Discovery Health has recently abandoned its efforts to reclaim roughly R170 million from 16 507 members following a widespread administrative error in processing medical claims. This happened after the successful intervention of the advocacy group MediCheck, which argued that the affected members were being unfairly penalised for a technical glitch which they had nothing to do with.
The glitch, which happened last year, resulted in over-reimbursement of certain medicine costs that occurred throughout 2025. Several specific technical and procedural issues were involved which caused the problem to grow undetected for nearly a year, as detailed by Moonstone.
The main error was that certain claims were incorrectly reimbursed at 100% of the Discovery Health Rate, regardless of the specific benefit limits that should have applied to those categories, when they should have been reimbursed at a lower rate.
Because these claims were incorrectly reimbursed at higher rates, they were inaccurately accumulated towards members’ benefit thresholds. This caused members who had Above-Threshold Benefit (ATB) as part of their plan to reach it prematurely. Upon reaching the ATB, subsequent medical claims were funded by the scheme. Normally, these claims would have been covered by the members’ medical savings accounts or out-of-pocket contributions.
Delayed detection allowed the problem to grow. The error was particularly difficult to identify because it was a “second-order impact”. The systemic failure only became apparent late in the year when members began reaching the ATB and the financial discrepancies were finally flagged.
This snowballing error eventually affected some 16 507 members on specific Executive, Comprehensive, and Priority plans. While Discovery Health initially sought to recover these funds, ranging from thousands of rand to as much as R80 000 per member, the Council for Medical Schemes stepped in to exert pressure amid widespread media coverage of the situation. Discovery gave in and committed to refunding any recovered funds and absorbing the total financial loss itself – estimated between R130 million and R170 million.
Hyundai Automotive South Africa reaffirmed its commitment towards embedding disability inclusion into its operations, through continuous disability-related employee training, improving dealership layouts and vehicle modifications.
The aim is to foster a culture that recognises disability as part of human diversity rather than a limitation. “Mobility is not just about getting from one point to another, rather, about access and dignity,” said Stanley Anderson, CEO of Hyundai Automotive South Africa.
“Our commitment is to ensure our vehicles and dealerships are adequately prepared to support the needs of all customers, including those with disabilities. More importantly, we want to empower our customer-facing employees with deeper understanding of disability, dismantle misconceptions. By so doing, we will ensure that customers with disabilities feel welcomed, respected and supported when visiting any Hyundai dealership.”
It has also implemented a range of practical measures to ensure its dealerships are physically accessible and welcoming to persons with disabilities. This includes improving dealership layouts for ease of movement, ensuring wheelchair-friendly access points.
The company works closely with a range of specialised suppliers who modify some of its vehicles to suit the mobility needs of persons with disabilities. “These partnerships ensure that more South Africans can access safe, reliable and custom-adapted mobility solutions suited to their lifestyles and independence,” stated Christine Masinga, Human Resources Director at Hyundai Automotive South Africa.
The national disability prevalence rate in South Africa is estimated at around 7.5%. Despite national government targets for 2% representation of persons with disabilities in workplaces, recent reports indicate that they comprise less than 1% of the total employees across both government and private companies.
According to the Department of Employment and Labour, eight out of ten disabled persons are unemployed nationally, which is significantly higher than the general unemployment rate.
Inspiring South Africa to Support Mobility, Inclusion and the Power of Possibility
Össur South Africa‘s Team 1: Rentia Retief & Travis Warwick-Oliver
Össur South Africa is proud to announce the launch of the 2026 ‘What’s Your Epic?’ campaign, an initiative that champions one simple truth: everyone deserves the freedom to move. As the world turns its attention to the Cape Epic from 15 – 22 March 2026, Össur is once again harnessing this global stage to drive awareness, spark action, and rally support for mobility access across South Africa.
Following the success of last year’s inaugural campaign, Össur South Africa has entered three amputee teams into the 2026 Cape Epic, one of the world’s most iconic and demanding mountain biking events. These six remarkable riders embody grit, courage, and the unbreakable belief that mobility transforms lives. Their mission is bigger than the race: to unlock meaningful support and funding for three exceptional non-profit organisations: Jumping Kids, Zimele and Rejuvenate SA.
“Movement is a fundamental right, not a privilege reserved for the few,” says Blignaut Knoetze, Managing Director of Össur South Africa. “Whether you’re an elite athlete, a child receiving their first prosthetic or an adult rebuilding independence; mobility unlocks dignity, participation, and potential. ‘What’s Your Epic?’ is our call to South Africa to stand with us in supporting organisations who make this freedom possible.”
The 2026 campaign aims to raise funds and awareness for four organisations driving mobility access and inclusion:
Jumping Kids: Providing quality prostheses, education access, and sport opportunities to children living with limb loss, giving them the tools to build confident, successful futures.
Rejuvenate SA: Founded on the belief that movement is a basic human right, Rejuvenate SA supplies mobility aids to those who cannot afford them, restoring dignity and independence.
Zimele: Meaning “independence” in Xhosa, Zimele supports adults with physical disabilities to regain control over their lives, reintegrate into society and build economic self-sufficiency.
Together, these six athletes across three teams are redefining what’s possible.
Team 1: Rentia Retief & Travis Warwick-Oliver
Rentia (33, Somerset West), an artist and amputee athlete, who survived a cycling accident in 2023. Her journey is a testament to courage and the belief that mobility is a right every person deserves. Partnering with her is Travis (32, Durban), founder of Rejuvenate SA, adaptive athlete, and two-time UTMB finisher who has transformed his own amputation into a mission to help others move freely and live without limitations.
Team 2: Mhlengi Gwala & Kean Dry
Mhlengi (34, Durban), an international para-triathlete and multiple African champion who continues to defy all odds after a 2018 attack that led to the amputation of his right leg. Riding alongside him is Kean (30, Cape Town), a dedicated endurance athlete and community motivator whose story of resilience inspires thousands to believe that adversity does not define possibility.
