SAMJ VOL tifically correct in not doing so this
Shared by: Commonthread
574 SAMJ VOL 79 4 MEI1991 tifically correct in not doing so, this failure to agree is not helpful quine are unavailable or not indicated). Neither mefloquine nor to the practicing clinician or pharmacist who is increasingly called proguanil are freely available in South Africa but might be obtain- upon to give advice on this issue. None the less, it was hoped that able in the country of the traveller's destination. the various comments and opinion would be of value in assisting The blanket applicability of these recommendations to all malarial therapeutic decisions to be formed. areas of southern Mrica is controversial in our opinion. Several points were considered by the participants as being par- For obvious reasons, which medication to use is a decision that ticularly relevant. should be taken by the clinician in consultation with the patient if Clinicians should take care to be as familiar as possible with the possible. Various regional reference centres exist and should be con- various issues and should preferably know their patients well enough sulted if there is doubt. to be able to individualise therapy if necessary. Patients at particu- lar risk, (such as the pregnant or immunocompromised) should be F. S. E. Monteagudo discouraged from entering malarial areas. 4 Advice about the use of C. F. Hansford mosquito repellants, particularly between dusk and da...., o, was con- sidered crucial. Patients should be told that no prophylactic treat- REFERENCES ment is totally effective, and should be given a clear description of I. Spracklen FHN, Monteagildo FSE. Malaria prophylaxis. S Afr Med J 1986- the clinical syndromes associated with malaria. 70: 316. In areas with no or little chloroquine resistance the preferred treat- 2. Hansford CF. Prophylaxis and treatment of falciparum malaria. CMEIVMO ment would still be chloroquine (with or without pyrimethamine) 1989; U: 1440-1443. 3. Pelteret RM, Kibel MA, Heese H. de V. Malaria prophylaxis in children. together with Fansidar as 'back-up'. S Afr Med J 1987; 71: 128. In areas with moderate or extensive chloroquine resistance, such 4. Isaacson M. Malaria and its management in pregnancy and childhood as Malawi or Mozambique, advice is less easy to give. The absence CMEIVMO 1989; 2: 132-137. 5. Talmud J, Straughan JL, Pillans PI, Folb PI. Malaria prophylaxis: dosage of proguanil (used in combination with chloroquine) for this pur- recommendations for South Mrican travellers. Loose leaflet produced by th" pose is unfortunate. The use of chloroquine alone in this setting Department of Pharmacology, University of Cape Town, 1989. would imply a significant likelihood of contracting malaria with its 6. Cook GC. Prevention and treatment of malaria. Lant:ec 1988; i: 32-37. associated morbidity and mortality. 7. International travel and health: vaccination requirements and health advice. Geneva: World Health Organisation, 1990: 61-68. A recent WHO document has classified all malarial regions in 8. WHO Scientific group repon: practical chemotherapy of malaria. Technial Mrica as category C which, worldwide, places the continent as a Report Series 805. Geneva: World Health Organisation, 1990: 78-90. whole in the highest risk category. 7 The WHO malaria prophylaxis 9. Hansford CF, Pammenter MD. Diagnose en profJlakse van malariG. CMEIVMO 1989; 2: 138-145. recommendations -for Category C areas are either mefloquine; or 10. Tester-Dalderup CBM. Antiprorozoal drugs. In: Dukes MNG, ed. Mey/er 1 doxycycline; <>r chloroquine with proguanil (if doxycycline or meflo- Side-effeccs of Drugs. Amsterdam: Elsevier, 1988: 590. In memoriam George Russell Giles also had pan-time sessions as urological consultanrat Edendale anJ Ncrthdale hospitals. He had a very practical approach to urological M.B. B.Ch., F.R.C.S. (Edin) problems, with exceptional ability as a clinician and surgeon. Drs Rob Caldwell and Bernie Wolff of Natal write: To all that met him, Russell represented fair play, courage, courte- Russell Giles was born in Johannesburg on 16 June 1942. He was ousness and good humour. These qualities reinforced themseives educated at King Edward VII High School, where he became head the longer one knew him. One realised too that his exceptional ta- boy and captain of rugby. He matriculated in 1959. After completing lents and intelligence were complemented by humility and simplicity. a B.Sc. degree he changed to medicine and graduated from the Almost 5 years ago a high-grade cerebral malignancy was diag- University of the Witwatersrand in 1%8. Russell was awarded the nosed. Although this meant the end of his medical career, Russell Abelheim Medal and Prize as the best student in obstetrics. He con- defied the odds. He not only survived the few months that co d tinued to play excellent rugby throughout his smdent days. be considered his maximum, but he lived a life full and productive Russell did his internship at Johannesburg General