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Dr Thozama Siyotula (37), a paediatric surgeon at Red Cross War Memorial Children’s Hospital, devotes her entire time daily to ensuring young patients receive the best treatment and their health is restored. She does it all with passion.
Siyotula’s day starts at 07:25 daily where she meets with the nursing staff to discuss cases that have been booked for theatre.
On Wednesday 26 July, a group of journalists had the opportunity to spend a day in the life of three surgeons at Red Cross War Memorial Children’s, Tygerberg and Groote Schuur hospitals.
About 55 000 surgeries are executed between these three hospitals annually.
August marks child health month and on Wednesday, Siyotula and a team of specialised surgeons performed a laparotomy to remove a tumour from a four-year-old patient’s kidney.
Siyotula says the tumour, known as the Wilms tumour is common among children. “The child was taken to theatre for a laparotomy, where we make a cut in the abdomen. Once inside the abdominal cavity we identified that the mass (a large body of matter with no definite shape) was there.
“In the process you have to move other structures out of the way; for example the intestines, and ensure that we don’t cause any injury to other structures such as the liver or the major blood vessels in this child and identify this tumour.”
She explains that the operation was challenging because of the position of the tumour.
“We have to take it (tumour) off its blood supply because it’s a tumour that involves a kidney. The kidney is supplied by certain vessels. We need to ensure that we tie off these vessels that supply the kidney and subsequently the tumour itself.”
“It was quite a big tumour – the size of a coconut. It started forming collateral vessels that were supplying the mass of the tumour. We needed to ensure that we were meticulous not to cause any major bleeding for this child. To ensure that, we take it off the major blood vessels of the body and don’t cause any injuries.”
Siyotula explains that the operation, which lasted a few hours, was successful. “The child did well in theatre. We didn’t have any major bleeding and went to ICU to recover. The child is recovering well. He is not on any supportive measures in terms of a ventilator. He was having breakfast a day after the operation.
According to the doctor, the patient will recover speedily.
“We are happy with the procedure. We were able to identify this child’s problem quickly. “We were able to get the child to the theatre quickly after admission and operated on after all the investigations were done.
“It was rewarding to see the tumour removed from the body with no complications and minimal bleeding and the child being up and recovering, having breakfast is really encouraging so that we can continue this work and offer safe surgery in our services.”
Siyotula, who has been in the medical field for about 12 years, says her role as a qualified specialist started more than a year ago at Red Cross. She says her curiosity for the paediatric profession was piqued as a child when her younger brother landed in a hospital.
“When my younger brother was admitted to the hospital with acute appendicitis, my experience of the hospital, service delivery and impact to restore health drew me to the possibility to want to become a part of changing children’s lives through surgery.”
A decision she does not regret making.
“I have an opportunity to wake up every day and deliver specialised health care to children in South Africa. A child’s resilience teaches me to never give up and continue to fight for the things I believe in and love. It is a privilege to work with children and in this institution.”
Siyotula believes teamwork in the theatre is imperative.
“Medicine is a team sport and collaboration is an important part of this. We are all goal-directed to ensure excellence in service delivery.”
The doctor describes paediatric surgery as a challenging field in medicine.
“The delay of children accessing our specialised service as a result of the delayed presentation, referral or transport limitations which may have an impact on the outcome, is a challenge. We also have a long waiting list for children who need surgeries.”
She explains that she would like to see more surgeons and supporting staff employed to meet the demand for surgical services of a growing population.
When asked what she sees for the future in surgery she says: “To impact change and hope in patients, their families and the health system. An increase in surgical access and care, improve global priority for children’s surgery and have effective governance structures and facilities.”