Team 3: Brian Style & Rudi Joubert
Brian (40, Springs), a passionate cyclist who has rebuilt his life through mountain biking, uses sport as a platform for giving back. He rides with Rudi (42, Secunda), a determined amputee athlete known for his positivity, teamwork, and commitment to raising funds for mobility solutions.
“These riders are not just racing, they are raising their voices for those who cannot and shining a spotlight on organisations that restore dignity, independence, and hope,” says Knoetze. Össur South Africa is inviting the public, corporates, partners, and communities to be part of this extraordinary movement. Whether through donations, corporate partnerships, fundraising initiatives, or simply sharing the message, every contribution helps someone stand, walk, run, play, work, or dream again.
“‘What’s Your Epic?’ is about pushing boundaries; not just on the bike, but in society,” adds Knoetze. “When we support mobility, we support access. We support inclusion. We support futures. We are asking South Africa to back our riders, our NPOs, and the belief that everyone deserves the freedom to move.”
Donate, fundraise, or get involved as an individual and/ or company. Your support can help someone take their first step, return to work, join a sport, or believe in possibility again. Össur Donations, ABSA Bank, Account number: 4123 215 542, Branch code: 632005 Reference: company name and contact number
Please contact Amelda Potgieter (apotgieter@ossur.com) for more information and/ or Section 18A certificates.
This is more than a race. It’s a movement. What’s your Epic?
Catalan Atlas, 1375. Credit: Bibliothèque Nationale de France, via Wikimedia Commons
Clues contained in tree rings have identified mid-14th-century volcanic activity as the first domino to fall in a sequence that led to the devastation of the Black Death in Europe.
Researchers from the University of Cambridge and the Leibniz Institute for the History and Culture of Eastern Europe (GWZO) in Leipzig have used a combination of climate data and documentary evidence to paint the most complete picture to date of the ‘perfect storm’ that led to the deaths of tens of millions of people, as well as profound demographic, economic, political, cultural and religious change.
Their evidence suggests that a volcanic eruption – or cluster of eruptions – around 1345 caused annual temperatures to drop for consecutive years due to the haze from volcanic ash and gases, which in turn caused crops to fail across the Mediterranean region. To avoid riots or starvation, Italian city-states used their connections to trade with grain producers around the Black Sea.
This climate-driven change in long-distance trade routes helped avoid famine, but in addition to life-saving food, the ships were carrying the deadly bacterium that ultimately caused the Black Death, enabling the first and deadliest wave of the second plague pandemic to gain a foothold in Europe.
This is the first time that it has been possible to obtain high-quality natural and historical proxy data to draw a direct line between climate, agriculture, trade and the origins of the Black Death. The results are reported in the journal Communications Earth & Environment.
The Black Death was one of the largest disasters in human history. Between 1347 and 1353, it killed millions of people across Europe. In some parts of the continent, the mortality rate was close to 60%.
While it is accepted that the disease was caused by the bacterium Yersinia pestis, which originated from wild rodent populations in central Asia and reached Europe via the Black Sea region, it’s still unclear why the Black Death started precisely when it did, where it did, why it was so deadly, and how it spread so quickly.
“This is something I’ve wanted to understand for a long time,” said Professor Ulf Büntgen from Cambridge’s Department of Geography. “What were the drivers of the onset and transmission of the Black Death, and how unusual were they? Why did it happen at this exact time and place in European history? It’s such an interesting question, but it’s one no one can answer alone.”
Büntgen, whose research group uses information stored in tree rings to reconstruct past climate variability, worked with Dr Martin Bauch, a historian of medieval climate and epidemiology from the Leibniz Institute for the History and Culture of Eastern Europe, on the study.
“We looked into the period before the Black Death with regard to food security systems and recurring famines, which was important to put the situation after 1345 in context,” said Bauch. “We wanted to look at the climate, environmental and economic factors together, so we could more fully understand what triggered the onset of the second plague pandemic in Europe.”
Together, they combined high-resolution climate data and written documentary evidence with conceptual reinterpretations of the connections between humans and climate to show that a volcanic eruption – or series of eruptions – around 1345 was likely the first step in a sequence that ultimately led to the Black Death.
The researchers were able to approximate this eruption through information contained in tree rings from the Spanish Pyrenees, where consecutive ‘Blue Rings’ point to unusually cold and wet summers in 1345, 1346 and 1347 across much of southern Europe. While a single cold year is not uncommon, consecutive cold summers are highly unusual. Documentary evidence from the same period notes unusual cloudiness and dark lunar eclipses, which also suggest volcanic activity.
This volcanically forced climatic downturn led to poor harvests, crop failure and famine. However, the Italian maritime republics of Venice, Genoa and Pisa were able to import grain from the Mongols of the Golden Horde around the Sea of Azov in 1347.
“For more than a century, these powerful Italian city-states had established long-distance trade routes across the Mediterranean and the Black Sea, allowing them to activate a highly efficient system to prevent starvation,” said Bauch. “But ultimately, these would inadvertently lead to a far bigger catastrophe.”
The ships that carried grain from the Black Sea most likely also carried fleas infected with Yersinia pestis, as previous research has already pointed out. But why grain was so urgently needed by the Italians has now become much clearer. It is still unknown exactly where this deadly bacterium originated, but ancient DNA has suggested there may have been a natural reservoir in wild gerbils somewhere in central Asia.
Once the plague-infected fleas arrived in 14th-century Mediterranean ports on grain ships, they became a vector for disease transmission, enabling the bacterium to jump from mammalian hosts – mostly rodents, but potentially including domesticated animals – to humans. It rapidly spread across Europe, devastating the population.
“In so many European towns and cities, you can find some evidence of the Black Death, almost 800 years later,” said Büntgen. “Here in Cambridge, for instance, Corpus Christi College was founded by townspeople after the plague devastated the local community. There are similar examples across much of the continent.”
