Focusing on the hearts of Soweto

From October this year, the Soweto Cardiovascular Research Unit (Socru) and the CH Baragwanath Cardiac Unit will implement a pilot nurses training programme that will help change the way cardiac illnesses, in are being managed in the Soweto community.

The programme will equip nurses with knowledge and tools needed to educate cardiac patients on how to self-manage their condition. Patients visiting the cardiac unit will be handed a toolkit which will include information and advice on how to monitor blood pressure, the pulse and weight, on eating correctly and on exercise. A scale and a diet book adapted to the Soweto community will also be provided.

Prof Karen Sliwa, clinician and researcher at the Baragwanath Cardiac Unit for the past 15 years, and director of SOCRU, says, “The primary challenge is that people have difficulty accessing public healthcare facilities and often seek medical attention when the cardiac condition has already progressed to a late stage. A pilot outreach programme will investigate how to teach people to identify symptoms and to manage their cardiac illnesses before complications set in, will hopefully reduce the impact of cardiac disease on the individual, will reduce the need for doctors’ visits, decrease complications leading to hospitalisation and ultimately lower the cost burden on the public healthcare system.”

The rationale is that raising awareness of the signs and symptoms, teaching people how to live healthier lives, and providing tools for self-management will help earlier detection of the illnesses, decrease complications, extend life and decrease health costs. This is in response to a large survey undertaken by Prof Sliwa, colleagues and the SOCRU team at the cardiac clinic at Baragwanath Hospital in 2006 (The ‘Heart of Soweto Study’ funded by ‘Unite for Health’/Tigerbrands), which revealed that, of 4600 patients that presented at the cardiac clinic, 52% had signs of heart failure. 

People generally had a low awareness of the signs and symptoms of heart conditions, therefore they sought help at advanced stages of the illness. Furthermore, the survey revealed that patients did not stick to their medication regimen and were unable to self-manage their illnesses adequately, which often led to frequent hospitalisation, increasing the burden on the healthcare system.

Heart failure is escalating in SA and research shows that cardiovascular problems are the second biggest killer in South Africa after HIV/AIDS. The CH Baragwanath Hospital serves approximately two million people from Soweto and the surrounding areas, and is a world-renowned training hospital, attracting doctors wanting to specialise from around the world. At present, two of the unit’s doctors, who are specialising in cardiology, are from Zimbabwe and Kenya. Both have fellowships sponsored by the Medtronic Foundation. The cardiac unit services 120 patients a day and has 20 000 patient visits per year.