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Medical Negligence and Common Factors Contributing To Medical Negligence Cases In South African Hospitals

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Medical negligence definition is derived from the Law of Delict, which comprises the evaluation of medical practitioner’s conduct according to acceptable societal standards. It is also defined as when the conduct of the medical professional does not meet the standard of a reasonable person. Such conduct is blame-worthy in South African law, therefore any medical practitioner who violates this will be at fault. Given such a context, medical malpractice is a negligent act or omission by the medical professional that results in damage to property or personal injury of the patient. The definition of negligence requires inter alia the following; 

  1. wrongful conduct, 
  2. fault, 
  3. causation;  and 
  4. damage or personal injury.

The skill and care of a reasonable medical practitioner under the same circumstances will be used as a yardstick to measure the reasonableness of the medical practitioner’s conduct.

The Common Claims In South Africa Are As Follows: 

  1. Botched operation.
  2. Faulty Blood Transfusions.
  3. Treatment delays.
  4. Anaesthesia accidents.
  5. Prescription Errors.
  6. Misread X – Rays.
  7. Dental Malpractice.
  8. Misdiagnosis.
  9. Emergency room negligence.  

A Contractual Obligation Between The Doctor/Hospital And Patient 

The medical profession is considered a noble profession because it helps in preserving life. We believe life is God given. A patient generally approaches a doctor/hospital based on his/its reputation. Expectations of a patient are two-fold: doctors and hospitals are expected to provide medical treatment with all the knowledge and skill at their command and secondly they will not do anything to harm the patient in any manner either because of their negligence, carelessness, or reckless attitude of their staff. Though a doctor may not be in a position to save his patient’s life at all times. He is expected to use his special knowledge and skill in the most appropriate manner keeping in mind the interest of the patient who has entrusted his life to him. Therefore, it is expected that a doctor carry out necessary investigations or seeks a report from the patient.

Furthermore, unless it is an emergency, he ought to obtain an informed consent of the patient before proceeding with any major treatment, surgical operation, or even invasive investigation. Failure of a doctor and hospital to discharge this obligation is essentially a tortious liability. A tort is a civil wrong (right in rem) as against a contractual obligation (right in personam) and breach that attracts judicial intervention by way of awarding damages. Thus, a patient’s right to receive medical attention from doctors and hospitals is essentially a civil right. 

The relationship takes the shape of a contract to some extent because of informed consent, payment of fee, and performance of surgery/provision of treatment, etc. while retaining essential elements of tort.

Factors That Contribute To Increased Medical Negligence Claims

Countries face different challenges in respect of medical negligence claims. Of which reporting at times can be affected by socio-economic status and dynamics that affect the provision of health services. In South Africa, public hospitals by and large tend to be the epitome of the medical negligence cases. Thus in comparison to private hospitals. The same trend can be observed in other developing countries. Potential reasons for this are explored below.

i) Shortage of Staff and unfavourable working conditions: The shortage of staff in public hospitals contributes to the increase of medical negligence in South Africa. The shortage of medical practitioners including doctors, nurses or paramedics has a knock on effect in escalating the rate and percentage of medical negligence.  A case in point is that there is a high ratio of nurse to patient (more patients than nurses); therefore the nurses are not able to provide qualitative medical service expected from reasonable medical practitioners.

ii) Shortage of qualified Medical Practitioners: The assignment of  medical practitioners that are still in training, when given tasks outside of their scope, knowledge and skills also has a knock on effect on increased medical negligence cases, especially in rural areas. To avoid such cases, more trained and skilled medical practitioners should be recruited by the Department of Health. To ensure that medical interns have sufficient guidance during their training. In addition, only trained and rightly qualified medical professionals should be assigned to task regardless of the task’s magnitude or unless sufficiently guided.

iii) Working Hours and Workload: It is common cause that medical practitioners are human beings, who can equally be exposed to mental exhaustion. ‘Mental overload’ (ie fatigue and diminished concentration) can interfere with one’s ability to process other stimuli.

iv) The public awareness of their rights: The Constitution of South Africa, provides the Bill of Rights that have been cemented through Consumer Protection and National Health Insurance. The general populace has been empowered with the knowledge regarding their rights. Hence, can now easily trigger litigation and/or claims against public hospitals. This is exacerbated by lawyers who are now keen to work on the contingency fee basis which is No Win No Fee basis. The lawyers carry the costs for medical negligence cases and only claim their legal costs should they win the claim in courts or through negotiation.

In conclusion the medical practitioners are entrusted with a duty of care towards the patients. The patients are always required to sign for informed consent as a result creating a contractual relationship between the doctor and patient. Although there are various factors contributing to the increase. The increase in medical negligence is noted in public hospitals vis-à-vis private hospitals. Thus according to reported medical negligence in South Africa. The public awareness regarding constitutional rights should equally prompt the shift of public policy in addressing such a perennial problem.

Acknowledgements

We acknowledge Dr Maribanyana Lebeko who is part of the advisory for Simanye Clinic for his assistance with respect to compilation, editing and proofreading of this article.

Image credit: Getty Images.

