Every year, on 7 April, we observe World Health Day; a day to highlight critical issues and spark conversations that can shape healthier futures. This year, the focus is on maternal and newborn health; a campaign centred on “Healthy Beginnings, Hopeful Futures.” It’s a call not just to governments and medical professionals, but to all of us, to confront the silent tragedies of preventable deaths, and to work toward a world where every mother and every child has access to quality care.
To deepen this conversation, we invited the insightful and deeply inspiring Dr. Joy Saville to share her story, her passion, and her dreams for a better, more inclusive health system in South Africa.
Rooted in faith, fuelled by purpose
When asked what fuels her inner fire, she doesn’t hesitate: “Being a child of God.” That unwavering sense of identity, she says, is the source of her childlike optimism and boldness. It’s what gives her the courage to believe that nothing is impossible; that healing, even in the darkest spaces, is always possible.
“I am the daughter of a King,” she says with a smile, “and there’s a certain authority that comes with that… but also a humility.” Outside her work, she is a wife, a mum, a plant-lover, every plant has a name, and a pillar of her local church community. Her life is layered with colour, warmth, and conviction. But behind the radiant joy is a path that was anything but easy.
The path to medicine, and back again
Dr. Joy always dreamed of being a doctor. But volunteering at Red Cross Children’s Hospital as a teenager shook her. She witnessed pain too heavy for a child to carry, and it left her deeply unsure if she could survive a career inside those hospital walls.
One infant, in particular, left an indelible mark. A baby boy, joyful despite the fact that he had already lost limbs to burns, changed the course of her life. “I remember thinking, I’m not strong enough for this.” After walking away from that dream, it would take years of searching and healing before she would find her way back, this time, through the door of natural medicine.
Finding healing in the water
Growing up in Mitchell’s Plain, Dr. Joy didn’t have access to things like homeopathy or traditional Chinese medicine. But the natural world still found its way to her. As a child, she suffered from a persistent abscess. Countless treatments failed, until a family holiday in George, where days in the sea finally cleared her skin enough for doctors to operate. “It was the salt water,” she remembers. “Nature healed me.”
This experience, alongside her formal studies in natural medicine at the University of the Western Cape, opened her to the power of alternative healing. But even as she grew in that space, her heart never fully left Western medicine. “I’d dream about it. Pray about it. I wondered if I was coveting something that wasn’t meant for me.” But as time passed, and after losing a young patient to an incurable disease, Dr. Joy realised she needed to go back. Not just for her own calling, but to be fully equipped to serve those who needed her most.
Technology with a heartbeat
Now, Dr. Joy is part of Medescreen, a pioneering South African medical technology company working to make healthcare more accessible, affordable, and equitable. The brilliance of Medescreen lies in its dual mission:
- To serve underserved communities by offering rapid screening for 10 common medical conditions through a portable, AI-supported backpack;
- To support unemployed doctors through mentorship, financial literacy, and business training, skills not taught in traditional med school curriculums.
“We had over 800 unemployed doctors last year,” she notes. “This year? More than double.” For Medescreen, solving this problem isn’t just about employment, it’s about justice. It’s about restoring dignity to both patients and practitioners.
When medicine forgets women
Dr. Joy speaks candidly about the gender gap in medical research and treatment. “Menopause is inevitable,” she says, “but suffering is not.” Yet many doctors receive only a surface-level education on it. Symptoms are missed. Misdiagnoses are common. Women are often left suffering in silence, shuffled through a system built for male bodies.
The inequalities run deep. From under-anaesthetised procedures like IUD insertions to gender-based violence survivors having little to no access to mental health services, the landscape is difficult, but not hopeless. “There is movement,” she says. “More female doctors, more conversations. But we still have a long way to go.”
Dreaming beyond the now
Dr. Joy hasn’t forgotten where she came from. Her dream is to one day return, not permanently, but intentionally, to Mitchell’s Plain, to show young girls growing up in townships that they can dream bigger than survival. “I want to be the voice I didn’t have,” she says. “To say, you are allowed to take up space. You are allowed to believe you can change the world.” And with doctors like Dr. Joy Saville leading the way, rooted in faith, anchored in compassion, and armed with both science and soul, perhaps we’re already on our way there.
