Monday 18 July 2016

REVISITING SAAHIP’S FIRST ANNUAL CONFERENCE

The following is an opinion piece I wrote for the South African Pharmaceutical Journal. It was published in the January/February 2016 issue, Vol 83 No 1, in the Nibbles section.



On the dates of 10th to 13th March, 2016, The South African Association of Hospital and Institutional Pharmacists (SAAHIP) will be holding its 30th Annual Conference and its 59th Annual General Meeting. The theme of the event is Our Journey-Time to Refuel”. Whether the journey commenced nearly sixty years ago with the first AGM or whether the journey commenced with the first Annual Conference thirty years ago, I think it may be appropriate to revisit the start or the halfway point, whichever the case maybe, of the journey.

 In the July 1987 (Volume 12 No. 3) issue of FORUM, the Association’s official journal, a comprehensive report of an historic occasion in SAAHIP’s history, the First Annual Conference, was published. The editorial in that same issue outlined the history and progress of FORUM.  That editorial “About this issue” (as all FORUM editorials were headed) was written by me and it was my swan song, after having been editor of that journal for eight years.
This is what I wrote:

“This year, 1987, is proving to be a momentous one for SAAHIP. Firstly, this year SAAHIP held its 30th Annual General Meeting, and secondly, SAAHIP held its first national conference, and judging by the comments made by the highly satisfied delegates, it hopefully won’t be the last conference. A full report of this incredibly successful event, together with pictures, appears further on, and our thanks go to Bob Wilson for writing the report.
“The pharmaceutical industry demonstrated its recognition of SAAHIP by supporting the conference in a manner which can only be described as phenomenal. Without any doubt, it was their unstinting sponsorship that helped create history for SAAHIP, and SAAHIP is most grateful for this display of generosity.
“When I first took over the editorship of FORUM from Mike Timms back in 1980 my long-term goal was for FORUM to become a glossy journal which would be The South African Journal of Hospital Pharmacy. At that stage FORUM was typed by me and reproduced by the PSSA in Braamfontein. Then for several years the typist at the Natal Coastal Branch of the PSSA kindly did the typing for me and this I forwarded to Braamfontein, from whence FORUM was posted to members. Then in 1986, when Ciba-Geigy started sponsoring FORUM I merely sent copies of the articles through to the PSSA where the Pharmacy Journal staff took over and processed the material for publication by the printers. So, my goal has to a certain extent been achieved – FORUM is glossy and is the only journal specifically pertaining to hospital pharmacy in South Africa. FORUM even has its own envelope! Now I think it is time for someone else to take over and develop FORUM further. I recently asked the Executive Committee to find a successor and at the last Executive Committee meeting the Transvaal branch volunteered to take over. This then will be the last issue of FORUM edited by me.
“At this stage I would like to record my thanks to the following people, who over the years have been of tremendous assistance to me, and have made my task so much easier: Neville Lyne, Carrie Smith and Joy Gasson, all of the PSSA, Braamfontein; Doug Gordon and his typists at the Natal Coastal Branch of the PSSA; Bob Wilson of the Natal Inland Branch of SAAHIP, and all those persons who submitted material for publication. Without them FORUM wouldn’t exist. Thanks also to those people over the years who
encouraged me, as it was this encouragement that kept me going in the early days when I was never sure whether or not the issue I was working on would be the last, because of the lack of material. Lastly a tribute to my family for uncomplainingly tolerating so much of my leisure time over the years being spent in front of the typewriter instead of with them. Thank you, all.”

Hereunder I am including Bob Wilson’s report on the First SAAHIP National Conference.  Despite its length, I believe it is important for current members and leaders to be acquainted with what transpired at that first conference, especially with the format, the subjects that were discussed, and the goals that were set for SAAHIP and its members; then compare the content with what is currently taking place in hospital pharmacy practice and the professional organisations. Perhaps at the forthcoming conference it may be a useful exercise to discuss the comparisons and also debate on how much has been achieved over thirty years. Are the same problems still besetting hospital pharmacy? Has membership increased beyond expectations? Have pharmacists learnt anything from history? Why do pharmacists still appear to be dissatisfied? The world, and South Africa in particular, has changed dramatically over the past three decades. Think about the changes: incredible developments in technology, the internet, computers, cellphones; advances in medicine; the advent of an HIV epidemic; the challenges of multi-resistant TB  and the emergence of antibiotic  resistant bacteria; and of course  that other major event that occurred twenty years ago - the new political dispensation.


