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Singing and dancing in hospital lifts spirits

11 December 2021 - Wits University

Rheumatologist takes innovative approach to managing Covid-19.

Sometimes you just need to dance, to sing and to create – because living is much more than having a pulse and a heartbeat.

This is what went through Dr Kavita Makan’s mind when the clinical head of the Covid Medical Response Unit at Chris Hani Baragwanath hospital said yes to getting the largest hospital in the country on board for the “Jerusalema Challenge” in the middle of 2020.

“We had just come out of the first wave and I felt that we needed to do something uplifting, find a bit of escapism, something outside of medicine.

“When we put the call out we thought maybe 50 people would sign up, but in the end we had close to 250 people,” she says.

Makan, a lecturer in the Department of Internal Medicine and Physician Rheumatologist, has been lauded as one of the Wits Covid-19 Heroes for several initiatives at Bara and surrounding hospitals.

The production that she and her team created was in the end a polished eight-minute celebration to the catchy Master KG hit, and a salute to healthcare workers from across the Bara community and a shout-out to a hospital that embodies the spirit of Soweto that pumps like an engine room. It has had over 156 000 views! Watch

“There was such camaraderie - it was really a unifying project and a way of introducing Bara to the rest of the world - because there is nowhere else on the planet like it – it beats to its own drum,” she says.

For Makan, Covid shone a spotlight on the significance of science and medicine but it also came as a reminder that behind these disciplines are people. And what some of these people have been through, who have had to carry an unimaginable burden of grief and loss – including breaking devastating news to patients’ families over and over again. She’s understood too that healthcare workers have had to face their own fears and anxieties in a time of uncertainty. For her these past few months have been about recognising these human needs, also managing everyone’s expectations and harnessing their strengths while sidestepping their weaknesses.

“As a leader you try to be in control but also relatable, it has been very hard because Covid is not what you imagine you’d ever experience in your lifetime as a doctor.

A core group of friends and colleagues who understand her work have been invaluable during this period. “You go through the worst of days and the best of days together – celebrating and commiserating together,” she says.

It has helped that her approach has been to look at solutions through innovation, also to trust in herself and her staff. For instance it was Makan’s networking abilities and professional standing (she’s the current president of the South ��һ�Թ��� Rheumatism and Arthritis Association - SARAA) that made it possible for her to get an international film and documentary producer to edit and produce the “Bara Jerusalema Challenge”; also to lean on a pharmaceutical giant to donate doses of the drug Tocilizumab (TCZ), an expensive biologic agent that has been essential in fighting inflammation in Covid patients at Bara. “We hope to publish results on the outcomes of the patients who’ve received this therapy as we utilised a non-standardised regimen, based on limited access.”

Makan has set up debriefing sessions for her colleagues – dubbed Covid Confidentials, a pandemic playback, which included input from a psychologist and life coach; initiated COVID-19 treatment protocols; designed templates for more efficient admissions processes to get patients to the correct units as fast as possible and improved communication channels with the Nasrec field hospital when it was operating, and more recently the ABT (alternative building technology) facility  to ensure patient transfers were carried out without glitches. “We’ve had great collaboration between all our specialist units within the hospital as well as with our surrounding centres, through effective communication and mutual understanding.” She also set up a teaching programme for junior doctors. It includes weekly tutorials and discussions to keep the doctors on track with their academic programmes even as they have been pulled in to be part of the all-hands-on-deck emergency teams as successive Covid waves have unfolded.

In the rheumatology space, Dr Makan has been pivotal in informing practice during the COVID pandemic for rheumatologists and their patients, through the development of national management and vaccination guidelines, as well the establishment of a national COVID-19 rheumatology database in collaboration with international rheumatology organisations as part of the global rheumatology alliance. “Even though I have dedicated much time in the past year and a half to managing COVID-19 at Bara, I still have to ensure that the advancement of the science and practice of rheumatology in South Africa is on an upward trajectory.” This includes regular lectures and academic presentations to the medical community, the establishment of national guidelines for rheumatic disease and improving access to specialised treatments for her patients, all the while pursuing her PhD in her main area of interest: systemic lupus erythematosus.

She acknowledges that the peaks of waves “can be all-consuming”. But she jokes that the best part of being so busy is that she is no longer a TV series binge-watcher.

“I was that person; so I’m quite proud of myself for watching so much less TV these days,” she says.

But she still believes in the reprieve of a bit of escapism and for Makan it’s in art, fashion, writing, music and creating. Many of these interests she gets to combine and express in projects like her SARAA publication, NewsRheum. For the other interests there’s retail therapy that she admits is a guilty pleasure.

There’s also spending time with her family, especially her four-year-old who she had to prepare for pre-primary school during the pandemic.

Ultimately it’s to look at things as a journey. She says: “I love when an idea becomes a project and is something that I get to see through to the end. That’s how I draw energy to keep on finding dynamism and innovation to try to find solutions in the worst situations,” she says.

��һ�Թ��� Wits Covid-19 Heroes

The Wits Heroes Series celebrates staff and students who went beyond the call of duty at the onset of Covid-19 in 2020. Wits Heroes were nominated by members of the Wits community. Discover other Heroes.