Status of Respiratory Care
in South Africa
Lina Puckree, PT, PhD
Department of
Physiotherapy,
University of KwaZulu Natal,
Westville Campus,
Durban, South Africa
South Africa in Africa
University of KwaZulu-Natal
(Westville campus)
1st and 3rd World
Need for respiratory Care
in South Africa
Demand has increased
due to increasing pollution
Increased number of patients with
HIV/AIDS
More patients with TB and multiple drug
resistant TB
Implementation of health for all and
primary health care focusing on
prevention and promotion
7% of the population 60 years and older
compared to 19,5% in developed countries
Pollution
Levels of Care
Primary care- homecare, awareness,
education
Secondary care- district hospitals,
clinics
Tertiary care- advanced levels of care,
specialized ICU, clinics
Quartenary care- high tech surgery
performed, clinics
Provincial Distribution of Pulmonologists
and Pulmonary FTE (1998)
Indicators of service provision in
pulmonary care by province in SA
Team work
Physicians- have own specialization in
pulmonology.
Physiotherapists- cardiopulmonary sub
group of national physiotherapy association
Nurses- routine and unrecognised- ICU
specialization at masters level
Traditional Healers- isolated from
mainstream health care and unregulated up
to now.
Some teamwork at hospital level
Person power
Physiotherapists in South Africa
1: 10 943 (1998). 4000 therapists with 628
(15%) in the public sector serving 81% of the
population of 45 million. More than 5 % are
practicing outside the country.
Nurses 1: 458
Doctors 1: 1512
Environmental health practitioners
1: 19244
Training
Physiotherapy- 4 yr
bachelors degree with
approximately 25% devoted to
cardiopulmonary training
Postgraduate– masters and
Ph.D by research. 3 of 6
physiotherapists with PH.D in
respiratory related research
Continuing professional
Development
Physicians specialize in
pulmonary care at Masters level
Clinical Practice
Mainstream- curative,
maintenance, prevention and
promotive
Moving more to evidence based
care.
Techniques largely comparable to
those used in Britain- largely
conservative.
Research
Experimental-laboratory based
Effects of –
Intercostal stretch -validating breathing exercises
Passive movements -
Bed rest
Thoraco lumbar corsets
Clinical studies
Lung function in hemiplegics
Laproscopic cholecystectomy
Passive movements in paraplegics
Surveys
Comparison of ICU Clinical practice in SA and Great
Britain, etc
Effects of thoracolumbar corsets
New dimensions in respiratory
care
Psychosocial aspects especially
with traditional healers and
community based workers.
Collaboration and sharing with
countries in the rest of Africa
Palliative care especially with
increasing morbidity and mortality
associated with HIV/AIDs