Written By Advocate Dennis Chamisa and Dr Kim Lamont-Mbawuli (Legal Practitioner). In collaboration with Dech Legal & Associates and Simanye Mobile Clinic.

 

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Inaugural Pan-African Nutrition and Health Summit set to shape a healthier continent

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The inaugural edition of Africa’s Nutrition and Health Summit is set to convene on November 16, 2024, bringing together an extensive network of healthcare practitioners, nutrition experts, agricultural stakeholders, policymakers, and influential leaders from all over the continent under the theme, ” Soil to Wellness: Shaping a United Approach to Africa’s Health.” This groundbreaking summit aims to address the critical rise of non-communicable diseases (NCDs) across Africa through integrative approaches to preventive health, nutrition, and sustainable lifestyle practices.

This movement would explore holistic and practical solutions that unite stakeholders along the health and nutrition value chain, with a critical focus on how surging rates of NCDs like diabetes, hypertension, and obesity can be curbed via sustainable agriculture, improved food quality, and healthier lifestyle choices, to reshape our food and lifestyle culture, thereby laying a foundation for better health outcomes, for generations to come.

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A Key Focus on Nutrition and Lifestyle Practices

The summit’s agenda will include panels on integrative approaches to nutrition and preventive health, the dual burdens of malnutrition and obesity, the impact of digital health in preventing diet-related diseases, and the role of sustainable agriculture in food quality. Our holistic approach strives to demonstrate how Africa’s diverse and rich agricultural resources can play a pivotal role in ensuring food security, balanced nutrition, and wellness for all citizens.

Call to Action

The inaugural edition of ANHS is especially relevant to anyone invested in the long-term health and wellness of the African continent. Such stakeholders are not limited to health professionals, nutrition experts, agricultural stakeholders, policy influencers, researchers, food producers, and processors. It is indeed a legacy-defining opening for businesses and community leaders interested in leaving their prints in the sands of policies that would advance health and wellness on the continent.

Participants will gain insights from leading experts and join the cause to champion Africa’s health by focusing on the most essential aspects of disease prevention and overall wellness. Now, more than ever, it is crucial to prioritize wellness at the societal level, addressing the connections between soil health, food quality, and sustainable practices that contribute directly or indirectly to healthy living.

Join us at the inaugural edition of Africa’s Nutrition and Health Summit on November 16, 2024, as we unite to shape a healthier continent – one that intentionally harnesses her resources and expertise to combat non-communicable diseases.

Register here to attend ANHS 2024

For more information, press inquiries, or partnership opportunities, please contact:

RSB

Official Branding Partner of ANHS

info@africasnutritionhealthsummit.org

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Dr. Jesupelumi Adenihun: Adopting a lifestyle of sustainable health practices with food

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Dr. Jesupelumi O. Adenihun (Image: Supplied)

You have likely heard the saying, “You are what you eat,” and it couldn’t be truer. What we consume plays a far greater role in our health than many of us realize. Over time, our eating habits can either support our body’s natural healing processes, leading to improved health and vitality, or contribute to nutrient deficiencies, inflammation, and even chronic diseases.

What this means is, our eating habits over time sets off a series of chain reactions in our bodies that impact our overall well-being. The good news, however, is that by consistently making the right food choices, we can put ourselves on the path to a state of good health and well-being. While this might sound daunting at first, it is often the small, consistent actions that yield the best results. Let’s take a look at 10 simple but effective habits you can begin to cultivate for better health and adopt as lifestyle practices:

  1. Substitute soda with water: No beverage is more refreshing or beneficial than plain water. It hydrates, cleanses, and confers numerous health benefits. 
  2. Snack on nuts and seeds: When you are craving a snack, go for nuts or seeds, unless you have an allergy. They are nutrient-dense and can also be satisfying.
  3. Opt for grilled or baked over fried: Choosing grilled or baked foods helps reduce unhealthy fat intake without compromising on flavor. This also helps reduce the risk of developing high cholesterol levels which is a cardiovascular risk.
  4. Enjoy homemade smoothies over sugary drinks: When time permits, make homemade smoothies making use of reliable recipes. If you are short on time, consider vendors who provide fresh, nutrient-packed options.
  5. Practice mindful eating: Mindful eating means being fully present during meals, savoring each bite, and listening to your body’s signals. Eating mindfully is a game changer for a lot of people.
  6. Be well-informed about what you consume: Whether it’s food or drinks, it is essential that you stay conscious of what’s in your food and drinks. Many packaged products contain hidden sugars that the body doesn’t exactly need. Always take a moment to check the ingredients.
  7. Add more vegetables to your plate: Think beyond the usual veggies—some varieties exist which also depends on your geographical location. Be open and willing to explore new options and add color to your meals.
  8. Prioritize lean proteins: Not all proteins are created equal. Make lean protein choices and consider plant-based options to support your overall health.
  9. Use natural spices over salt-laden seasonings: High salt intake is known to be a contributor to heart-related conditions like hypertension. Opt for natural herbs and spices to add flavor without carrying on health risks.
  10. Stay physically active: Find an activity you enjoy and can commit to, whether you are at home or on the go. Consistency is key. Also seek the counsel of a coach if you need to.

