Radioactivity standardization in South Africa.

South Africa's national radioactivity measurement standard is maintained at a satellite laboratory in Cape Town by the National Metrology Laboratory (NML) of the Council for Scientific and Industrial Research. Standardizations are undertaken by a number of direct methods utilizing liquid scintillation counting (LSC). The successful application of LSC to the 4pi beta-gamma coincidence method is reviewed. The activity unit is maintained through radionuclide specific calibration factors relating to a pressurized re-entrant well type ionization chamber. A comparison is made between normalized factors given by the manufacturer and deduced factors obtained by a method used to transfer calibration factors from the International Reference System of the International Bureau of Weights and Measures based on the NML's own absolute standardizations.     

Paget's disease of bone in South Africa

A survey of Paget's disease of bone in Johannesburg South Africa, has revealed a prevalence of 2.4% in whites aged 55 years and over, which is similar to some centres in Europe; it has also revealed an unexpectedly high prevalence of 1.3% among blacks. These findings are discussed in relation to recent concepts of the pathogenesis of Paget's disease.     

Ethics in South Africa: new challenges

One of the reasons why ethics is so much spoken about nowadays is that the moral certainties of previous times no longer exist. Recent events in South Africa have called into question many of the values and principles formerly adhered to. Formerly, we had confidence in the moral consensus that was shared by our families, religious organizations, educational institutions, professional associations and judicial system. Nowadays we have pluralism, and we live in a society with many competing moralities. Whereas in traditional societies, there is considerable agreement on values, in pluralistic societies, such as South Africa, individuals are subject to a clash of values and have the difficult task of deciding which should prevail. Euthanasia and assistance in suicide are currently hot issues in South Africa. Ethical conduct of medical practitioners dealing with cases of AIDS is an ongoing task. New issues like Telemedicine and the ethics involved therein, are a concept in South Africa and will receive much attention in this year.     

Lightning fatalities in the Transkei sub-region of South Africa

Lightning is a particularly unsettling product of bad weather. It kills more people than other natural disasters such as floods, hurricanes, and tornadoes, but, because lightning usually kills people one at a time, it tends to be an underrated hazard. High risk groups are uneducated, unsheltered and rural people. This study was carried out to determine the incidence of lightning fatalities in the Transkei sub-region. It is a review of records between 1993 and 2004 from the medico-legal autopsies at Umtata General Hospital (UGH). During the study period there were 10,860 autopsies performed on those who died of trauma and other unnatural circumstances which included 151 (1.4%) lightning fatalities. This represents 0.31 deaths per million per year. The highest (0.5/million) was in 1999, and the lowest (0.13/million) in 1997. The age of the victims ranged from 1 to 82 years, with a mean of 22 years. Males and females were almost equally represented (50%). The highest number of deaths (26.5%) was in the age group of 11 to 20 years, and the lowest number (2.7%) in the age group of 70+ years. There is a high incidence of lightning fatalities in the Transkei sub-region of South Africa. People need to be educated to disregard the myths of lightning strike.     

Determinants of suicide in the Transkei sub-region of South Africa

BACKGROUND: South Africa has a history of traumatized citizens and is a society in transition. Suicidal behavior among the black population group in South Africa appears to be on the increase. Under the post-apartheid dispensation they are undergoing a lot of stresses especially in relation to their as yet unmet expectations and demands from the government. OBJECTIVE: To identify the possible determinants of suicide in the Transkei sub-region of South Africa. METHODS: Interviews with relatives of suicide victims, and analysis of victims' demographic, socioeconomic, and psychosocial data. RESULTS: Rural people (> 90%) were much more likely to commit suicide than urban dwellers (< 10%). Suicide notes were left by 13% of the victims. Hanging was the method of choice in 57%, gunshot in 30%, and poisoning in 13%. Among those who died by hanging and by gunshot injuries, males far outnumbered the females (82% and 89%, respectively). By contrast, females constituted the greater proportion of deaths by poisoning (75%). Apparent precipitating factors included economic hardship (87%), alcohol abuse (23%), health related issues (17%), marital problems (13%), and social disputes (10%). The uneducated (70%) and unemployed (64%) used hanging as the method of choice. The highly educated 5 (17%) were all employed, and used a firearm in committing suicide. Family disputes 5 (17%) and separation of parents from teenage children were recorded in 17% of the cases. CONCLUSION: Financial hardship was the main underlying reason, identified in 87% victims of suicide. To break this vicious cycle of unemployment, alcohol abuse, and poor health, a comprehensive poverty alleviation program along with community education could be an important step towards reducing suicides in the Transkei sub-region of South Africa.     

Blood transfusions, HIV and legal liability in South Africa

This article deals with the legislation, regulations and clinical guidelines regulating blood transfusions in South Africa. Although these are aimed at protecting both the recipients and donors of blood, the risk of HIV infected blood being donated and transfused is on the increase, due to inter alia, the high prevalence of HIV infection among the South African population. The article discusses, in the absence of strict liability in South Africa, the possible legal liability of blood services, medical practitioners, the Department of Health, and the blood donor when a recipient of blood is infected. The need for informed consent by both the recipient and the donor is also discussed, as well as the legal repercussions where informed consent is lacking.     

