SOUTH AFRICA has a "grave shortage" of paediatric surgeons. They are mainly overworked and forced to delay non-emergency operations, leaving children waiting for months

The SA Association of Paediatric Surgeons (Saaps) has warned that there are only 27 of them registered in the country, but some have already retired and two work only in private practice.

The remaining 25 have to delay scheduled operations when emergency procedures are prioritised.

The dwindling number of qualified paediatric surgeons is causing massive backlogs, with long waiting lists for operations for conditions such as cancer, hernias, and bowels which are located outside the abdomen.

In the UK there is a relative "oversupply" of paediatric surgeons and in Europe there is one for every 300,000 children. In the US there is one paediatric surgeon for every 400,000 children, but in South Africa there is just one for every 2 million children.

These include:

• About 10 who work in the Western Cape, at the Red Cross Children's Hospital in Cape Town and in Stellenbosch.
• Six in Gauteng who work in teams of two at Johannesburg's Charlotte Maxeke and Chris Hani Baragwanath Academic hospitals, and Pretoria's Steve Biko Academic;
• One in the Free State;
• Five in KwaZulu-Natal; and
• Three in the Eastern Cape.

The waiting list for paediatric surgery, for children between birth and 16 years, is so long that at Chris Hani Baragwanath, the two surgeons there operate on children up to the age of 10. Those older are placed on the adult surgery waiting list.

To solve the backlogs at Charlotte Maxeke, paediatric surgeon and president of Saaps Prof Peter Beale arrange a biannual catch-up week during which more than 50 children are operated on in five days.

"It's a necessity really, otherwise we're swamped by never-ending overload of patients," he said.

A relieved Andisiwe Qum strapped her 17-month-old son to her back before he was discharged from the paediatric ward yesterday. On Friday, baby Avelile had his third operation.

The procedure, to remove a colostomy bag he has worn since he was born without an anus, had been delayed six times as emergency procedures took priority. The little boy has waited since last November.

"I was always stressed out and I started losing hope he would have the operation," Qum said.

Dr Leslie Pieterse, a surgeon training under Beale, said she often has to tell parents who have prepared their children for hospital and taken off work that their child's surgery has been cancelled.

"You feel so guilty, I hate doing it, I spend the whole day in theatre and then go and speak to the mums. Their kids are screaming and starving because they haven't eaten all day (in preparation for the operation)."

Pieterse said that the theatre lists were "usually overbooked" and the next available date: November 14.

Beale put the shortage of paediatric surgeons down to a "10 years minimum" training period but is grateful to now teach four trainees.