“And yet, we could also demonstrate that many Italian cities, even large ones like Milan and Rome, were most probably not affected by the Black Death, apparently because they did not need to import grain after 1345,” said Bauch. “The climate-famine-grain connection has potential for explaining other plague waves.”
The researchers say the ‘perfect storm’ of climate, agricultural, societal and economic factors after 1345 that led to the Black Death can also be considered an early example of the consequences of globalisation.
“Although the coincidence of factors that contributed to the Black Death seems rare, the probability of zoonotic diseases emerging under climate change and translating into pandemics is likely to increase in a globalised world,” said Büntgen. “This is especially relevant given our recent experiences with Covid-19.”
The researchers say that resilience to future pandemics requires a holistic approach to address a wide spectrum of health threats. Modern risk assessments should incorporate knowledge from historical examples of the interactions between climate, disease and society.
The research was supported in part by the European Research Council, the Czech Science Foundation and the Volkswagen Foundation.
October is Breast Cancer Awareness Month, and what better way to celebrate than with floral elegance, an exquisite high tea, motivational speakers, and a live auction – all in the spirit of hope and healing.
On Saturday morning, 25th October 2025, at 11 am, PinkDrive will host their Hope Blooms High Tea at the Radisson Blu Hotel, Durban Umhlanga, a time of spring celebration and impactful fundraising. And you’re invited!
PinkDrive is a non-profit organisation (NPO) committed to prolonging lives through early detection of gender-related cancers. They operate mobile health units – those iconic pink trucks – that travel to rural and township areas to provide essential screenings to those who lack or have limited access to adequate healthcare.
Recent Rio Tinto outreach statistics highlight the urgent need for such interventions. In just one week in KwaZulu-Natal, 2251 health services were rendered, including 146 mammograms and 141 clinical breast examinations.
PinkDrive receives no government funding, relying entirely on donations, corporate partnerships, and community support to sustain its essential work. Among these partners is Lee-Chem Laboratories through their Mandy’s brand.
“This cause is deeply important to us – we’ve proudly supported PinkDrive for many years as a long-term corporate partner because of the difference they make in communities that need it most,” says Bhavna Sanker, Marketing Manager at Lee-Chem Laboratories. “It is a privilege to stand alongside them in their efforts to promote early detection and prolong lives. The Hope Blooms fundraiser perfectly reflects our shared commitment to raising awareness, providing crucial screening, and ultimately bringing hope where it’s needed most,” she explains. “We therefore want to encourage the public to also get involved by purchasing a ticket and enjoying an uplifting morning in support of PinkDrive’s vital work.
According to Janice Benecke from PinkDrive, corporate sponsors and partnerships, like that of Mandy’s, enable them to deliver this essential community service. “Mandy’s has been a proud supporter of PinkDrive for many years, generously providing branding, hampers, and product samples, along with an annual donation,” she says. “Through sponsored events like Hope Blooms, we hope to inspire further partnerships and support for our mission.”
Dr Marion Algar, Clinical Oncologist at Hopelands Cancer Centre specialising in breast cancer treatment, and Advocate Pria Hassan, founder of Women of Africa and champion of accessible healthcare through initiatives like iBreast, will share their insights as guest speakers. The elegant affair will be hosted by the lovely Delia Kroll, Mrs SA 2024 finalist, and attendees can also look forward to a welcome drink, networking opportunities, raffle prizes, gift bags, and an exciting live auction. Proceeds will go towards supporting PinkDrive’s free services, including clinical breast examinations, education, pap smears, and funding toward a new mammogram truck. Last year’s event raised R25 000; this year’s goal is to double that amount through your support.
“Hope Blooms reflects the courage, resilience, and renewal that come with a breast cancer journey,” notes Benecke. “Just like flowers that bloom after winter, it’s a reminder that through awareness, support, and love, hope always finds a way to grow.”
She concludes: “We want everyone to leave with this key message, and it’sa motto that I live by: ‘Only Believe, All Things Are Possible.’ Just look at me, I am a walking miracle.”
Tickets are R695 per person with a floral dress code. 10% of proceeds go directly to PinkDrive, and bookings can be made at info.durban.umhlanga@radissonblu.com. So why not consider purchasing a corporate table, inviting members from your sports or social club, or coming along with friends to enjoy a morning of elegance and purpose?
Every day for ten years, Surgeons for Little Lives has stood beside children and families, providing life-saving care and support.
Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives at the Chris Hani Baragwanath Academic Hospital paediatric surgery department
For the past ten years, Surgeons for Little Lives has stood as a lifeline for thousands of children at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto – the largest hospital in the southern hemisphere. In a healthcare system often stretched to its limits, this dedicated non-profit organisation has filled critical gaps with compassion, resilience and an unwavering belief that every child deserves the best possible care.
Since its founding in 2015, Surgeons for Little Lives has walked hand-in-hand with doctors, nurses, patients and families, not only providing vital resources but transforming the hospital experience for young patients. From upgrading surgical wards and equipment, to nurturing the next generation of paediatric specialists and creating welcoming, family-friendly spaces that offer comfort in the darkest moments – its work has made healing more than just a medical process. It’s become a human one.
“Our first ten years have shown what’s possible when people come together with one shared purpose: to save and uplift the lives of children,” says Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives. “We are deeply proud of what has been accomplished – but we know the need is growing. That’s why we will continue, every single day, to build capacity, inspire future leaders, and give every child a fighting chance at a brighter future.”
Why this work matters
South Africa has one of the highest burdens of paediatric surgical disease in the region. Children make up nearly 40% of the population, yet there are too few specialists and limited facilities to meet the demand. Severe burns, congenital conditions, childhood cancers and trauma are common, and without surgery many children would not survive.
At CHBAH alone, the paediatric surgery department sees more than 11,000 patients each year and performs over 2,300 operations. Surgeons for Little Lives works closely with the Department of Health to turn overstretched wards into spaces where children can recover with dignity.
