A CPUT academic has become the first person in South Africa to earn a PhD in Forensic Medicine and his work is helping to improve the forensic accountability with which emergency care providers respond to victims of gender-based violence.

A personal tragedy in 1995 inspired Dr Navindhra Naidoo, acting Head of the Emergency Medical Sciences Department, to pursue his field of research.

“My 19-year-old sister was murdered by an ex-boyfriend. I was still studying to be a paramedic at the time and realised that there was nothing in my curriculum that prepared me for that. It didn’t prepare us for screening, detecting or preventing these horrible things from happening.”

Naidoo said his key topic focused on gender-based violence, in particular, domestic violence, and sought to understand emergency care workers’ “current and potential response” to gender-based violence.

“What we found is that the current responses are deficient. It’s not that the rescuers don’t want to help. There’s a lot of ambivalence largely because there isn’t a sufficient referral system so the practitioners are not guided on where patients need to go and what kind of services might be available.”

Through a cohort design, he first looked at thousands of archived medical records and found that the detection rate of domestic violence or related kinds of gender-based violence, including cases of rape, was 5.1 patient contacts per 1000 female patients presenting to the Emergency Medical Services. A nine-fold increase in detection following the evidence-informed screening training and implementation translated to the detection of 47,9/1000 emergency care patients, with no adverse events. These rates are unprecedented for South African emergency care and support screening-policy implementation. The difference in domestic violence detection, quantifies the extent of the practice gap, with an alarming missed case detection of 42,8 per 1000 patients (females, 14 years plus).

In consultation with Stanford University, Naidoo developed a curriculum for the sensitisation of health workers and this was implemented in the Western Cape Emergency Medical Services.
The Health Professions Council of SA has since adopted the screening protocol.
“So about 70 000 practitioners are now ethically obligated by the HSPCA to routinely ask the question about the presence of violence in someone’s life and then to do a risk/safety assessment and provide the necessary support they might need,” says Naidoo. His work has also served, at the HPCSA, to position gender-based violence as a social determinant of health.

“What we are doing is using emergency workers as sentinels. No other person in the health service actually walks into someone’s bedroom, where the abuse occurs, to treat them in an emergency. The screening helps us to ask victims about the presence of violence and screen for risk, for example, whether there’s the presence of a firearm. When there is a risk, they can then advise the victim appropriately and enhance both public safety and practitioner responsivity.”

Written by Ilse Fredericks
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The Faculty of Health and Wellness Sciences recently welcomed a team from the Department of Higher Education and Training (DHET) to the Bellville campus as part of the Clinical Training Grant (CTG) visit.

The purpose of the visit was to evaluate the impact of the CTG that is allocated annually to fund clinical training in four of the seven departments in the Faculty, namely the Departments of Emergency Medical Sciences (EMS), Biomedical Sciences, Nursing Sciences and Medical Imaging and Therapeutic Sciences (MITS), said Lloyd Christopher, Head of the EMS Department.

The DHET representatives were welcomed by Prof Tandi Matsha, Dean of the Faculty, who presented an overview of the Faculty before the Faculty’s CTG presentation by Christopher.

They were then taken on a tour of the departments’ state of the art facilities, including the Biomedical Sciences lab, the MITS Department’s computer-simulated learning environment, known as VERT, the EMS Department’s skills labs, including the immersive clinical simulation centre which can replicate emergency scenarios and the Nursing Department’s skills lab, where they got to interact with a life-like manikin named Jonathan.

The Faculty is investigating ways in which the CTG can improve the students' experience of clinical training and welcomed the DHET representative support for these initiatives.   

Meanwhile, the Medical Imaging and Therapeutic Sciences Department recently accompanied representatives of the Health Professions Council of SA (HSPCA) on a clinical site visit.

Dr Merlisa Kemp, Head of the MITS Department, said that in order for a radiology practice or clinical site to accept students for training, they have to be accredited by the HPCSA.

“Members of the Radiography and Clinical Technology board (HPCSA) inspect the clinical site to determine if the practice is adhering to the HPCSA accreditations guidelines which allow the practice to accept students for training,” said Kemp.

“Accreditation refers to the approval and recognition of professional programmes of study by the accrediting body. It is the recognition of academic and clinical quality by an impartial body, in this instance, the HPCSA.”

 The four BSc programmes offered by the Department of MITS includes a theoretical and clinical component. Work-Integrated Learning is part of the programme where the student would be allocated to various clinical sites to gain experience in clinical training. The clinical training involves students conducting radiographic and sonographic examinations under the supervision of a qualified sonographer and/or radiographer.

“Accreditation of clinical sites allows for students to be clinically trained and fulfil the learning outcomes for the specific programme/s and be deemed clinically competent for the specific level of study.”

Written by Ilse Fredericks

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