Have the technological advances which the world enjoys now and which did not exist thirty years ago actually been utilized to benefit hospital pharmacy and SAAHIP, and in what way?  Are the social media sites actually being used to their full potential for CPD and for all-encompassing communication, and not only for trivial matters and complaints. Are they being used for making membership of the professional bodies an essential and desirable state? How has hospital pharmacy been affected over the years by the change in government?  Has efficient and affordable access to medicine been realized? What is to be done about the out of stock situation bedeviling the treatment of patients?  Debating these questions may keep delegates entertained during their refueling stop. No doubt more ideas may be forthcoming.


Mr Louis Rӧntgen makes a few pertinent points which are still applicable today, but should they be? He also mentions that the PSSA Executive would like to see government in Health Care reduced so that the private sector could play a greater role. How is it that quite the opposite has occurred? How could that have been avoided? Pharmacy seems to be completely at the mercy of the Department of Health.  Are other health care professionals similarly fettered? Are pharmacists projecting a more professional image, and are their support staff doing the same? Is there something lacking in the training of pharmacists and their support staff?

On a point of clarification, the functions of the Commission of Administration mentioned in Dr AM Reynolds’ talk, were taken over by the Department of Public Service and Administration.
The National Drug Policy document, introduced with great fanfare in 1994, was revisited at the 2014 SAAHIP Conference, the theme of which was “Taking Stock”. The results were unsurprising, and can be found in the SAPJ Vol 81 No 5.  Is apathy the common factor?

The 1987 Report:-
 “A milestone in the history of the South African Association of Hospital and Institutional Pharmacists (SAAHIP) was reached at the Riviera International Hotel, Vereeniging when SAAHIP held its first National Conference on 20th and 21st March 1987.

“A welcoming cocktail/buffet sponsored by Abbott Laboratories (Pty) Ltd was held on Thursday evening 19th March which went on late into the night with old friendships being renewed and new ones sealed. 

“The next day, Friday 20th March, the Conference was officially opened by Dr JP Roux, Deputy Chief Director of Health Services.
“Immediately following his address the 30th Annual General Meeting of the Executive Committee was held. In his President’s Report, Ian Moore mentioned that the Conference was proof that SAAHIP was moving ahead to advance Hospital Pharmacy and that SAAHIP does have a definite plan for the future. He also appealed to all branches to actively seek out new members to increase the overall SAAHIP membership by an average of 3%. This is vital in order to keep the membership fees of SAAHIP at the existing level, he said.
“In the elections for the executive committee the same management were unanimously re-elected to a further term of office. They were:
·         Mr IW Moore – President
·         Mr JS du Toit  - Vice President (OFS/Northern Cape)
·         Mr J Cohen    - National Secretary/Treasurer
The other members of the executive present were:
·         Mr P Hearn – Past President, and the Chairman of the respective Branches:
·         Mrs S Putter (Vice Chairperson) – East Cape Border
·         Mr C Lowther – Natal Coastal
·         Mr K Gerson  - Natal Inland
·         Mr RM Britz – Transvaal
·         Mr B Friedland -  West Cape
·         Apologies: Mrs L Nel (Chairperson) – East Cape/Border
“The AGM was followed by a series of addresses from representatives of other pharmaceutical associations:
·         Louis Rӧntgen, President of the Pharmaceutical Society of South Africa (PSSA), gave an insight into the PSSA objectives and priorities for the future. In his message he said that pharmacy was its own enemy and that all pharmacists must become active in their respective associations, Most of all he appealed for unity amongst the various associations. He said that pharmacists must project a more professional image and that the new proposals to sell prescription medicines at cost plus a professional fee to cover the pharmacists’ services were in the view of the PSSA Executive a move in this direction. He also mentioned that the PSSA Executive would like to see government involvement in Health Care reduced so that the private sector could play a greater role.
 
·         Gary Kӧhn, Vice-President of SA Association of Retail Pharmacists (SAARP), reported that the drug and alcohol abuse programme initiated by Johnson & Johnson (Pty) Ltd was now being continued by SAARP. The programme PADA – Pharmacists Against Drug Abuse- was now being actively supported by the Association.
 
