In a series of shocking events, malpractice in local government hospitals and clinics has allegedly resulted in the death of two babies, and the gross neglect of women in labour. For young Thoko Mangena, giving birth to baby Yonela was supposed to be a joyous occasion. On the day she went into labour, she and her mother spent over twelve hours in the hospital. Although she was experiencing labour pains, the hospital staff told her to leave, and only return once her labour pains had grown more intense. Despite her baby? impending arrival, they ushered her out the hospital, where she subsequently gave birth on the pavement outside. Were it not for assistance from the ambulance staff and local residents, Thoko? mother is convinced she might have lost both her daughter and granddaughter. At present, both Thoko and Yonela are healthy and well, despite their ordeal.

The same cannot be said for the two infants apparently turned away from local clinics, who succumbed to their conditions, allegedly as a result of gross negligence and misconduct on the part of the staff manning the facilities. Both baby Unabantu Mali and Somila Tshangatsha died in separate incidents, after staff members turned their families away and refused to treat the infants. Baby Unabantu died after his grandmother was turned away from three different clinics, and baby Somila succumbed to a raging fever after nursing staff told her family she had no fever and did not need treatment.

In all likelihood, these unnecessary and tragic deaths could have been prevented if they had received adequate medical care at facilities where staff members are trained to deal with infants and their families with appropriate levels of empathy, scientific knowledge and genuine concern for the patients at hand.

This is yet another frightening reminder of how important it is to be a member of a medical aid fund that has your wellbeing as its priority, and that will enable you to get the best possible healthcare at all times.

Asthma is a respiratory disease that affects the breathing tubes and the lungs ?it can be triggered by a number of irritants, including dust, pollen and smoke. It is essential to know if you are susceptible to asthma, and if you are, to carry an inhaler with you at all times. The use of an inhaler can halt an attack immediately and prevent it from developing into something life-threatening. There are also certain preventative medications one can take to lessen the chances of an attack occurring; these must be prescribed by a GP.

It is very important, especially with children, to control the environment as far as possible, by keeping it clean and allergen-free. Obviously the home is far easier to control than outdoor areas or the school environment. Clean carpets regularly, ban smoking indoors, change bed linen weekly and wash it in hot water to kill all organisms (for example, house dust mites), keep the windows closed (especially in spring and summer) to keep out pollen, dust, and other airborne allergens, and keep animals outside. All of these actions will help to control the environment and limit the chances of an attack.

For more information, make an appointment with a Clicks Nursing Practitioner. To find your nearest Clicks Clinic, visit www.clicks.co.za or call 0860 CLICKS (254 257).

As most new parents would tell you, bringing your newborn home means facing a multitude of puzzling questions and many an overwhelming situation. It helps to have an idea of what you should expect from your newborn as he or she develops, even before you leave the safe haven of the hospital.

How often will your baby sleep?

Your new baby should initially sleep 12 - 20 hours out of 24. It is a good idea to get into a sleeping routine right from the start, for the wellbeing of both you and your baby. Each little person comes with their own personality and temperament, and this may also affect their sleep/wake pattern. Finding out which times work best for you and your baby will help you both stay happy and rested.

Monitoring your baby? progress

The most effective way to monitor your baby? progress is to check his or her weight-gain regularly. Initially your baby should gain between 100g and 250g each week. You can plot your baby? development on their ?oad-to-health?chart to help you assess their progress. Most hospitals have a baby clinic you can attend on a weekly basis to have your baby weighed and immunised, to discuss your concerns with the midwife, and to have a chat with all the other new moms. Visiting the clinic is a great way to build up your support network and make friends with other moms.

Providing the right stimuli

Babies are primarily a bundle of reflexes during their first 6 weeks, and at first, many parents feel at a loss as to how to provide stimulation for their babies. Although their cognitive abilities are limited at this stage, there are a couple of areas you can concentrate on, such as providing a stimulus they can practise focusing on. A bright mobile to hang over the cot or pram is a good start. Even something as simple as shapes cut out of bright cardboard or tissue paper hanging from a wooden stick or hanger will attract the baby? attention and help them with focusing.

Motor development

Encouraging motor development is also important. Establishing strong muscles in your baby is vital for the activities that come later, such as walking, running, jumping and skipping. Once you are settled into a routine with your baby, he or she will have periods of wakefulness, providing the perfect opportunity for some free-kicking. Set out a blanket in a warm spot, take off any constrictive clothing from your baby? lower body and allow them to move freely. Talk gently to your little one, look into their eyes and stroke the limbs, indulging in lots of skin-to-skin contact.

Other things you may notice

A few other developments you may notice in your baby? first six weeks are a response to bright lights and loud noises. Babies may be startled by sudden sounds, and should be able to follow bright objects when these are moved across their line of vision at about 20 to 30cm away. They may also suck on their fists, gurgle, sneeze and hiccup often. They will also start to recognise their mom and may begin to smile occasionally.

Safety

It is vitally important that your baby always has a supported head when they are being held, because at this stage of development they lack adequate head control, and an unsupported head may damage your baby? neck or cause other injuries.

We hope you enjoy every moment with your special little miracle. If you do have any concerns or queries please feel free to contact us on 021 937 8300.