Hospital and almost to the last. thereafter did further senior house jobs and GP locums in South Russell and his wife Sya reversed roles, and she was thus able to Africa and in Britain. He then decided to specialise in urology and complete her specialisation in dermatology while Russell held the was a registrar in Professor Van Blerk's Department at the Univer- fort. He developed a profound interest in philosophy and was able sity of the Witwatersrand. Professor Van Blerk had a tremendous to realise for himself, and to convince others, that life could have liking and admiration for Russell. He speaks particularly of his con- a meaning far beyond the fact of one's mere existence. sideration for his fellow man, his role as a family man, and he He died peacefully at home on 28 January 1991. His death on the regarded him as the ideal registrar. Russell obtained his F.R.C.S. one hand represents the tragic loss in the prime of life of awonder- in Edinburgh in 1976. ful husband, father, friend, and doctor. On the other hand, Russell On 20 December 1979 he entered private practice in Pietermaritz- lived life to the full before his illness. Thereafter he set about burg in partnership with Dr Bernie Wolff, to whom he was a won- re-learning what life meant to him. He did this in the way he did derful partner, colleague, and friend. As a result of his conscientious everything - with courage, care and fairness. We believe that he and efficient service he bullt up a large and busy practice but still was able to show us all that it is the triumph and gladness in his found time to follow his interest in'farming and dendrology, to fur- short life which will overcome the sadness. ther his love of woodwork, to play league squash and to be an active To Russell's wife, Sya, their children Ryan and'Francie, to his Medical Association member. mother, Seville; and to his family, friends and colleagues, we exter:d In addition to a heavy clinical wor~oad at Grey's Hospital, Russell our deepest sympathy. ' Official Announcement! Amptelike Aankondiging I Cholera warning Cholerawaarskuwing Although free of cholera for many decades in the past, South Mrica Terwyl Suid-Afrika oor baie dekades in die verlede geen choler.- was fairly severely affected by the seventh pandemic. From 1980 gevalle gehad het nie, is die land betreklik ernstig deur die.sewende to 1987, regular summer peaks occurred, resulting in a total of 25 ()()() pandemie aangetas. Vanaf 1980 tot 1987 het daar gereelde some;- SAMJ VOL 79 4 MAY 1991 575 proved cases and hundreds of thousands of infected individuals with pieke plaasgevind wat 25 000 bewese gevalle en etlike honderd- lesser symptoms or no symptoms at all. duisend persone met ligter sirnptome, of glad geen sirnptome nie, For the last year the World Health Organisation has been repon- ingesluit het. ing cholera infection in a number ofdistricts of neighbouring Mozam- Gor die afgelope jaar het die Wereldgesondheidsorganisasie meld- bique. The district of Maputo has been repeatedly cited and this ing gemaak van cholera-infeksies in etlike distrikte van die aangren- represents a serious warning signal to our people and the health sende M'osambiek. Die Maputo-distrik is herhaaldelik genoem. Dit services. The first cases in 1980 were diagnosed at Shongwe Hospi- veneenwoordig 'n ernstige waarskuwing vir ons bevolking en gesond- tal in the Mkomazi district of KaNgwane, which borders the now heidsdienste. In 1980 is die eerste gevalle by die Shongwe-hospitaal infected Maputo district of Mozambique. From here, infected in die Mkomazi-distrik van KaNgwane gediagnoseer, 'n gebied wat travellers may spread the disease funher inland, and the chances aangrensend is tot die geInfekteerde Maputo-distrik van Mosambiek. that South Africa may again become infected are considerable. Health Dit is duidelik dat geInfekteerde persone die siekte ver in die land workers are urged to be on the look-out for suspect cases. The elderly kan binnedra en die kanse dat Suid-Afrika weer besmet kan raak are most likely to be the first to contract the disease in new epidemics, is aansienlik. especially in areas near irrigation systems and/or where available Gesondheidswerkers word gemaan om op hulle hoede te wees vir potable water supplies are suboptimal. Suspect stools should be verdagte gevalle. Tydens nuwe epidemies word ouer mense gewoon- examined for Vibrio cholera in high-risk areas. lik die eerste aangetas, vernaamlik in die nabyheid van besproeiings- During the summer and in these high-risk areas, environmental aanlegte en/of waar die beskikbare drinkwater nie optimaal is nie. surVeillance is to be encouraged, for instance by testing open water Daar word aanbeveel om verdagte stoelgang vir Vibrio cholera te laat courses for evidence of cholera using Moore pads, All positive cases ondersoek, veral in hoe-risikogebiede. In sodanige gebiede sou die are notifIable, and notifIcation by telephone of people proved to be ondersoek van oop waterstelsels vir besmening deur cholera gerade infected will expedite control measures. wees deur van die bekende Moore-deppers gebruik te maak. Alle Details of the control strategy may be obtained from the Depan- positiewe gevalle is aanmeldbaar en telefoniese aanmelding van enige ment of National Health and Population Development, Private Bag persoon wat as positief bewys is, sou kontroledoeleindes bev'order X 828, Pretoria 0001; teI. (012) 325-5100 x 630. en bespoedig. Besonderhede in verband met die kontrolestrategie is by die Depanement van Nasionale Gesondheid en Bevolkingsont- wikkeling, Privaatsak X 828, Pretoria 0001, verkrygbaar. Die tele- foonnommer is (012) 325-5100 uitbr. 