·         Rhetha Ross, Manager of Transmed, talked about the problems facing Medical Aid Societies and in particular, Transmed with the escalating costs of medicines and what changes must be implemented in the future.
 
·         Dave Casalvolone, Vice President of SA Pharmacy Students’ Federation (SAPSF), told the meeting that the pharmacy students are becoming more interested in the clinical aspects of pharmacy and thus require greater clinical and practical training in hospitals. He mentioned that SAPSF were actively involved in a fund raising drive for establishment of Drug Rehabilitation Centres for the Blacks, Coloureds and Indians.
“In the afternoon the delegates were divided into 4 discussion groups each with a delegated group leader. The function of the group leader was to keep the discussion moving towards the objectives and to encourage everyone to contribute to the discussion.  They were also responsible for the report back and evaluation the next day – Saturday.
“As the time allocated was insufficient for all aspects of hospital pharmacy to be discussed, each group was instructed to discuss topics in order of priority as decided by the majority in each group. The topics discussed were interesting and varied – clinical pharmacy, drug information, cost-effective pharmaceutical services, IV additive systems, formulation of a 5 year plan, special hospital committees, cytotoxic medicine monitoring and continuing education amongst others.
“The active participation by all pharmacists brought about a sense of achievement as ideas were exchanged amongst colleagues of various hospitals. Everyone agreed that the discussion groups were of benefit to all and must play a larger part in future Conferences. That evening, a banquet, sponsored by Lennon Limited, rounded off a very fruitful and eventful first day of Conference. The banquet was attended by the Mayor of Vereeniging and Prof WA Ritchell, Professor of Pharmacology at the University of Cincinnati – guest speaker for the Conference, and their wives.
“The next day, Saturday 21st March, began with a slide presentation by Prof WA Ritschell on Drug Monitoring Programmes in the USA and the role of clinical pharmacologists in the hospital Health Team. He mentioned that physicians and clinical pharmacologists study together at University and are involved together in various aspects of their training that consequently they accept each other as equal professionals, with the physician doing the diagnosis and the clinical pharmacologist prescribing, planning the treatment regimen and monitoring the drugs that are used.
“Mrs J Lombard of the University of the North spoke on Drug Information Systems in SA Hospitals. She gave a brief account of existing Drug Information Systems presently in use at various hospitals and stressed that all hospital pharmacists should be able to provide some sort of Drug Information Service.  She went on to say that pharmacists should be involved in acquiring the necessary tools (text books, Journals etc.) and take up the challenge to provide such a service. Prof C van Wyk from Potchefstroom University spoke about the challenge of change that faces pharmacists in the future. He said that pharmacists must develop to become patient orientated and allow pharmacy technicians to be trained to provide a greater supportive role.
“The topic presented by Prof IHP Serfontein was “Communication with the Patient”. He stressed the importance of pharmacists to develop communication skills in order to correctly and accurately counsel patients on drug therapy. He spoke about the importance of listening and talking to patients to make them more responsive and receptive. He also mentioned the use of body language and the importance of voice tone and inflection.
“Prof HH Dȕrrheim of Pretoria University talked about continuing education for the pharmacist and mentioned what could and should be done, pointing out the various opportunities that already exist for continuing education.
“Finally, Dr AM Reynolds, from the Commission for Administration talked about career developments for the hospital pharmacist. He urged all hospital pharmacists to take pride in their profession and to “market themselves in the hospital environment. He mentioned that his department was aware that the PAS (Personnel Administration Standards) for pharmacists was inadequate and that it would be amended accordingly. He also spoke on merit assessment for pharmacists and that it should be used to enhance career developments for hospital pharmacists.
“These series of talks were followed by the Discussion Groups’ report back and evaluation, and the Saturday ended with an evening braai sponsored by Boots SA (Pty) Ltd.
 
“The Conference weekend also had its lighter and social moments – a sightseeing River Boat trip and swimming gala competition to mention two. The swimming gala competition, in which the Natal Coastal and Inland Branches challenged the rest of SAAHIP, was won by the Natal “Combined” after some excellent “tactical” swimming. A feeling of camaraderie developed amongst all fellow colleagues and the fabulous picturesque surroundings of the Riviera International Hotel on the banks of the Vaal River supplied an ideal environment for a very successful conference.”

