‘Huisaartskunde’ or Family Practice is rooted in the history of Belgium and the evolution of its health-care system. Training and supervision is predominantly a private sector-university partnership with government incentives and regulation. The health system is private sector-driven with a strong government-run social health insurance system. Whilst many things are not easily transferable to South Africa the lessons in Belgium in the structured interuniversity collaboration ie Interuniversitair Centrum voor Huisartsopleiding (ICHO), its relationship with stakeholders, its academic educational base of GPs and the single common assessment are proving invaluable to South Africans.

Infants are born with a natural immune system from their mothers. The effectiveness of this natural immune system drops significantly over the first two months, until after 8 weeks infants begin to build up their own immune resistance to pathogenic diseases. However, during this time, their immune resistance is very weak compared with that of an adult, their being especially vulnerable to bacteria which cause diarrhoea. It is for this reason that extra care should be taken with regards to bottle feeding, sterilisation and basic hygiene practises.

Having visited Flanders to benchmark with the training of trainers’ programme, an effort has been made by the participating South African delegation to translate some of the processes into relevant and useable alternatives in South Africa. One of the educational initiatives that interested the South Africans was the learning plan with its core of reflection leading to a focused plan of ongoing professional development for both the trainer general practitioner (GP) and the trainee registrar

Students in undergraduate training in Flanders have the choice in their seventh year which is a form of internship to get jobs in various specialist departments. Those entering the Family Medicine Department in Year 7 are regarded as being in the first year of GP (general practitioner) training. This year is organised independently of one another by the four university departments.

Various methods of assessment, formative and summative, similar to the South African context, are used in the undergraduate, 7th year and post graduate training program of Family Medicine in Flanders. The outcomes and objectives of training programmes are well defined, making the choice of assessment methods more valid and reliable.

The details of the curriculum and the way training is arranged in Flanders may not be as useful to us in South Africa as are some of the principles and paradigms on which the training is based. This section looks at some of those we came across which may be useful in developing the education of Family Physicians.

In December 2004, five representatives from family medicine departments in South Africa were invited to benchmark with ICHO, the family physicians’ organization in Flanders, Belgium in the framework of the VLIR Own Initiatives program (2003)

Health promotion is the process of enabling people to increase control over and to improve their health so as to reach a state of complete physical, mental and social well being. The World Health Organisation which was created in 1948, where some 190 countries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world a level of health that will permit them to lead a socially and economically productive lif

The identification of snakebite injury is uncertain, especially in the 40% of patients who do not see the offending snake, unless there are paired fang marks or typical findings of an envenomation syndrome. The differential diagnosis would include a thorn prick, spider bite or scorpion sting. Thorn pricks are not associated with the onset of progressive swelling or systemic illness within minutes. Swelling following dermonecrotic spider bites is slow in onset, whilst significant button (widow) spider bites and scorpion stings are associated with muscle spasticity which is not a feature of snakebites.

Instead of considering allergic rhinitis as a disease of acute symptoms, it needs to be understood as a chronic inflammatory disease that involves a level of persistent inflammation even in the absence of symptoms. Given the close functional, immunological and clinical link between asthma and rhinitis, it is reasonable to expect that an effective treatment of rhinitis would affect the co-morbid asthma; the occurrence of rhinitis in asthmatic patients ranges from 70% to about 90%.

The benefits of breastfeeding for infants in the first year of life in developing countries¹ and developed countries² are well established. In addition, maternal benefits such as earlier return to pre-pregnant weight^,3 increased child spacing^,4 improved bone re-mineralization postpartum,⁵ reduction in hip fractures in the postmenopausal period,⁶ reduced risk of ovarian cancer⁷ and pre-menopausal breast cancer,⁸ are well described

This is a follow-up study to evaluate and improve quality health care for the majority of the population in Bloemfontein. The aim of this study was to evaluate the changes implemented to address the cost of prescribing drugs at National District Hospital, Bloemfontein as described in a previous study

Abstract Maternal mortality rate in Potchefstroom Hospital, 2000 - 2002: How can these risks for mothers be reduced? Background: The aim of this study was to determine the maternal mortality ratio (MMR) in Potchefstroom Hospital, situated in North-West Province, for 2000-2002. The main causes of maternal deaths in Potchefstroom Hospital were determined and compared to the main causes for maternal deaths nationally. Methods: Data were collected in a retrospective manner from Potchefstroom Hospital’s yearbooks and statistics, 2000-2002.