630. Notice from the Department of Health and Population De- Kennisgewing van die Departement van Nasionale Gesondheid velopment. en Bevolkingsontwikkeling. Workmen's Compensation Act, Ongevallewet, 1941: werknemers 1941: employees injured on duty wat op diens beseer word As a result of the formation of a company on 1 April 1990 Transnet As gevolg van maatskappywording op 1 April 1990 beskik Trans- Limited has now adopted an own legal entity. Transnet is already net Beperk nou oor 'n eie regsidentiteit. Transnet is reeds as 'n registered as a private employer at the Workmen's Compensation private werkgewer by die Ongevallekommissaris geregistreer en as Commissioner, and as such is compelled to contribute to the Work- sodanig verplig om tot die Ongevallefonds by te dra, men's Compensation Fund. In die lig hiervan is die Ongevallekommissaris aanspreeklik vir, Consequently, the Workmen's Compensation Commissioner is lia- onder andere, mediese koste wat voonspruit uit gevalle van beser- ble for, inler alia, medical expenses resulting from cases of injury ing op diens wat op of na 1 April 1990 plaasgevind het. Rekeninge on duty that occurred after 1 April 1990. Accounts for these cases vir hierdie gevalle word dus nie deur Transmed vereffen nie. are therefore not settled by Transmed. Rekeninge vir gevalle van besering op diens wat op of na 1 April Accounts for cases of injury on duty that occurred on or after I 1990 plaasgevind het, moet na die werknemer se toesighouer gestuur April 1990 must be forwarded to the employee's supervisor. word. Accounts for cases of injury on duty, for employees as well as for Rekeninge vir gevalle van besering op diens van werknemers asook pensioners injured on duty before retirement, and which occurred van gepensioeneerdes wat op diens beseer is voordat hulle afgetree before or on 31 March 1990 must also be forwarded to the employee's het en wat voor of op 31 Maan 1990 plaasgevind het, moet ook na supervisor or former supervisor for cenifIcation. On receipt of die werknemer se toesighouer of gewese toesighouer gestuur word the cenifIed account, the necessary payment will be affected by vir senifIsering. Op ontvangs van hierdie gesenifIseerde rekening Transmed, sal die nodige betaling deur Transmed gemaak word. Transmed accounts Transmed rekeninge Accounts for the following examinations: medical; at employment; Rekeninge vir die volgende ondersoeke: medies; by indiensneming; periodical; special; at dismissal due to ill health; when a person periodiek; spesiaal; afdanking weens slegte gesondheid; wanneer is allegedly under the influence of an alcoholic drink 'n persoon na bewering onder die invloed van alkoholiese drank is When the abovementioned examinations are requested of business Wanneer die bogenoemde ondersoeke van besigheidseenhede/ unitslbusiness undenakings of Transnet, the accounts must, together besigheidsondernernings van Transnet aangevra word, moet die with the relevant repons, be sent directly to the employee's con- rekeninge direk, tesame met die betrokke verslae, aan die werknemer trolling officer. se beheervoerende amptenaar gestuur word. Should the services of a radiologist or pathologist, for example, Indien 'n radioloog of patoloog se dienste byvoorbeeld benodig be required to assist in completing your repon, such medical prac- word om u behulpsaarn te wees in die afhandeling van die verslag, titioner must be provided with a copy of the controlling officer's moet sodanige mediese praktisyn van 'n afskrif van die beheer- lener. The arrangement will ensure that the medical practitioner con- voerende amptenaar se skrywe voorsien word. Hierdie reeling sal cerned will also submit his account to the employee's controlling verseker dat die betrokke mediese praktisyn ook sy rekening aan officer. die werknemer se beheervoerende amptenaar sal stuur. NB: When these accounts, which must be cenified by the employee's NB: By ontvangs van hierdie rekening, wat deur die werknemer se controlling officer, are received, the necessary payment will be made beheervoerende amptenaar gesenillseer moet wees, sal die nodige by Transmed. betating deur Transmed gemaak word. Accounts and reports of this nature must not be submined directly Rekeninge en verslae van hierdie aard moet nie regstreeks van to Transmed. Transmed gestuur word nie.