3,650 days of achievement
Hospitals can be intimidating places for children. Surgeons for Little Lives has transformed the hospital environment with projects like an outdoor play area for recovering patients, family sleep-over facilities, and a fully revamped Ward 32 with a library, playroom, and upgraded bathrooms. Most recently, the organisation launched the Wells Paediatric Burns Unit, which doubled ICU beds, improved infection control, and added rehab spaces. For families, these changes mean children receive life-saving surgery and care in an environment designed with their needs in mind.
Beyond facilities, Surgeons for Little Lives has created programmes that focus on children’s emotional and physical wellbeing. Healing Through Art & Music gives young patients a way to process trauma through creativity and the SCAN programme, launched in 2023, helps to detect and prevent child abuse. In partnership with the South African Breastmilk Reserve, Surgeons for Little Lives also set up lactation support for new mothers. Other practical initiatives – from discharge packs to Mandela Day donations – have provided small comforts that make a big difference in long hospital stays.
Training for the future
Paediatric surgeons are scarce, and training takes years. Over the past decade, Surgeons for Little Lives has supported the journey of 17 qualified surgeons and backed another 15 registrars currently in training, supplying equipment like surgical loupes and funding access to academic opportunities. In 2024, the first Rolls Royce Oncology Fellow, Dr Andinet Beza from Ethiopia, trained at CHBAH before returning home with new skills. “This initiative, along with other training efforts, is helping to build the next generation of paediatric surgeons equipped to deliver world-class care. Training these specialists is a responsibility we take seriously and a privilege we don’t take for granted,” says Prof Loveland.
Community and partnerships
Community engagement has been central to the success of Surgeons for Little Lives. Fundraising events such as Bara Ride and Joberg2C, together with job shadowing opportunities for young people, have brought South Africans closer to the realities of paediatric care. Volunteers and donors provide not just resources but also comfort to families who spend weeks or months at a child’s bedside.
“This impact has only been possible thanks to the support of partners,” says Prof Loveland. “Contributions from corporates, foundations, and philanthropists have funded essential equipment, upgraded facilities, supported family-centred programmes, and helped fill critical gaps in care, ensuring that more children receive the treatment they need.”
10 years in numbers
11,000+ patients seen in the paediatric surgery department each year
2,300+ operations performed annually at CHBAH
3,000+ burns patients treated since 2015
Mortality halved in the burns unit after upgrades
ICU beds increased from 6 to 11 in 2025
17 paediatric surgeons trained; 15 registrars in training
Hundreds of families supported with sleep-over spaces, counselling, lactation services and more
Join us
Surgeons for Little Lives invites supporters, partners and the wider community to join in building the next chapter. By funding new projects, volunteering time or raising awareness, everyone can help ensure that more children get the surgery and support they deserve.
For its 10th anniversary, the organisation is calling on the public to donate R365 – one rand for every day of the year. In hospital that amount can cover burn dressings for a child, a week of meals for a parent at their child’s bedside or supplies for play therapy to make recovery less frightening, among many other things.
Dr Deidre McPherson is one of ten women trauma surgeons in South Africa’s public healthcare sector. (Photo: Discovery Foundation)
By Biénne Huisman
Groote Schuur Hospital in Cape Town has one of the busiest emergency centres in the Western Cape. As it turns to the public to raise R20 million for the opening of a new emergency centre, Dr Deidre McPherson chats to Spotlight about the hospital’s trauma frontline.
Deep into the night while most of Cape Town is asleep, trauma surgeon Dr Deidre McPherson slips into work scrubs, hitting the highway to Groote Schuur Hospital to save the lives of critically injured patients.
In a boardroom next to the hospital’s Trauma Centre, McPherson details her solitary early-morning drives along the deserted N1 highway to perform life-saving surgery on people hurt in road accidents, gang violence, and other incidents.
She says she is called out from her home in Bellville past midnight at least once or twice a week. “It’s a surreal feeling,” she says. “I mean driving alone while the rest of the world is sleeping. By now, my husband is used to me leaving at weird times and coming back at like 03:00 or 05:00.”
In South Africa, trauma surgery only became a defined sub-speciality in 2008, meaning a formal training pathway for trauma surgery as its own discipline was created. Trauma surgeons are trained to manage multi-system injuries.
McPerson explains: “We are there at the most crucial moments, when life hangs in the balance. For me, there is nothing more rewarding than seeing a patient arrive critically injured, and walk out the hospital three weeks later, back to their lives.”
R20 million to equip new emergency centre
A new state-of-the-art emergency centre, which includes a new trauma centre, is being constructed at Groote Schuur, beside the existing facility. While it is set to open in 2026, hospital executives are turning to the public for R20 million in additional funding to fit the new premises with upgraded equipment.
As part of the fundraising drive, healthcare professionals recently took journalists on a candid tour of the existing facilities. Inside, corridors are clean but with linoleum floors peeling in places; some patients on trolley beds are stationed against walls, indicating wards filled to capacity.
Just beyond a sign that reads “C14 Welcome to Trauma Centre” – with translations in Afrikaans and isiXhosa – McPherson points out the trauma centre’s resuscitation ward, which can hold six intubated patients, she says. One recent admission can be seen on life support.
Increased capacity and privacy for critically injured patients
McPherson says the new facility will have a more spacious assessment or triage area, where staff decide which patients require immediate life-saving care and which can safely wait.
She says the new trauma centre will expand capacity across all three colour-coded wards. The resuscitation ward (red) will increase from six to ten beds. “This is severe trauma, for example [patients involved in] a motor vehicle accident, with head injury, chest injury and fractures needing life support”. The intermediate ward (yellow) will increase from 12 to 16 beds. “This is moderate trauma, for example, [patients with] multiple fractures, but stable”. The minor ward (green) will increase from 12 to 14 beds. “This is minor trauma for example, [patients with] cuts, bites and bruises – the walking wounded”.
