert the liver retractor and drop the table down.'

With the retractor holding Timothy's liver out of the way, the team can now start working on his stomach.

Dr Banieghbal: 'We're disconnecting any blood vessels that are holding the stomach so that it becomes more mobile. So once we have it more mobile, we can actually go around it. And turn it on itself.'

Dr Banieghbal makes an opening underneath Timothy's oesophagus, through which he will be able to pull part of the stomach, and wrap it around the oesophagus.

Dr Banieghbal: 'So now you can see the stomach on either side - there's the stomach on either side, so this is going to go up like this to close that gap. That will allow the reflux to be controlled - that's how they're going to suture it.'

Using a tiny needle the surgeon sews one side of the stomach to the other, making sure that Timothy will no longer suffer from reflux and all the ensuing complications. Gastric wrap surgery isn't new, but the level of care that this hospital can now offer children is far superior to before.

Dr Banieghbal: 'Previously we had an old generation equipment with lower resolution. So this kind of an operation would have been a lot more challenging and more hazardous. With the better technology we do a better operation.'

The hospital now expects to double the number of endoscopic procedures performed every month. And the next patient is 5-year-old Marvin Makhombothi. He also has a problem with reflux, and often vomits after eating. His mother Christine stays with him while the anaesthetist puts him under. Endoscopic surgery is minimally invasive, so little Marvin will have less post-operative pain, and be able to go home sooner.

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Dr Banieghbal: 'This operation was made more complicated than normal surgery we do because the opening in the diaphragm was much larger, and because of it the stomach has collapsed inside the chest which is not something that we see that often. Because of that we had to pull the stomach down into the abdomen and release adhesions, close the defect, and do the wrap.'

After the doctors do the last stitches up, the doctors wake Martin up and send him to his mother waiting in the ward. Just one more child for whom the sponsors have made a difference.

Nedbank donated R1-million.

Sakkie O'Neil (Nedbank): 'It's an absolute delight to be part of the process, where actually you could see that somebody took it from an idea right down to delivery.'

Mediclinic also donated R1-million.

Biren Valodia (Mediclinic): 'This 'Making a Difference' campaign is very commendable, and we are very glad to be associated with this campaign.'

Standard Bank gave R600 000 towards this particular theatre.

Tina Eboka (Standard Bank): 'If we wake up every day and [ask], 'Today, did I make a difference?' Then I can say I made a difference to that one.'

The Langa Trust gave half-a-million rand.

Helene Pouroulis (Langa Trust): 'Everybody should actually be entitled to this kind of care, especially when you are talking about sick children. Everybody should be entitled to this kind of care. So as a family, we really are honoured to be a part of this.'

Marcus Medical gave R450 000 in discounts.

Gernot Pansi (Marcus Medical): 'This theatre now boasts state of the art equipment, which I am sure will make a big difference to many children in the community.'

Group Five gave R100 000.

Isabelle Makuta (Group Five): 'We feel that really we have done the right thing, so we are truly grateful that we have been part of this initiative.'

R90 000 of Coal Procurement's R1-million donation went to this theatre.

George Mayer (Coal Procurement): 'This is outstanding. My daughter was treated at the Jo'burg Gen many years ago and is very well. And to see what the kids today can have, it makes it even more worthwhile.'

John Craig, Novo Nordisk, National Brands and the Mall of Rosebank each gave R50 000.

Donations were also received from Java Capital, Mugg & Bean, Defy and Rudolph & van Vuuren.

In the children's waiting room outside the paediatric theatre, is one of dozens of TV sets donated by LG.

Dr Michelle Potgieter (LG Electronics): 'Within this environment children will come here before they go into theatre, and the TV's will make a difference.'

Two weeks after his surgery Marvin is back in the saddle of his favourite bike, and he's no longer in pain.

Christine Makhombothi (Mother): 'He's coming alright now - he's eating, he's playing, he's doing everything.'

The small scars in his tummy will eventually disappear, and he can now get on with the important business of being a child.

Producer : Kate Barry
Presenter : Bongani Bingwa