Listen to the episode
Links
Website: Medescreen
Transcript
Kami 00:00:03 – 00:00:57
You have just tuned into InnoStation where the latest and hottest topics are always on air. I’m your host, Kami, and each episode we serve up heats with fun chats, fire insights and special guest appearances with some surprises along the way. Now, World Health Day comes along every year on the 7th of April. And this year it launched a year-long campaign that focuses on healthy beginnings and hopeful futures, focus on maternal and newborn health and urging governments and the health community alike to intensify efforts to end preventable maternal and newborn deaths. And this is definitely a very important conversation that we want to have. And so we’ve invited the lovely Dr. Joyce Saville to give us some insights into these focus points and the state of healthcare for women and children in South Africa at present. Dr. Joy, welcome to InnoStation.
Joy Saville 00:00:57 – 00:01:02
Thank you so much, Kami. It’s such a pleasure and an honor to be here today.
Kami 00:01:02 – 00:01:07
Of course. I’m so excited to have you. You always have such great energy.
Joy Saville 00:01:07 – 00:01:09
Thank you.
Kami 00:01:09 – 00:01:16
To kick off this episode, let’s get to know a little bit about you. Tell us who Dr. Joy is and what fuels your inner fire.
Joy Saville 00:01:16 – 00:01:53
Okay, perfect. I love this question so much. I think I’ve had so much time to reflect on it. The last year has been a bit of a whirlwind for me and so it really made me question my identity and where I’m putting my identity in. Yeah. And you know, after a series of like reflection and introspection, I can really say that the thing that now defines me is being a child of God first. This is definitely where I get my childlike optimism. The thought that nothing is impossible.
Joy Saville 00:01:53 – 00:02:33
You know, I can do whatever it is that I want to do because I am the daughter of a king. So there’s a certain authority that comes with that, but there’s also a humility that comes with that. Outside of, there’s no outside of my faith, but outside of that, I am also a wife to a Zambian born Filipino. We’ve been married for 14 years now. He’s an artist. His name is Jojo. This is his artwork behind me. I’m also a mom to an incredible 10 year old daughter, Gabriella.
Joy Saville 00:02:33 – 00:03:03
She is someone to look out for. I’m pretty sure she’s going to take the world by storm one day. She’s a dancer and an actress and also a budding artist like her dad. I also, I love children, I love animals, I love plants. And this is where I get to be my quirky, childlike self. Do all of my plants have their own names? I have two dogs and a cat. Yeah. What else about me? I love my community.
Joy Saville 00:03:03 – 00:04:05
So I have a fantastic, very close knit church community, a very diverse bunch of people that belong to our church from all over the world and then from all walks of life here in South Africa we do. We also bless to live in a country like South Africa where there’s, you know, diversity in race and culture and class and I get to experience all of that. And if we zoom out a little bit, in terms of my community involvement here in the Fourways area, I loved working with underserved communities in and around Fourways and in the Greater Gauteng. And one day I hope, like I said, big dreams. But I really do hope and pray that I’ll have the opportunity to go back to Cape Town. Not on a permanent basis, but I grew up in an area called Mitchell’s Plain. It’s a coloured township in Cape Town. And I would love to serve as an encouragement to people like me who grew up not thinking that we could dream big.
Joy Saville 00:04:05 – 00:04:14
So I would love them to know that you can, your dreams are valid. You can dream big. There’s nothing that’s impossible.
Kami 00:04:14 – 00:04:58
Oh my goodness, Dr. Joy, your life sounds hopeful and so beautiful and I love that. And I, I know that like when you want to go back to Cape Town, to Cape Town and everything, it definitely is possible. You have a very inspiring story and even your career path has been very inspiring. I mean, you started off studying natural medicine and then you later then went into Western medicine and with that was with the hopes of sort of going into specialising in pediatrics. Right. Can you walk us through that journey? Like what first prompted you to want to study natural medicine and then what also led to you sort of sliding into Western?
Joy Saville 00:04:58 – 00:05:45
Yeah, definitely. My dream was always to be a doctor. I think it was one of my earliest childhood memories. I’m going to be a doctor and I’m going to be a pediatrician. But along the way that dream got derailed. I volunteered at Red Cross Children’s Hospital in Mowbray, Cape Town as a teenager. A very, depressed and moody teen, as most of us are at that age. And during that time, I remember coming home devastated, like, just completely shattered that these beautiful children were suffering so much. They were just, you know, they were either terminally ill or they were maimed in some way.