Through the public funding drive, they hope to upgrade the computer system, buy more mobile ventilators for critically injured patients, and get a new full-body X-ray machine for rapid imaging in seconds, which McPherson says is “critical for assessing multiple gunshot or high-impact injuries”.
She says that the centre’s current computer has been in use for over 15 years and frequently stalls. “Sandy, our secretary, is on the phone to IT every second week,” McPherson says, adding that it isn’t necessarily dangerous but that it’s very frustrating. “Time matters so much in trauma,” she emphasises.
In addition, there are lighting issues in some of the examination rooms, with doctors occasionally having to do sutures by headlamp or the flashlight on their phone, McPherson says.
A woman in a male dominated field
During our follow-up interview in the boardroom, McPherson’s gestures are soft, framing her words. Her eyes are level, her cadence precise and unaffected. At present, she is one of ten women trauma surgeons in South Africa’s public sector, compared to 22 men. She is the only woman of four trauma surgeons at Groote Schuur’s trauma centre, which is led by Professor Andrew Nicol.
“Surgery has always been male-dominated and even more so sub-specialties like trauma,” says McPherson. “I was discouraged from following this path by colleagues and even family. This is not a career for women, they said. What if I have a family? The hours are so unpredictable. And there are the violent things we see each day…”
But she was determined. For McPherson, it was a calling, a job she loves. “it doesn’t feel like work,” she says.
Road accidents and gang violence
On average, 1000 patients are admitted to Groote Schuur’s trauma centre per month. Critical injuries, particularly road accidents, spike around Easter, on public holidays, on pay day, and in December, she says. She suggests semigration to Cape Town has seen an additional traffic burden and increased road accidents. Another major contributing factor is accidents involving delivery motorcycle drivers.
In addition, August and September this year have seen a marked month-on-month increase in gunshot wounds, McPherson says, with up to three patients with firearm injuries admitted each day.
“On particularly violent days, that number can rise to as many as 10 patients in 24 hours,” she says.
“What is particularly striking is not just the frequency, but the severity. These are not single gunshot wounds – we often see patients who have sustained multiple injuries, sometimes up to 20 bullet wounds at once.”
This echoes damning murder statistics recently quoted in The Guardian, which notes six people aged from 19 to 25 shot dead over two days in Wallacedene and Eikendal, on the Cape Flats.
Responding, McPherson says: “Sadly what is described in The Guardian is not an isolated incident – it is our daily reality. At Groote Schuur Hospital, we feel that burden first-hand. Every day we are treating teenagers and those in their twenties – who should be building their futures, not fighting for their lives – in our resuscitation bays.”
The latest crime statistics from the South African Police Service lists four precincts on the Cape Flats among the country’s five police stations with the highest murder rates. From January to March this year, Delft had 66 murders, Mfuleni had 65, Nyanga had 63, and Philippi East had 59. This is topped only by Inanda in KwaZulu-Natal which had 74 murders. In each of the last three years over 25 000 people were murdered in South Africa.
This constant cycle of violence is devastating and disheartening, she says, particularly “the high rate of recidivism – when patients return again and again with new injuries”.
For McPherson, cases linked to gender-based violence are especially disturbing. “And yet, as trauma surgeons, we try to focus on what we can do in those critical moments: stop the bleeding, repair the injuries, and give our patients a second chance at life.”
Are there any solutions?
Ultimately, McPherson says the real solution to trauma lies “upstream” in prevention.
“This means tackling the drivers of violence: unemployment, poor housing, failing schools, and the lack of opportunities that trap so many young people in cycles of crime and despair. It also means building safer communities through stronger policing, a justice system that works, and meaningful gun control laws to reduce the number of firearms circulating in our neighbourhoods,” she says.
Then there is preventable road accidents.
“Road traffic injuries remain one of the leading causes of admissions to our unit. As we move into the festive season, I want to urge the public to take responsibility for one another: do not drink and drive, wear seatbelts, and slow down on the roads. These are simple actions that can save lives,” she says.
To this end, she points out the importance of South Africa’s “Arrive Alive” campaign which aims to decrease the number of lives lost on the country’s roads through raising public awareness of road safety. Western Cape officials estimate that 139 people died in road accidents in the province between 1 December 2024 and 11 January 2025, with 627 arrests made for drunk driving.
Childhood inspiration
Born in Bellville to parents who worked in education, the eldest of three sisters, McPherson’s interest in medicine started early, fuelled by a weekly booklet series called How My Body Works. “It was out every Friday, I couldn’t wait for it to arrive. These booklets sparked my fascination with biology and science and it has stayed with me ever since. I still have them at home, packed away in a box,” she says.
McPherson matriculated at Settler’s High School in Parow and studied medicine at Stellenbosch University. She completed her internship at Tygerberg Hospital with a community service year in Atlantis, on the West Coast, where she first saw “how daily violence devastates young people”.
A mother to three-year-old twins, a boy and a girl, McPherson scrolls on her phone to her WhatsApp profile picture, which features her children dressed up in tiny doctor’s scrubs – pink and blue – each with a tiny stethoscope. “It was ‘career day’ so we chose outfits that was easy,” she says, smiling.
McPherson, who also counts a PhD on her resume, says she has processed pangs of “mum guilt” for her children. “My husband has been a constant pillar of support,” she says.
“Plus, I am happy and fulfilled, my children are growing up with a happy mother – but yes, it’s a juggling act, sometimes I have to decide which ball to drop. Is it a rubber ball, that will bounce back, or a glass ball that might shatter?”
To relax, she says she likes to read “sappy romantic fiction” like novels by Danielle Steele.
On her future radar? Becoming a full professor.
In the meantime, McPherson says she believes every encounter is an opportunity to make a difference. “We don’t just treat the injuries, we also try to offer support and counselling, hoping that this time might change the trajectory of a life,” she says.