South African Pharmaceutical Students' Federation Conference, Cape Town, 1961


SAPSF CONFERENCE, CAPE TOWN, 1961

In 1961 I was elected as secretary of the Natal Pharmaceutical Students’ Association (NPSA). When that year’s annual conference of the South African Pharmaceutical Students’ Association took place in Cape Town, three committee members of NPSA attended, and they were Tito Sello-Rolando, chairman, Trevor Becket, vice-chairman, and myself.

The conference took place from Monday 3rd July till Friday 7th July. In order to get there we three delegates left Durban station on Thursday 29th July on the 4 pm train to Cape Town, arriving at our destination at 11 am on Saturday 1 July. The main towns the train travelled through were Pietermaritzburg, Bloemfontein, and Kimberley. This was my first ever pharmacy conference, as well as my first visit to Cape Town. The President of SAPSF that year was Rubin Birin, and Johan Offermeier was elected into office at the conference for the following year.

Marie Dreyer (now McKenzie), a delegate from Rhodes University, and I were the only two female delegates, and what an amazing time we had. What wonderful hosts the Cape Town people were. To illustrate how welcome we were made, Mike Gibbons from the host branch boarded the train in Bellville and accompanied us on the last few miles of the journey to Cape Town.

Dave Abromowitz was at the station to meet us, and he drove us to the Hotel Avalon, in Gardens, where the conference was to take place and where we would be staying. After checking in and leaving our luggage in our respective rooms, we strolled downtown and had some lunch. Bertie Young, another member of the team of hosts took us for a drive to the Yacht Club, thereafter we were taken to a succession of parties being held at various venues, and ended up at a flat, which in those days could be described as “beatnik” in Clifton .The time was 2.30 in the morning when we were finally deposited at the hotel.

At this juncture let me make it quite clear, that my notes of that memorable conference comprise brief references to all the social events we attended, but nothing about the business side. I have no printed matter such as agendas or financial statements or minutes of meetings. But what a wonderful social programme it was! The Cape Town Branch of SAPSF did us proud.

After a late breakfast a trip up Table Mountain was on the agenda. Bertie was our tour guide once again. When we arrived back at the hotel, many more delegates were arriving and the place was a hive of activity. Supper was eaten at the hotel and all the delegates got to meet each other. Marie had also arrived and of course we shared a room.   

I cannot remember the names of all the delegates, but those that come to mind are Natie Finkelstein, Dave Sieff, Len Ortlepp, Ronnie Hill, Jeremy Whysall, and Markus.

Monday and Tuesday were spent in conference   proceedings, but with a special lunch in the hotel’s Vinery Restaurant on Tuesday. Some lectures took place during the evening.

On Wednesday morning the delegates were taken on a tour of popular tourist spots, including Constantia, Bertrams, Hout Bay, with a stop for tea at a restaurant “Red Sails”. Conference proceedings continued during the afternoon and evening.

There was an opportunity for those who so wished to see a movie on Thursday afternoon after a morning session of conference.   Another evening of visiting pubs and restaurants ensued, with bedtime sometime after midnight.

The last formal session of the conference took place on Friday morning, and then the official conference photos were taken. The official formal dinner took place at Constantia Nek Restaurant. Roy Anderson, a delegate from Port Elizabeth and I travelled to the venue with Mr and Mrs Harold Zets. Mr Zets was an active member of the PSSA in Cape Town for many years. It turned out to be a most congenial evening, with lively and entertaining conversation, excellent food, and good wines.

The climax of the conference was the ball which was held in the hotel on Saturday evening. Most delegates left for home the next day, Sunday. However the Natal delegation was only due to depart on Monday.

Marie’s parents lived in Hermanus, and the folk from Natal were invited to spend Sunday in Hermanus with her family. We all enjoyed a picnic on the beach. Mr and Mrs Dreyer were wonderful hosts and had no qualms entertaining a bunch of students.

Many long-standing friendships were forged at that conference. I have visited Cape Town a number of times since then, but my first visit to attend the SAPSF conference will always be looked upon as being very special.