Even though she has been involved in more than 1 000 kidney transplants, Professor Elmin Steyn is still amazed when a transplanted kidney becomes a healthy red when the blood starts flowing through the arteries and the veins.
This passionate transplant and trauma surgeon, who was head of Christiaan Barnard Memorial Hospital’s Kidney Transplant Unit for many years, returned to her alma mater, Stellenbosch University, last year.
Here she joined the Department of Surgical Sciences of the Faculty of Medicine and Health Sciences as head of its surgery division – a first for a woman in this academic environment.
After years in the private sector, it was a culture shock to find herself in a public healthcare environment once again, she admits. She emphasises that the difference does not lie in the quality of the care, but in the condition of the patients, with higher concentrations of advanced diseases than when she worked here as a consultant in the 1990s.
“On the one hand it is tremendously stimulating, and it offers much that is valuable to potential research and training. On the other hand, one cannot ignore the fact that the patients present late as a result of their socio-economic conditions,” she says.
“Transport, education and poverty are problems, not to mention the trauma levels caused by interpersonal violence, alcohol, drug abuse and violence in the community, which has such a huge impact on patient numbers.
“One feels that as a surgeon you deal with the end result of a problem that should actually have been solved in some other way.”
Although the Department of Surgical Sciences has not traditionally been involved in the prevention of violence, she feels that a type of upliftment system should be created that would give doctors more of a say in this.
This could possibly be in the form of anti-violence messages to children to try and break the cycle.
“In the 1980s I worked in a hospital where a transplant programme for black patients had just been started. Until then no transplants had been done on black people (in South Africa), since it was incorrectly assumed that, as a medical treatment, it would not be culturally acceptable to them.
“I witnessed the effect a transplant could have on the life of someone with end stage organ failure, and realised it could work for all cultural groups.
“The whole complex situation of one person dying, who could then ultimately save several lives, fascinated me. Physically it is also a pleasant operation: it is a vascular procedure which is usually successful despite the many risks.
“It is tremendously rewarding for both the surgeon and the patient, who immediately starts feeling better.”
The rights of the patient are of deep concern to this humble surgeon, who for a long time managed the emergency units of both Christiaan Barnard and Vincent Pallotti hospitals.
Professor Steyn has high praise for the department in which she now finds herself. “Professor Brian Warren (her predecessor) wisely managed to assemble an excellent combination of talented consultants with the necessary skills,” she says.
The challenge lies in providing an excellent service to large numbers of patients, while simultaneously producing research publications and training people in the high-level technological skills that they will need for their future careers.
Fortunately, she likes challenges. And despite problems such as the chronic lack of funding in the provincial healthcare system, she enjoys a great deal of goodwill and support from both the department and Tygerberg Hospital.
One of Professor Steyn’s goals is to create a pancreas transplant programme in the Western Cape in order to find a cure for diabetes. She has already gained experience in the United States to perform this challenging procedure, which requires a team of trained surgeons.
The procedure is currently only performed in Johannesburg, although the first pancreas transplant was done at Tygerberg Hospital by Professor Don du Toit in the late 1970s.
“It is a legacy that is certainly worth reviving. It would, however, only be possible if the great number of potential donors in the referral area is more efficiently identified, referred and managed,” says Professor Steyn.
Over the years there were many firsts for her, such as being the first female president of the South African Transplant Society as well as of the Trauma Society of South Africa. As a trauma expert, she is in demand for training and presentations worldwide.
Professor Steyn is also passionate about art, nature, cooking, wine, and flying, although she feels that she is not spending nearly enough time in the air as a helicopter pilot these days.
“What better way could there possibly be to escape?” asks the woman, who is also the art patron of the South African Air Force Museum in Ysterplaat.