Director of the Primary Health Care Directorate
Prof Reid took up his new post as Director and Glaxo-Wellcome Chair of Primary Health Care at the beginning of 2010 and melodiously introduced himself to the staff by playing the violin, one of the many instruments in which he is adept. He is also an avid cyclist. Prof Reid was the Director of the Centre for Rural Health at the University of KwaZulu-Natal for 10 years and has a deep understanding of the district health system and the human resource challenges that are faced at a national level. He has for many years immersed himself in the theories and realities of primary health care. Rural health, community-oriented primary care, population-based approaches to health, and the collaboration of health equity through education and research are just some of his passions. Prof Reid received his doctorate in April 2011 entitled "Education for rural medical practice" which critically examines the educational determinants of medical practice in rural and underserved areas in South Africa.
Intermediate Care in the Western Cape
Prof Reid worked in a small team at UWC in 2012 on a policy for Intermediate Care in the Western Cape, which has been accepted as policy by the DoH. The policy provides a framework for the delivery of facility-based services for step-down care, palliative care, chronic care and short-term rehabilitation in the province, collectively to be referred to as Intermediate Care (i.e. between hospital and community-based care). The idea is that there should be an intermediate care facility within each sub-district in the province. The project continued in 2013 with a review of the Community-Based Services (CBS) in Eden involving a review of exactly what community health workers of different types (home-based carers, TB Dots supporters, farm workers) actually do, that will offer suggestions and options for a more comprehensive and population-based approach in line with the PHC re-engineering ideas.
Multi-Lateral Agreement (MLA)
At a provincial level 2012 will be remembered as the historic year in which the MLA between the province and the 4 higher education institutions (UCT, Stellenbosch, UWC and CPUT) was finally signed, almost 60 years since the last one! The MLA provides the legal framework for operating as equal partners and a number of teams, such as the Service Platform Task Team of which Prof Reid is a member, have been put in place to develop the agreements.
Collaboration for Health Equity through Education and Research (CHEER)
CHEER which is made up of a collaboration amongst the 9 partner faculties across South Africa, and is chaired by Prof Reid, has been successful in pursuing the theme of social accountability in health sciences education on various levels, including through international collaborations as well as successful university peer reviews. Claudia Naidu, a Research Officer in the PHC Directorate is currently engaged in a PhD on “An evaluation of the development of social accountability of medical graduates at the University of Cape Town” as part of the CHEER collaboration research focus.
Clinical Teaching Platform (Vredenburg & George)
The main purpose of extending the teaching platform is to allow for students to have greater exposure to community, primary and secondary level care than the traditional platform based in tertiary hospitals in Cape Town. Such a model of learning and teaching requires significant community engagement on the part of the clinician teachers and the teams of people with whom they work. The Faculty will need to develop sites where students can easily access a team of community-based workers, witness a positive interaction between the health service and the community in action, and do some of it themselves through guided assignments and supervision by clinicians. Both because of the future need for secondary places on the clinical teaching platform and the need to grow the rural component of the teaching platform, Vredenburg was set up as a clinical learning site by the Directorate and its success can be largely attributed to Frank Molteno (Clinical Teaching Platform Coordinator) and Sandra Adams (Site Coordinator) work in setting up and integrating the site. The site has been a very important precedent for further development of the teaching platform outside of Cape Town. The development of the George Hospital Complex as a new teaching and learning site will be piloted in 2015. In addition to the secondary level hospital in George the site may include the Knysna, Mossel Bay, Oudtshoorn, Beaufort West, Ladismith, Riversdale and Uniondale district hospitals.
European Forum for Primary Care Conference, Sweden (2012)
Prof Reid was invited to give a keynote address to this conference, which had the theme of Crossing Borders and comprised about 500 GPs, health managers and public health types from all over Europe. He used the title: Integrating personal and population approaches to health care: A Perspective from Africa in order to talk about crossing different types of borders: Geographical borders between north and south, between urban and rural; organizational or structural borders between individual patient and community, between clinical practice and population health; and process borders like flexibility, innovation and creativity in practice. The talk went down well, particularly a video clip of the normal morning prayers at a rural KZN clinic, which consists of staff and patients singing gospel songs unaccompanied in 4 part harmony. This was used to illustrate innovation by describing the project he had been involved in at the South Coast Hospice, where singing at work was introduced as an intervention, and had remarkable effects on staff and patients.