Joy Saville 00:05:45 – 00:06:20
One particular example of this was in the burns unit at Red Cross Hospital. There was this infant. He was so joyful. It was as if, you know, he had no sense of awareness of what was going on around him. He looked and he played, but this little boy, you could smell the paraffine as you walked into the room. And at under 1 years of age, he was already a double amputee. You know, arm off, leg off. And it was at that moment that I thought, you know, I’m just not, I’m not strong enough to do this.
Joy Saville 00:06:20 – 00:06:54
Yeah. And so I had no life plan after that. You know, I went to UCT for a year, not really knowing what I wanted to do. My heart’s full in some ways, bleeding to be a doctor, but I really wanted to escape the trauma that came with being in hospital. It was during that time, that first year of uct, that I found out about the program called Natural medicine. And Natural Medicine allows you to become a doctor, but you don’t need to work in the public sector. And so I was like, okay, this is great. Like I get to experience, experience the best of both worlds.
Joy Saville 00:06:54 – 00:07:28
You know, I get this title doctor, but I don’t have to deal with the trauma. So it’s a five year double bachelor’s program that was offered at the University of the Western Cape. And I had no formal exposure to natural medicine prior to this. I mean, like I said, I came from a colored township. You know, we were a low income family. There was no money. I was a recipient at Red Cross Hospital myself. There was no money for things like homeopathy and, you know, traditional Chinese medicine.
Joy Saville 00:07:28 – 00:07:54
But indirectly I had been a recipient of the healing powers of nature. So like I said, I had seen the wards of the Red Cross one too many times. I had been admitted a couple of times. I had, you know, acute gastroenteritis, I had meningitis. One of the things that I had more recurrently was a hole in my ear. And many people are born with it. You know, it’s just like a little hole over here. Yes.
Joy Saville 00:07:54 – 00:08:30
Have you seen that before? Yeah, called a preauricular sinus. And typically it’s not problematic at all. Obviously it became problematic for me. Mine became infected and I would get recurrent abscesses that would develop and then it would burst, and then it would develop and it would burst. And so the ents at the time thought that it would be best to operate, but, but they had to clear the infection. I had received countless antibiotics and nothing was working. I remember being held down in hospital and I don’t know if they gave me an injection in my head. Whatever it was was really, really painful.
Joy Saville 00:08:30 – 00:09:27
But even that didn’t work. And after going on holiday with my family to George and spending a week in the ocean, just like swimming and having fun, this access healed, so it was salt water, the sea water that had resulted in the healing of this abscess long enough for them to actually operate it because they needed, they needed intact skin and they couldn’t operate over this infection. And so, yeah, so indirectly I had this, you know, natural type experience. But when I was studying natural medicine, I really fell in love with it. I loved the philosophy of natural medicine. You know, there’s just so many modalities and therapies available, a big emphasis on lifestyle. But my heart still longed for western medicine.
Joy Saville 00:09:27 – 00:10:10
It was just like this desire that never left me. I would dream about it, I would pray about it, I would be like, lord, like, you know, is this from you? Is this life? Am I coveting like something that I’m not supposed, supposed to have? Yeah. But in 2013, I saw an 8 year old boy. He had a condition called pulmonary hypertension. This is a condition to which there’s no cure. And his parents were looking for, they were looking, they were looking for a cure. They’re looking for an alternative approach with the hopes of finding a cure for him. After about a month of seeing him and I saw him call quite regularly, we did something called cupping therapy.
Joy Saville 00:10:10 – 00:10:43
We made adjustments to his lifestyle. We had seen big improvements in his quality of life. He went from being couch bound on oxygen to riding a scooter, driving a car for the first time at 8, playing soccer. And so we were really, really hopeful. But he had a short stay in hospital. He had developed an upper respiratory tract infection, and had an overnight stay in hospital. They’d run all the tests. The test came back beautiful.
Joy Saville 00:10:43 – 00:11:21
You know, the first time in a year that he was getting, you know, normal test results. And a few days later, he woke up around 4 or 5 in the morning and he told his mom, I’m going to die now. And he took his last breath and he. And he died. And this completely devastated me. You know, it sent me spiraling into this deep depression. But what it also did was it set off this cascade of parents with terminally ill kids coming to me looking for an alternative. After a few years, I didn’t for a while.
