Both because of its size – being the third largest hospital in the world – as well as a teaching hospital, Bara is an immensely challenging environment to work within to deliver consistent quality of care to all patients. Because of the legacy of apartheid spatial planning and structural inequality in the distribution of resources, Bara is an over-burdened and considerably under-resourced hospital. However, through the commitment of all of its staff – from cleaners, porters and administrators to nurses, surgeons and clinicians, the hospital still punches above its weight to bring dedicated and quality services to all of its patients leading cutting edge treatment protocols and innovating solutions complex problems faced by health-facilities in low-resource contexts in South Africa and beyond. Collaboration is fundamental to making this hospital work and excel as it does – and in spite of its many challenges. And this is among the reasons why, this year, we have made the award to not one but two doctors from the hospital. Each is a fitting Integrity Icon in their own right, but they have had a particular impact on the Covid-19 response and recovery plan of the hospital, patient care, health worker safeguarding and the national health worker vaccination roll-out plan. Together they are a clear example of how accountability, innovation and going the extra mile is not work that can be done by any individual. They demonstrate how delivering the highest quality of care in a global pandemic requires and is enhanced by inter-disciplinary collaboration and intentional team-work. They show us how through professionalism and thinking intentionally about the why of their work can deliver enhanced access to services equitably in spite of immense and unforeseeable circumstances, as our public health system has experienced under the pandemic. Dr. Kavita Makan works as a rheumatologist at the Chris Hani Baragwanath Academic Hospital (Bara) in Soweto, Johannesburg. In addition to her contribution in her specialist field, her contribution towards the treatment and management of the Covid-19 pandemic has been immense for both the hospital and her patients. During the first wave of the Covid-19 pandemic, treatment options were limited mainly to supportive measures as well as ventilatory support available to patients. Dr Makan committed to searching for more effective treatment protocols in aiding and assisting her patients as the hospital braced itself for each wave of the Covid pandemic. Dr Makan was able to procure fairly “novel” therapies in the treatment of Covid as she secured a number of treatment doses of tocilizumab to be administered to patients who might otherwise have gone on to have severe and debilitating disease. This was a major breakthrough for the face of treatment in Covid-19 disease at Chris Hani Baragwanath Academic and a prime example of how Dr Makan stops at nothing to provide world class treatment to her patients. Professor Ziyaad Dangor is a paediatric pulmonologist from the suburb of Lenasia in the south of Johannesburg. He works with children and their families at the Chris Hani Baragwanath Academic Hospital (Bara) to treat and improve the respiratory health diseases experienced by young people. Working in one of the most challenging institutional environments in South Africa, Prof. Dangor rises to the occasion with passion, dedication and a solutions-driven attitude to provide excellent patient-care and service delivery. In the wake of the Covid-19 pandemic he was appointed to head the Covid-19 paediatric response team, and in doing so played a part in developing a model in which the vaccine roll-out program for healthcare workers would be implemented at the hospital. Through his intervention, and working with a multidisciplinary team of clinicians, Prof Dangor’s mass vaccination campaign for health workers was so robust and attuned to the various challenges experienced across the public health system, it framed the standard model for getting health workers in South Africa vaccinated. More than a clinician and a researcher, Prof. Dangor also teaches undergraduate and post-graduate students at the University of the Witwatersrand where he emphasises the values of humility, engagement and collaboration to his students. He is currently developing an open-access online undergraduate paediatric educational program that will be made available to healthcare professionals working in resource limited settings. Professor Dangor goes about his daily responsibilities with great pride, bringing hope to both the patients and his fellow medical practitioners. In an environment that is considerably under-resourced, harbouring its own set of unique challenges, he continues to be solution based.