There can be very few practitioners whose daily working life is not involved someway in teaching or learning. Used in its broadest sense, we engage teaching everyday in our advice to patients, and conversely we learn from each of our patients. As we move inexorably towards compulsory reaccredidation for all practitioners, purposeful and effective continuing professional development takes over from the previously passive continuing medical education model.

The Family Medicine Education Consortium (FaMEC) was formed in 1997 by all the Departments of Family Medicine/Rural Health in South Africa. It has been going from strength to strength.¹ It set a broad developmental goal in 2003 “to contribute to a higher accessibility and quality of family medicine/primary health care in South-Africa, with special attention to underserved groups”. The needs for equity and transformation through the district health system and the adaptability of the medical practitioner, team and system in South Africa have been strong values.²

This prospective and observational study included in- and out-patients attending the Immunology Clinic at Kalafong Hospital, Pretoria, Gauteng. The study was divided into three phases, the first of which was to evaluate the kappa values and prevalence of DCO. The second was to determine the disease associations of in-patients, and the third phase consisted of nail evaluation in an out-patient HIV-positive population

Anterior knee pain is a very common clinical presentation. In this article, the classification of anterior knee pain syndromes according to the anatomy of the knee extensor mechanism is described. The clinical diagnosis, special investigations, and principles of management of the more common causes of anterior knee pain are discussed.
(SA Fam Pract 2005;47(8): 20-22)

The aim of this study was to ascertain what doctors perceive to be their role in visiting district clinics. Methods: Individual and focus group interviews were conducted with hospital doctors of different seniority and with doctors who work solely in the clinics

In 1994 Flemming, a British doctor who had retired because of Myalgic Encephalomyelitis (ME) stated, “medical training had not equipped me to understand ME”

Providing estrogen alone to the postmenopausal woman with an intact uterus is associated with an increased incidence of hyperplasia and endometrial cancer. It is therefore fundamental, in the overwhelming majority of cases, to add progestogens to estrogen when managing her menopausal symptoms. Provided appropriate doses and duration of progestogens are used, their addition has successfully eliminated almost all the increased risk of endometrial hyperplasia.

South Africa is a multicultural, multiracial and multilingual nation with many different values, traditions and cultural practices. Different belief systems may give rise to different attitudes and practices relating to disability, which may impact on rehabilitation. The purpose of this study was to investigate the knowledge, attitudes and beliefs relating to disability in three broad cultural groups in the Western Cape.

It is essential to manage and budget for primary health care in order to deliver a sustainable, accessible and quality health service to the majority of the population. The aim of the study was to establish the cost per script at the Heidedal Community Health Centre (HCHC) and at the National District Hospital (NDH) in Bloemfontein and to evaluate prescribing patterns, the protocols and use of the Essential Drug List (EDL) and Standard Treatment Guidelines (STGs) and to budget more accurately for medicine.

The main aim of the prevention and treatment of hypertension is to prevent or minimise target organ disease, and thus decrease morbidity and mortality. In the latest version of the consensus document of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VII, May 2003)1, normal hypertension is defined as systolic blood pressure less than 120 mmHg and diastolic blood pressure less than 80 mmHg.

As busy practitioners it becomes commonplace to look back over the day’s professional activities. All too often, and despite a preponderance of positive interactions, the reflective eye reviews the negative aspects of daily activity and interrupts the intended social relaxation.