Remember, true wealth lies in your health. Let each meal choice you make be a step toward a healthier, more vibrant life. Eat to wealth, health is wealth. 

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Written By: Dr. Jesupelumi O. Adenihun (Nutrition Coach, Preventive health care specialist).

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Bridging The Gap Between Menstrual Health and Mental Health in Africa

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Menstrual health is not just about periods; it’s about breaking the cycle of exclusion and empowering the future of Africa – one girl at a time.

Empowering women and girls who menstruate worldwide starts with breaking the silence around periods. Eno, a 14-year-old girl from a remote community in the south, shrinks when her period arrives each month. Shame and fear are a constant part of her experience. “At school, whispers follow me. They call me ‘dirty’ because I can’t afford pads. I use the white piece of cloth my mother gave me and the extra layer of pad I had sewn on our neighbor’s machine using pieces from his shop.” Eno’s story, though heartbreaking, is far from unique. Across Africa, millions of girls and women face a hidden crisis: period poverty. 

Period poverty refers to the inability to afford and access menstrual products, sanitation and hygiene facilities, and education and awareness to manage menstrual health. Globally, more than two billion people around the world menstruate monthly.

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Menstruation, a healthy and natural biological process continues to be shrouded in silence and stigma across many parts of Africa. This silence perpetuates a cycle of neglect and exclusion, where the menstrual health needs of women and girls are ignored, leading to significant physical and mental health issues. 

Daily, women and girls are unable to afford sanitary pads, forcing them to resort to unhygienic alternatives like old rags, leaves, old clothes, cotton wool, toilet paper, newspaper, and make-shift hygienic pads. This lack of access not only affects their physical health but also their mental well-being, as they experience anxiety, shame, and isolation during their menstrual cycles. With limited to no access to safe water and sanitation to manage their menstrual health and hygiene, these women and girls who cannot afford menstrual products do not live well within their rights and freedoms as their menses interrupt their day-to-day flow.

Human-Centered Stories 

To truly understand the impact, we must listen to the voices of those affected. Nike, a 15-year-old girl from a rural community in Ogun State shared, “I have to stay home when I have my period because I don’t have pads. I miss out on school and feel ashamed.” Rukkayat, another young woman from a community in Abuja stated, “The stigma around menstruation is so strong that I can’t even talk to my teachers about it. It feels like a dirty secret. I feel dirty walking around my school. So, I’d rather stay at home when I’m on my menses to endure the pain and take care of myself.” These anonymous quotes reflect a common reality for many girls and women across Africa, highlighting the urgent need for change.

Addressing Stigmas and Period Poverty 

Period poverty stems from persistent stigmas around menstruation. These stigmas include the belief that menstruating women are impure, leading to their exclusion from everyday activities and social interactions. Such beliefs not only undermine women’s confidence but also reinforce gender inequality. Periods, already a source of physical discomfort, become a breeding ground for anxiety, shame, and isolation. This can lead to depression, decreased self-esteem, and a reluctance to seek help. The link between menstrual health and mental health is undeniable.

To combat these stigmas, sensitization initiatives, and project outreaches need to provide menstrual products and education. These programs will empower girls with knowledge and resources, breaking the silence and changing societal attitudes toward menstruation. 

Breaking the Cycle: Investing in Solutions, Empowering Futures 

So, how can we bridge the gap between menstrual health and mental health by showing one can’t do without the other? By recognizing that menstrual health is intrinsically linked to mental well-being, we can create holistic approaches that address both.

  • Combat Stigma Through Education: Open conversations are key. Educational programs that address menstrual hygiene and dispel myths can empower girls and communities. Schools and communities should provide comprehensive menstrual education that includes mental health support.
  • Invest in Sustainable Solutions: Supporting the development and distribution of affordable, reusable menstrual products is crucial. Access to menstrual products should be seen as a basic human right, and efforts should be made to ensure that all girls and women have the necessary resources.
  • Build Sanitation Infrastructure: Safe and private sanitation facilities in schools and public spaces are essential for dignity and hygiene management.
  • Champion Advocacy: Investing in menstrual health advocacy at the local and national level can lead to policy changes that prioritize girls’ needs. From providing dignity kits to advocating for safe and private facilities, menstrual hygiene management is crucial for their well-being and development. Through advocating for women and girls, we can ensure every girl has the knowledge and resources she needs to thrive. 

By investing in menstrual health, we invest in a future where girls like Eno, Nike, and Rukkayat can access education, participate fully in life, and thrive. Through increased conversations and heartfelt advocacy, the Going North Project initiative is addressing the urgent need for quality healthcare, education, and the eradication of period poverty through targeted outreach programs.

The Going North Project aligns with the Sustainable Development Goals (SDGs) of Education, Health, and Gender Equality, which are crucial for fostering a brighter future and empowering girls – one at a time.

Let us address the urgent need for accessible menstrual health resources and education, highlighting how this issue impacts individuals globally. This advocacy inspires and reminds us that menstrual equity is essential for a just and healthy world. Together, we can break the stigma and ensure menstrual equity for all.

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