Prof Salome Maswime wants to see the African community as a whole receive safe and timely surgical care, especially pregnant women.

She is an obstetrician, gynaecologist and Head of Global Surgery in the Department of Medicine at the University of Cape Town. 

‘Global surgery’ combines several disciplines to provide better and equitable surgical care. This is critical in Africa, where maternal mortality remains high.

When Maswime was a junior doctor, she lost a patient to anaesthetic complications, because she and her team did not have the skills to help. “These are skills that can be taught to medical officers and junior doctors — you don’t need to be a specialist,” she says. 

She says global surgery is about how to capacitate healthcare workers looking after patients, to make better and timely decisions. “These are simple, system issues,” she says.

Maswime turned to research to improve outcomes for mothers who undergo caesarean sections. She went on to become one of the first experts to establish global surgery as its own discipline in Africa. 

A key turning point for her was during her first few international meetings at the World Health Organization (WHO). “Suddenly I found myself in rooms where healthcare in Africa was being discussed, with hardly any people from the African continent in the rooms,” she says. 

Maswime realised then that there’s much to be done on health leadership and science in Africa. She says there are two key areas that the surgical community needs to do better on: understanding the patient, and engaging with the communities they serve.

“It’s one thing to operate on a woman with cervical cancer, to remove the uterus and to do all the major things. But has anyone stopped to ask patients, ‘how much do you know about pap smears?’ or ‘do you do pap smears routinely?’,” she says. Pap smears can help detect cervical cancer early, and earlier treatment can improve patient outcomes.

“Even within the hospital space, there’s a lot of things that we can do to improve the flow of work and to make our services accessible to many more people,” says Maswime. “But we often don’t tap into that because we are used to just using what is there.”

Maswime hopes the success of her ongoing work will one day be measured by concrete impacts on our complicated health systems, and by how much the surgical outcomes and life expectancy of African patients improve.

Prof Salome Maswime won the NSTF-SAMRC Clinician-Scientist Award for her contribution through research and its outputs over a period of up to 6 years of research work from the commencement of the research career, predominantly in SA, and focussed on work to enhance life and to improve the health of the community. This award is sponsored by the South African Medical Research Council (SAMRC). — ScienceLink

Read the special Mail & Guardian supplement about all the NSTF-South32 Award winners.

A contribution to new knowledge, skilled graduates and tools for better water management flows from the Centre for Water Resources Research (CWRR) at the University of KwaZulu-Natal.

“I think all of us recognise that water is probably the most critical resource in South Africa,” says the Director of the CWRR, Prof Jeff Smithers.

“We have for a long time been living with demand for water exceeding the supply and availability, and this has been exacerbated by deteriorating water governance and maintenance of water infrastructure, such as distribution networks and waste water treatment works. At the CWRR we are trying to narrow that gap, by developing improved water management practices and governance,” says Smithers.

As agriculture is the biggest user of water in South Africa, the CWRR puts significant resources into modelling water systems related to agricultural production, such as irrigation. They assess how land-use, climate change and catchment management impact on water availability and quality. 

Smithers says that through research and innovation, we can make improvements in water use efficiency, for example in irrigation, which would make water available to meet other demands.

The CWRR has done detailed modelling of water systems to estimate the impact of different tree species on runoff, and on the amount of water that fills up dams. “This estimate of the impacts of afforestation on runoff is currently being used by the Department of Water and Sanitation to determine charges for stream flow reduction caused by the forest industry.”

They’ve also looked into the potential impacts of climate change on crop yields and on the amount of water available from catchments. “There’s a lot of uncertainty given the range of predictions that are coming from different climate change models,” he says, “and the consequences vary across the country.

“What we really aim to do is to make sure we are generating new knowledge and improved understanding, in order to develop tools and data information systems that can be used by industry.”

Since 2012, a total of 63 Honours, 59 Master’s and 33 PhD students working on CWRR projects have graduated, with expertise in hydrology and related earth and engineering sciences.

“In terms of human capacity development, I think we’ve made a significant contribution,” says Smithers. “There has been a lot of new knowledge generated and capacity developed with postgraduate studies, giving us a new understanding of hydrological processes and water resources management.”

The Centre for Water Resource Research won the NSTF-WRC award for a contribution by an individual or an organisation towards sustainable water management, knowledge generation and solutions over the last 5 to 10 years. The award has been sponsored by the WRC since 2017.
— ScienceLink

Read the special Mail & Guardian supplement about all the NSTF-South32 Award winners.