Dr Saul Kaplan (left) stands next to Dr Kenny Beck, with mother Zukiswa Panyaza as her baby receives a full leg cast at the clubfoot clinic in Tygerberg Hospital’s Division of Orthopedic Surgery, while medical students observe. (Photo: Sue Segar/Spotlight)
By Sue Segar
When Karen Mara Moss’s son was diagnosed with clubfoot, she travelled to the US in search of a life-changing treatment. She made a promise to bring it home and two decades on, her non-profit is at the heart of a remarkable success story.
“I looked at those tiny feet. They were turned over and rigidly pointing inwards,” recalls Karen Mara Moss about the day her son Alex was born in 2003.
For her, the memory is as vivid today as it was then. Within moments of his birth, a concerned obstetrician commented on Alex’s feet. Then the paediatrician diagnosed Alex with bilateral clubfoot, a condition in which a baby is born with one or both feet twisted inward and downward.
“I remember thinking: Will he walk with a limp? Will people mock him?” Moss tells Spotlight. “It was a traumatic time.”
She says the paediatrician told her not to worry. “He said they’d have to cut his feet and straighten them, and it would all be perfect,” says Moss.
Despite having several prenatal scans and tests, the condition had not been picked up before birth.
The most common form of clubfoot present at birth is idiopathic clubfoot, medically known as talipes equinovarus. It is when a baby’s foot is pointed in and down because the tissues connecting the muscles to the bone are shorter than usual, leading to pain and reduced mobility if left untreated, according to a review study published in The Lancet medical journal. In most cases, the cause of this congenital anomaly which ranges from mild to severe, is unknown, baby boys are twice as likely to be born with clubfoot as baby girls, and about half of children with clubfoot have it in both feet. Globally, an estimated 176 000 babies are born with the condition every year.
Eight days after Alex was born, Moss says she met with a paediatric orthopaedic surgeon. She says he told her he’d fixed many clubfeet using the Kite method and even had one patient playing first-team rugby. The Kite method was developed in the 1930s and uses manipulations and castings to achieve a sequential and gradual full correction of the forefoot, then the hindfoot, and finally, the ankle. After the casting is done, the baby wears a special splint to keep the feet pointing slightly outward and upward, but, critically, many would also require further surgery.
Back then, the standard of care for clubfoot was surgical management, says Dr Pieter Maré, an orthopaedic surgeon who heads up the clubfoot clinic at Greys Hospital in Pietermaritzburg, Kwazulu-Natal. “The reality was that a large number of children required extensive surgery before the Ponseti method,” he says.
Moss followed the doctor’s advice, and during that first appointment, she says he began applying casts up to Alex’s knees. “He started wrenching Alex’s foot, holding the back, whilst pushing the front of the foot, and plastering the foot. Alex was blue in the face from screaming. I was crying while holding him down,” she says.
Another way
But after two months and seven casts, she says there was little improvement in Alex’s feet. That is when Moss began searching for answers herself. Doing research on the internet, she discovered the University of Iowa Children’s Hospital website, where she read about a technique developed by Dr Ignacio Ponseti, which he claimed could help children have pain-free, functional feet without surgery.
The Ponseti method was developed in the 1950s but only became more widely used in the United States in the 1990s, and later in much of the rest of the world. The technique uses gentle manipulations and plaster casts to correct the midfoot, hindfoot, and forefoot simultaneously, while the ankle is treated afterwards. In some cases, before the last cast is applied, it may require a percutaneous tenotomy which is a minimally invasive procedure to cut the heel cord that is resistant to stretching. A brace is then fitted the same day as the last cast is taken off.
“The Kite method was developed to correct clubfoot but over time it was realised that this method was using the wrong anatomical methods,” explains Professor Anria Horn, a consultant orthopaedic surgeon at the Red Cross Children’s Hospital in Cape Town.
“There are multiple joints in the foot and the Kite method was, effectively, manipulating the wrong joint in an attempt to bring about the correction in the foot. Ponseti discovered that the manipulation should occur at a different joint,” she says.
Back in 2003, Moss emailed Ponseti, and a few days later called his office. “I was put through to a man with a Spanish accent. He said he’d read my email, and that he’d seen the photos I sent of my son’s feet; that what we’d done was not the way his method worked. He suggested I go to Iowa because nobody in South Africa was practising his method,” she says.
Not long after this, Moss and her husband travelled with ten-week-old Alex for 10 000 miles from sunny South Africa to an unseasonable snowstorm in Iowa.
The idea of travelling to a foreign country to see a “special” doctor that one read about on the internet, with a treatment carrying his name, may raise red flags for some. There are after all no shortage of quacks out there exploiting vulnerable people with just this type of story of an underutilised treatment. Ponseti, however, was a serious scientist and, even by 2003, his method had performed well in several studies and had been quite widely adopted by doctors in the United States.
Moss says in that first visit, Ponseti eventually did a cast all the way up Alex’s leg. “He looked like a little turtle with his legs sticking out. By the time he’d done the second cast, Alex was asleep,” Moss recalls.
“Dr Ponseti’s normal protocol was to remove the cast every week, then re-manipulate the foot into a different position, and reapply the cast. For out-of-town patients, he accelerated the treatment and changed the cast every five days,” she adds.
After just one cast, Alex’s foot looked different, says Moss. “They did another cast, and five days later, it was time for the third cast. Dr Ponseti took the second cast off and then did the percutaneous tenotomy, as well as the third and final cast.”
After this procedure and with Alex now in his final casts, they were told they could return to South Africa and take the casts off three weeks later. Moss said an orthotist measured Alex’s feet before the tenotomy and gave her instructions on how to fit the clubfoot brace he would wear for four years while sleeping.
Three weeks later, back home, Moss soaked the casts off and started to put the brace on at night. She says Alex’s feet were straight.
