A developing interest in improved care of the aged by the authorities of Settlers' Hospital in Grahamstown led to an invitation to the Geriatric Unit of the University of Cape Town in March 1984 to visit the hospital. The impressions gained on this visit indicated a need to expand hospital-based geriatric medicine into total community care of the elderly. Data were gathered concerning 50 acutely ill and 31 long-stay elderly black patients in Settlers' Hospital. These findings and the recommendations of various committees are discussed against the background of a model for the delivery of better geriatric care throughout the country. The most urgent necessity for Grahamstown appeared to be provision of better care for aged black people in the community.

Black or African American↗

PubMed1983

Inflammatory bowel disease in Cape Town, 1975-1980. Part I. Ulcerative colitis.

Previously documented and new patients with ulcerative colitis seen between 1975 and 1980 in the Gastro-intestinal Clinic of Groote Schuur Hospital were studied to establish the local incidence and clinical features of this disease. There were 220 patients and the mean follow-up was 7,7 +/- 0,4 years. Sixty per cent of patients were White, 37% Coloured and 3% Black. The incidence for the Coloured and White population was calculated to be 1,3 and 2,4/100 000 per year during 1970-1974 and 1,6 and 2,1/100 000 per year during 1975-1980, respectively. In Jews the rates were 8,5 and 10,4/100 000 per year for the two periods. Insufficient data are available to calculate an incidence for the Black population. The disease was limited to less than 15 cm above the anus in 14% of patients, to the rectosigmoid colon in 45%, and to the rest of the colon in 40%. Although the severity of symptoms was related to the extent of disease, 22% of patients with extensive colitis had mild symptoms, while 15% with disease limited to the rectum had severe symptoms. The clinical features were similar in the White and Coloured population groups. A total colectomy was performed on 20% of patients with extensive colitis; in 2% the disease was complicated by colonic carcinoma.

Adolescent↗

PubMed1983

Inflammatory bowel disease in Cape Town, 1975-1980. Part II. Crohn's disease.

Patients with Crohn's disease seen in the Gastro-intestinal Clinic of Groote Schuur Hospital between 1975 and 1980 were studied to establish the incidence and clinical features of this disease. There were 117 patients and the mean (+/- SEM) follow-up was 6,1 +/- 0,5 years. Of these patients 72% were White, 37% Coloured and 1% Black. The incidence for the Coloured and White population groups was calculated to be 0,4 and 0,9/100 000 per year during 1970-1974 and 1,3 and 1,2/100 000 per year during 1975-1980 respectively. In Jews the rates were 5,0 and 7,2/100 000 per year for the two periods. Insufficient data are available to calculate an incidence for the Black population. The disease involved the ileum in 39%, the colon in 17% and both areas in 44% of patients. At presentation 18% of patients had mild, 37% moderate, and 45% severe disease. The severity of symptoms was not related to the extent of the disease. A peri-anal fistula was present in 24% of patients. There was no difference in clinical features between the different population groups. Surgical resection had been performed in 50% of patients and 29% of these had had two or more resections. The surgical rate in the ileitis group was 63%, in the ileocolitis group 49% and in those with colitis 20%.

Adult↗