Inadequacies in the promotion of life before birth in South Africa

The legal and ethical principles relating to the protection of the unborn foetus in South Africa are expounded and discussed. It is submitted that, while the law intends to be over-protective towards the unborn foetus in some respects, it is seriously deficient in others. Consideration should perhaps be given to a comprehensive consolidation of the legal principles relating to the protection of the unborn foetus within the framework of a fundamental policy in respect of the matter.     

Unnatural deaths among children in the Transkei region of South Africa

Nearly 99% of the 10.9 million children worldwide under the age of five years who died in 2000 were from developing countries. This amounts to at least 29,000 deaths per day (UNICEF, 2005). This study aims to trace the pattern of unnatural deaths in the Transkei region of South Africa. It is a records review of the medico-legal autopsies carried out between 1996 and 2004 at Umtata General Hospital (UGH). All subjects aged 18 years or below were considered as children. Between 1996-2004, 7,303 unnatural deaths were recorded. Of these, 1,449 (19.8%) were children. Trauma accounted for 1,028 (70.9%) child deaths and 421 (29.1%) were deaths related to other causes such as hanging, burns, lightning strike, drowning, gas suffocation, falls from a height and poisoning. Motor vehicle accidents accounted for 469 (45.6%) deaths and homicides for 553 (54.4%) deaths. The homicides were firearms injuries, 196 (19%), stab wounds, 185 (18%), and blunt trauma, 178 (17.3%). Non-traumatic deaths were hanging, 81 (19.2%), drowning, 166 (39.4%), lightning strike, 38 (9%), burns, 51 (12.1%), gas suffocation, 24 (5.7%), poisoning, 33 (8.4%) and falls from a height 28 (6.7%). There is a high risk of unnatural death among children in the area of Mthatha. It threatens the survival of young children in this region of South Africa. Poverty is an underlying cause for these preventable deaths.     

Medical, legal and financial aspects of rape in South Africa

Rape is an emotive topic, about which has been generated much heat but little light. Some cynics (usually male) believe that there is no such thing as rape. At the other extreme are those (usually female) who believe that every woman who alleges rape has been raped, and that many more rapes go unreported. The truth obviously lies somewhere in between. This paper examines the practical and financial difficulties involved in the medico-legal management of complainants and of their accused.     

Image interpretation by radiographers in South Africa: A systematic review

Purpose

To determine the current knowledge on the accuracy, experiences, influence of training, and potential impact on patient management of image interpretation/reporting by South African diagnostic radiographers.

Traditional male circumcision-related fatalities in the Mthatha area of South Africa

Traditional male circumcision is still widely practised by the Xhosa population throughout South Africa. Male circumcision is carried out mainly during summer and winter seasons. This is a retrospective record review of the male circumcision-related fatalities at Mthatha General Hospital during 2005 and 2006. The purpose of this study is to highlight the problem of circumcision-related deaths in the Mthatha area of South Africa. Twenty-five deaths related to traditional circumcisions were recorded over the period. The common causes of deaths were septicaemia (9 patients; 36%), pneumonia (5; 20%), dehydration (3; 12%), assault (3; 12%), thromboembolism (2; 8%), gangrene (2; 8%) and congestive heart failure (1; 4%). All fatalities were among black Africans with a median age of 17.56 (SD = 2.56) years. In seven deaths (28%) the young men came from the Libode District. The youngest victim was 12 years old. Most of the deaths (13; 52%) occurred in July 2006. The mortality associated with traditional male circumcision in the Mthatha area of South Africa is alarming.     

Ethics review of health research on human participants in South Africa

In terms of South African legislation, all health research on human participants must be submitted to an accredited research ethics committee for independent ethics review. Health research covers a broad spectrum of research, including clinical trials. This article sets out the ethical-legal framework for the functioning and composition of such committees. It also deals with the newly created National Health Research Ethics Council, which registers and audits health research ethics committees. Special attention is given to the conduct of clinical trials. In conclusion, it is submitted that the National Health Act, the Draft Regulations Relating to Research on Human Subjects, and two sets of ethical guidelines adopted by the Department of Health provide a much needed and coherent ethical-legal framework for research in South Africa.     

Trends in fatal motor vehicle accidents in Transkei region of South Africa

This paper aims to estimate the incidence of motor vehicle accident (MVA) related deaths and identify the factors associated with the causes of the high road death toll in Transkei region. A retrospective review and analysis was performed of all medico-legal autopsies (n=6181) between January 1993 and December 1999, of which 39% (1778/4525) were deaths as a result of MVAs. During the seven-year period (January 1993-December 1999), MVA deaths in Transkei region accounted for an average of 63 deaths per 100,000 population per year. It reached a peak of 80 deaths per 100,000 in 1997, and then slowly came down to 48 deaths per 100,000 in 1999. MVA deaths have come down from 39% (248) of all trauma-related deaths in 1993 to 29% (193) in 1999. The male/female ratio is 3.3:1; and 50% of victims were between 21 and 40 years of age. In conclusion, there are high motor vehicle accident-related deaths in Transkei region of South Africa.