‘A parting gift’
On her final day in Iowa, Moss recalls Ponseti telling her: “You’re the first South African that’s ever been here. Please go back home and tell the doctors not to operate on clubfoot”. He gave her his book, copies of his research papers, and CDs demonstrating his casting method – a parting gift that would shape the course of her life.
Determined to share her what she had learnt, Moss created a website to provide information on clubfoot. The website gained traction and soon she started getting requests from parents across southern Africa for help to access the Ponseti method.
At the time, Moss says she knew of only one doctor using the method, whom she recommended parents consult. “I’d met him soon after my return to South Africa in 2003 and had lent him Dr Ponseti’s book and papers. He’d then gone to the US to attend a Ponseti training workshop and started using the method. I was sending everyone to him.”
The founding of STEPS
Moss realised the best solution was to bring the training directly to South Africa. In 2005, despite having no experience in running a non-profit organisation, she founded STEPS, driven by her commitment to introduce the Ponseti method across the country.
Moss says STEPS held its first two-day Ponseti training course in 2006, with about 60 paediatric orthopaedic surgeons attending. “Three Ponseti experts came from Canada, Brazil and the UK to give the training. They taught a lot of theory and used bone models to demonstrate the method,” she says.
The second STEPS Ponseti workshop in 2007 focused on public health facilities. Moss says the training took place at the Charlotte Maxeke Johannesburg Academic Hospital.
Partly due to the workshops, partly due to the strength of the accumulating scientific evidence, the method caught on in the country. In 2012, the South African Paediatric Orthopaedic Society officially endorsed the method. A Cochrane Review published in the same year found that, while the available evidence was far from complete, it did indicate that the method works well. Cochrane Reviews are a highly regarded type of study that attempts to assess evidence from all randomised clinical trials relating to a specific medical question.
“The Ponseti method has become the gold standard for the treatment of idiopathic clubfoot,” stated an article published in the World Journal of Orthopedics in 2014. And according to the Lancet study cited earlier, “the Ponseti method is widely recognised as an effective conservative treatment approach for clubfoot that avoids corrective surgery in over 90% of cases”.
Today, Horn says the Kite method isn’t used in South Africa any more, having been replaced by the Ponseti method. “STEPS has played a big part in promoting the Ponseti method in South Africa, as well as providing training, workshops and conferences and supporting clubfoot clinics across the country. Our job would have been much harder without the support that STEPS provides,” she adds.
Ponseti in the public sector
Given the equipment and know-how involved, making the Ponseti method available in South Africa’s public sector was a challenge. In 2013, Moss launched a support programme to help government clinics offer the treatment. STEPS began by partnering with just six clinics. With support from donors, they recruited staff to visit each clinic weekly to guide families or trained someone on-site to do so. They also provided educational materials to help raise awareness. Over time, this led to STEPS helping develop standard systems and processes for running the clinics, making care more consistent and accessible. When some clinics couldn’t provide braces, STEPS arranged for it to be donated.
Today, STEPS has 48 partner clinics across South Africa, ranging from a tiny rural clinic in Lusikisiki in the Eastern Cape to bigger clinics in Gauteng and the Western Cape. “Lusikisiki might see three patients a week, and Chris Hani Baragwanath Academic Hospital could see 80. They all open once a week, except for some small, rural clinics,” Moss says.
Based on stats that STEPS collected, Moss estimates that at least 2 000 children are born every year with clubfoot in South Africa. Through the help of her organisation, she says: “More than 20 500 children have accessed effective treatment. We’ve … distributed 22 628 clubfoot braces. In 2024, we supported 4 592 children at partner clinics in different stages of the four-year treatment protocol.”
Moss adds that STEPS has conducted over 20 training sessions across South Africa, Namibia, Botswana, and the Seychelles, with more than 2 000 healthcare professionals. “Parents were bringing their children over the border as they couldn’t access treatment back home. We worked with the ministries of health in those countries to teach the Ponseti method there,” she says.
Though separated by an ocean, Moss says she stayed in close contact with Ponseti. She says the last time they saw each other was at a clubfoot symposium in Iowa in 2007. Two years later, he passed away at the age of 95.
“I felt as if I’d lost a member of my family,” Moss says. “He was the master, and he inspired me in my work to improve the lives of children born with clubfoot.” She said she would always carry the ache of missing him, but bringing his method to South Africa, just as she had promised, was something that gave her a deep sense of purpose and peace.
That promise, purpose and peace started with Alex who is today in his final year of a Bachelor of Commerce degree and who, in his own words, “enjoys being active outdoors with my friends”, likes playing padel, and going on hikes.
*This article is part of Spotlight’s 2025 Women in Health series, featuring the remarkable contributions of women to healthcare and science.
But women doctors in this attire are often misidentified as nurses or medical assistants. And preferences for doctors’ dress strongly influenced by clinical context/medical specialty
Patients are still more likely to trust doctors and consider them more professional when they wear white coats, although women doctors in this attire are often misidentified as nurses or medical assistants, finds a review of the available research on the topic, published in the open-access journal BMJ Open.
But patient preferences for doctors’ attire seem to be strongly influenced by clinical context and medical specialty, with a growing acceptance of scrubs, especially in emergency or high-risk settings, the findings indicate.
In the 19th century, doctors primarily wore black, because medical encounters were viewed as serious and formal occasions. But with the growing emphasis on hygiene and scientific advancements in medicine, white coats represented cleanliness and professionalism and became standard attire for doctors worldwide in the 20th century, note the researchers.
Since the publication of a previous comprehensive review of published research on the impact of doctors’ attire at work, which highlighted the significant role this has in patient satisfaction, trust, and adherence to medical advice, health care practices and societal expectations have evolved, they explain.
The researchers therefore wanted to update those findings, broadening the scope to include diverse clinical contexts, in a bid to gain a deeper understanding of how doctors’ attire might influence interactions with patients and treatment outcomes.