Rendez-Vous Conference, Canada (2012)
This was the largest of the rural health conferences that Prof Reid has attended so far, with over 800 delegates. It was hosted by the Northern Ontario School of Medicine (NOSM), which has established a distributed clinical teaching platform across 1000km between the towns of Sudbury and Thunder Bay. The most important evidence that was presented and discussed was the positive graduate outcomes that are emerging from the longitudinal community-based placements that are being implemented in a number of schools, particularly in Australia and Canada, but also the USA and a few other countries. By longitudinal they mean placements in small communities of up to a year, or repeated visits to the same community over a period of years throughout the curriculum. The graduates of these programmes have been shown to fare at least as well as their counterparts in traditional curricula, but to be significantly better than them in terms of the graduate outcomes such as teamwork, communication, integration of knowledge and skills, as well as career intentions. It is an exciting development, and indicates new directions for medical education. One of the published experts, Prof David Hirsch from Harvard, was invited by the Directorate to give a presentation to the faculty in 2013.
Inaugural Lecture "The Music of Health for All" (2011)
"For some years I have puzzled over how to integrate my rational, goal-oriented working life as a medical academic with my more whimsical musical life as a violinist and pianist. I inhabited them both as two completely separate entities, and my identity as a physician seemed to be irreconcilable with my identity as a musician. However over time I have come to make the connections more explicit, and to deliberately seek out or create the linkages between these two worlds. As a classical musician I took the opportunity in my inaugural lecture on the 24th August to explore the themes of primary health care and "health for all' using music as a medium and to give primary health care a fresh face."
Prof Reid’s aim for the lecture was to engage the faculty and audience in understanding primary health care in a new way that is applicable to teaching, research and clinical practice. The objectives were therefore to get and hold the audience's attention; to communicate primary health care in a fresh way; to show the application of theory to practice; and to provoke a change of attitude towards primary health care.
Bonteheuwel & Langa Community Visit
Staff of the PHC Directorate all joined together for a staff tour and meeting in Vanguard, one of the 4th year MBChB teaching sites, with the aim of visiting communities and gaining a better understanding of students-in-the-community; the health-education (schools) nexus; multi-professional teaching and learning on the health platform; and the role of students in service delivery within the GWC DoH, City Health and NGOs. They visited the Langa Museum, Mzamo Place of Safety, LoveLife youth centre, Langa City Health Clinic, Thusong Centre in Bonteheuwel, and the Lilyhaven old-aged-home and frail-care centre.
4th Year MBChB Health Promotion Project Student Prize
Johannah Keikelame, the convenor of the 4th year MBChB Health Promotion/Primary Health Care course was very proud when one of her students, Sbongiseni Mashinini, won a prize at the 2012 Faculty Research Day for the poster she produced on "Understanding barriers to health education: An observation of the efficacy of epilepsy health talks, support groups and information materials". Health education forms an integral part of any health care system and despite interventions that have been put in place to promote health education, barriers to patient's abilities to access the provided information still exist. This study looks at observations done at two CHCs, as well as a support group within Cape Town. Mrs Keikelam is engaged with a PhD on "Perspectives on epilepsy on the part of patients and carers in a South African urban township".
Arts in Health
As part of the 2nd year MBChB curriculum Prof Reid has supervised Special Studies Modules (SSM) on "Music and Medicine" which explore the links and integration of music and medicine in the South African context. Students interrogate issues of where and how music happens in a medical context; what the underlying paradigms are of these two disparate fields; how these areas are able to converge; the benefits of working across disciplinary boundaries in this way; and what those benefits could be. The SSM is an exploration of ideas, theory and practice to bring the worlds of biomedical science and creative arts together explicitly and practically via set weekly tasks, literature reviews, critical analyses, interviews, digital stories and musical events
"Our intention, as current and future health professionals, is to collaborate with artists and musicians, from the various arts faculties and within medicine, in integrating music and art more effectively into the world of healthcare." Student SSM group
Prof Reid cycles 1000 kms through the rural back roads of the Eastern and Western Cape to raise funds for rural healthcare in the Eastern Cape
Imagine you fell seriously ill while living in Cape Town. You could call an ambulance to transport you to your choice of any number of hospitals. There would be cutting edge medical facilities available, teams of highly-skilled doctors waiting to diagnose and treat you, a ready supply of life-saving medications, and a clean, warm, secure environment in which to make your recovery. Now imagine you live in the Peddie district of the Eastern Cape. There is just one doctor servicing 11 rural health clinics, many of them accessible only by the roughest of roads. The nearest hospital is miles away, and it will be a long wait before an ambulance can get you there. The facilities are in many cases rudimentary, and the supply of drugs, sporadic. Thanks to the efforts of four Cape Town medical professionals, including our very own Director, they are about to be drawn a little closer together. Their primary aim is to raise enough money for a vehicle which can be used to transport patients to clinics and hospitals.