The worldwide nursing shortages continue, forcing healthcare providers in the state and private sector to improve nursing compensation and benefits and put measures in place to improve nursing skills through training. Medi-Clinic is in the process of addressing these shortages to meet the hospital? needs through its nursing training and recruitment programme.

The exodus of nurses from South Africa remains a problem, though it seems the rate of departure is not as rapid as it was a few years ago. Statistics show that in 2007 the emigration and immigration of Medi-Clinic registered nurses were virtually equal. Internationally, restrictions are being placed on the recruitment of foreign nursing staff to alleviate the problem.

Growing need for specialist nurses

In addition to the training limitations, there is also a shortage of specialist nurses. The Hospital Association of South Africa (HASA) reports that there is an increased demand for certain specialities. Due to an ever increasing burden of disease and changing disease profile, acuity in hospitals has been rising rapidly. As a consequence, hospitals are experiencing increasing utilisation of intensive care units, with cardiac monitoring, respiratory assistance and intense treatment a growing part of the average patient's plan of care. Nurses are thus required to be more specialised, which impacts on their training requirements.

?e have an armoury of courses for all the specialist areas, ranging from 3-month fundamental courses to more advanced certificates and diplomas,?says Andrea Haakestad, Nursing Process Specialist. In addition, Medi-Clinic also supports Masters Students in certain fields.

Medi-Clinic is the first hospital group to have taken the step, as an interim measure, to recruit nurses from abroad. The first foreign nurses are all specialist critical care and theatre nursing practitioners, but nurses are being recruited for the general wards too. The work ethic and positive approach of these nurses are highly appreciated by colleagues and patients alike.

Medi-Clinic? professional approach to training and development has resulted in excellent relations with various tertiary institutions and regulating bodies such as the SA Nursing Council, Department of Education, Department of Labour, and the Council on Higher Education. This positions Medi-Clinic well to meet future challenges in dealing with the skills shortage.

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Expecting a baby can be as stressful as it is thrilling, and so we feel that it's important for you to know exactly what we cover, and what support you can expect from us during and after your pregnancy.

What is covered?

The insured ante-natal benefit per annum for the year 2009 varies according to the plan you belong to. This benefit covers pregnancy consultations with your general practitioner, midwife or gynaecologist. In order for you to receive this benefit, it is vitally important that the ICD10 code on your account reflect that you are pregnant.

There are three different amounts:

• Healthpact Premium - R2000 (pro rated according to take-on date)
• Healthpact Silver - R1600 (pro rated according to take-on date)
• Healthpact Gold Plan - R3000 (pro rated according to take-on date)

The scans covered by this benefit are your foetal maturity scans, which are usually done at three separate intervals during your pregnancy if necessary. These intervals are at 12 weeks (Tariff Code 3615), 20 weeks (Tariff Code 3617), and after the 20-week period (Tariff Code 5107/3617).

What the ante-natal benefit DOES NOT cover

The ante-natal benefit does not cover any earlier scans, such as internal or external abdominal scans (Tariff Code 3618 or 5100). Any materials used, and the urine dipstick done at each visit, is also not covered by this benefit.

What we need you to do

We encourage our expecting members to negotiate with their practitioner from early on in their pregnancy, in order to obtain the best possible rate from them, including for confinements.

The rates paid for confinements are as follows:

• Silver at 100% of NHRPL/CMP tariff
• Premium and Gold at 200% of NHRPL/CMP tariff

Once we have received a quote from your practitioner, you will receive an authorisation number for your confinement from us.

CMP and hospital fees

We have contracted rates with the following four major hospital groups:

• Medi-Clinic
• Life Health Care
• Netcare
• National Hospital Network

If you decide to deliver your baby at a facility that does not belong to one of these groups, the hospital will be reimbursed at NHRPL rates.

Blood tests

During your pregnancy and post-natal period your practitioner will refer you and your baby for multiple blood tests. Please remember to advise your caregiver upfront that all CMP members are contracted to Pathcare and Lancet Laboratories for all specimen requirements, and that this will be reimbursed from your insured benefits.

How to register your baby

We need you to register your baby with us so that we are able to reimburse and process claims for paediatricians, laboratories and normal hospital births. To register your baby, you need to phone us and supply your baby? date of birth and name. If you decide to register your baby more than a month after the birth, you will need to submit a written application.

What to do if your baby needs to be admitted to hospital

You must ensure that your baby is registered with us as a beneficiary, so that any costs can be covered if he or she needs to be admitted to hospital.

Unexpected costs that may occur if your baby is admitted with Respiratory Distress

An example of the costs for a pre-term (32 weeks) baby, admitted with respiratory distress at a birth weight of 1.750 kg:

• Paediatrician's Fees: Approx. R16,000 (doctor charging 100% NHRPL/CMP rates)
• Pathology Fees: Approx. R1,600 (100% NHRPL/CMP rates)
• Radiology Fees: Approx. R1,700 (100% NHRPL/CMP rates)
• Ward Fees: Approx. R120,000
• Medicine and Material Fees: Approx. R11,000

We will cover this account of R150,300 in full, at 100% of the NHRPL/CMP guidelines.

These rates can be further inflated by a service provider charging a higher rate, and reimbursement by CMP will depend on your chosen product option.

The above example only exists for Healthpact Silver members.

We care.