They scoured research databases for relevant studies published between January 2015 and August 2024. From an initial haul of 724 studies, 32 were eligible for inclusion in the review.
Most of the studies were carried out in the U.S. (17); two each came from Japan, China, and Pakistan; and the rest were carried out in Indonesia, India, Ethiopia, Korea, Germany, Malaysia, Saudi Arabia, Singapore and Switzerland.
Clinical setting had some bearing on patient preferences. For example, palliative care doctors’ attire didn’t affect patients’ trust, or assessments of the practitioner’s capabilities, but patients preferred emergency care doctors to wear white coats or scrubs. And they were happy for primary care doctors to be dressed casually and to wear white coats.
Specialty also seemed to influence perceptions, with patient preferences for doctors to wear white coats observed in orthopedics, surgery, dermatology, ophthalmology, and obstetrics and gynecology, for example.
The included studies indicated a distinct preference among patients for male doctors to wear suits. One study indicated that accessories, such as watches and glasses worn by male doctors, significantly enhanced perceived professionalism and trustworthiness, which aligns with the findings of previously published studies, note the researchers.
The UK, however, has implemented a ‘bare below the elbows’ policy, which bans doctors from wearing white coats, watches, ties and long sleeves to minimize infection risks.
And even when male and female doctors wore identical attire, female doctors were still more likely to be misidentified as nurses or medical assistants—a misidentification that was consistently observed across different cultural settings.
But patients preferred white coats over business or casual attire for both male and female doctors, and irrespective of gender, they favored doctors wearing white coats, perceiving these practitioners to be trustworthy, respectful, skilled, communicative and empathetic.
Notably, male surgeons wearing a white coat over scrubs were looked on less favorably than those wearing a suit with a white coat, scrubs, or just a suit. On the other hand, female surgeons in white coats over scrubs were preferred over those in suits or casual attire.
“This preference aligns with recent evidence indicating that female physicians are often judged more on appearance than their male counterparts. The way female physicians dress significantly influences perceptions of competence and professionalism, highlighting the gendered expectations that patients hold,” write the researchers.
“These gender-specific preferences for surgical attire were each supported by a single study and warrant further validation… Nonetheless, gender-related perceptions of physician attire were consistently reported across studies with a low risk of bias, supporting the robustness of this theme,” they add.
A few studies explored doctors’ attire during the COVID-19 pandemic, when numerous doctors reported a preference for wearing scrubs to prioritize hygiene and ease of movement.
These studies consistently reported a shift in patient preference towards practical and hygienic attire, such as scrubs and face masks, reflecting heightened sensitivity to infection control, say the researchers.
The researchers acknowledge various limitations to their findings, in particular the fact that most of the included studies were carried out in the U.S., there were none from South America, and only a few from European, Asian, and African countries. Many of the studies also relied on self-reported data, and none included children or patients with mental health issues.
“While the traditional white coat is seen as a symbol of professionalism and trust, patients have increasingly accepted scrubs, especially in emergency or high-risk settings,” they write.
“The expectations regarding attire are often gendered, particularly affecting the recognition and respect given to female physicians, which highlights the importance of institutional initiatives aimed at reducing bias and fostering equitable perceptions among patients,” they add.
Medical institutions should consider adopting flexible dress codes that align with patient preferences for different clinical environments and medical specialties, they suggest.
Medieval manuscripts like the Cotton MS Vitellius C III highlight uses for herbs that reflect modern-day wellness trends. Image Credit: The British Library.
A new international research project has shown that Europe in the Dark Ages wasn’t in the dark when it came to medicine. The research, featuring faculty at Binghamton University, State University of New York reveals that people were developing health practices based on the best knowledge they had at the time – some of which mirror modern wellness trends.
“People were engaging with medicine on a much broader scale than had previously been thought,” said Meg Leja, an associate professor of history at Binghamton University who specialises in the political and cultural history of late antique and medieval Europe. “They were concerned about cures, they wanted to observe the natural world and jot down bits of information wherever they could in this period known as the ‘Dark Ages.’”
The Corpus of Early Medieval Latin Medicine (CEMLM), funded by the British Academy, has collected hundreds of medieval manuscripts containing medical material predating the 11th century. Countless manuscripts that have been left out of previous catalogs were included, nearly doubling the number of known medical manuscripts from the Dark Ages.
Some of the recipes resemble health hacks promoted by modern-day influencers, from topical ointments to detox cleanses. Have a headache? Crush the stone of a peach, mix it with rose oil and smear it on your forehead. It might sound odd, but one study published in 2017 showed that rose oil may actually help alleviate migraine pain.
Then there’s lizard shampoo, where you take pieces of lizard to help your hair become more luscious and flowing – or even to remove it, a modern-day parallel to waxing.
“A lot of things that you see in these manuscripts are actually being promoted online currently as alternative medicine, but they have been around for thousands of years,” said Leja.
Leja spent the last two years with the rest of the team preparing the new catalogue (which was just released online), reviewing manuscripts from throughout Europe, and editing and formatting the catalog. She had previously written about medieval medicine in her first book, Embodying the Soul: Medicine and Religion in Carolingian Europe.
Many of the writings were found within the margins of books totally unrelated to medicine—manuscripts on grammar, theology, poetry , etc. Leja said that this speaks to a preoccupation with the body’s health and figuring out ways to control it.
“It’s true that we do lack a lot of sources for the period. In that sense, it is ‘dark.’ But not in terms of any kind of ‘anti-science’ attitudes—people in the early Middle Ages were quite into science, into observation, into figuring out the utility of different natural substances, and trying to identify patterns and make predictions” said Leja.
The research team will continue to update the catalogue with new manuscripts and are working on new editions and translations of medical texts that could be used in teaching. Leja noted that while previously catalogues focused on texts from well-known authorities like Hippocrates, this isn’t necessarily material that people in the Dark Ages would have prioritised, and a more comprehensive catalogue will allow historians to show medicine in its fullness.