Joy Saville 00:11:21 – 00:12:09
I didn’t practice. You know, I was, I was too devastated to go back into practice. But after a few years with much pre, I had realised that I couldn’t run away from something that I was ordained to do. You know, I was ordained to become a medical doctor in addition to my natural medicine degrees. I realised that I was not in control of life and death. You know, I am a vessel for healing, but the healing doesn’t come from me, it comes from God. Yeah. And that I really needed the experience and the education and training that you receive when you are a medical doctor because I was out of my depth with some of these conditions.
Joy Saville 00:12:09 – 00:13:07
I had never heard of some of them until my parents would come and speak to me about it. So I really needed that extra training. And so that was the start of, you know, my journey into reapplying to study medicine. In 2016. I’d applied to study at this. They have something called a graduate entry medical program. So that means that if you are a former graduate, you can enter into your third year of medicine. Yeah.
Joy Saville 00:12:39 – 00:13:07
So instead of doing medicine over six years, you do it over four years. And obviously that was very appealing to me. And so I applied for this course. I did the, it’s called a WAC test, with an additional placement test. At the time my brain was not braining. I had a two year old daughter. The porridge brain was hitting me hard. But again, by God’s grace, I passed that exam.
Joy Saville 00:13:07 – 00:13:43
It was also during that time that my husband was going through a retrenchment process. His salary had already been cut by 60%. Yeah. And so we had no financial means of covering this 70 plus thousand rand fees a year. But God was so good to us and I received a full bursary for the four years of my studying. In 2017 I received a scholarship that covered my living expenses. My brain somehow got back to normal and I passed all my exams very well.
Joy Saville 00:13:43 – 00:14:33
Yeah. And, and so that was, that was me and medicine. And like I said, the intention was to specialise in pediatrics. That’s definitely a big part of my heart that belongs to children. But last year, you know, things didn’t work out the way I thought that they would work out. Yeah, I was, I was busy doing my diploma in child health last year, but I just could not find a position in PEDs. However, the time that I had off, you know, with unemployment, it also made me realise that I’ve been an absent mother for like seven years by that time. And I really wanted to be present for, for my daughter and for my husband.
Joy Saville 00:14:33 – 00:14:47
And so now, I prayed about it and, and God said, well, you don’t have to specialise to serve children. You can be in general Practice and serve kids. And so that’s, that’s where I’m at right now.
Kami 00:14:47 – 00:14:59
And speaking of where you are at right now, right, you are currently working with Medescreen as well. Can you give us a little bit of background into sort of the organisation and what the intention is behind it?
Joy Saville 00:14:59 – 00:15:50
Okay, so yeah, so Medescreen is a fantastic organisation and they also, they hockey school, you know, community development, but essentially they are pioneering medical technology company and the dream is to create accessible and affordable health care for South Africans whilst serving the unemployed medical doctors. Just on the side note, last year, so it was my first service. Yeah, it was post community Service, there were 800 unemployed medical doctors in the country at the time. Wow. This year that number has almost doubled. Yeah, actually it has more than doubled. It’s not almost doubled. It has more than doubled.
Joy Saville 00:15:50 – 00:16:49
And so Medescreen. Yeah, the aim of Medescreen is to do it in two fold, provide accessible and affordable health care. Serve unemployed doctors with accessible and affordable health care. They’ve developed this backpack that screens 14 of the most common medical conditions. The information is then processed through AI and it generates an electronic report that gets sent directly to the patient’s device. It has something like 110 data points that we can then use to make further decisions, you know, see what the need is in that community. Alongside the backpack. When it comes to the unemployed medical doctors, Medicine really wants to provide mentorship, business acumen training.
Joy Saville 00:16:49 – 00:17:39
So because we don’t get any of that, you know, at med school, there’s no business training at med school. And so in order for us to run successful practices, you know, we really do that. That’s also the financial literacy part as well. So the ministry has really tailored this complete package for us as post community service doctors to have a better chance of having a successful practice and then simultaneously, you know, providing better access. If we, if it’s someone that is from Limpopo, there’s no need for you to be in, you open up your practice in Limpopo. It creates better access to health care for the greatest of Africa.
Kami 00:17:39 – 00:18:00
Yeah, and I love that because you are right. The case of unemployed doctors really has become quite intense because you see, I’ve seen a lot of conversations online with just people, a lot of doctors coming out and saying they’re unemployed and a lot of us that aren’t doctors are like what do you mean? What do you mean?
Joy Saville 00:18:00 – 00:18:01
Absolutely.
Kami 00:18:01 – 00:18:55
I thought we had a shortage and there are doctors with no jobs, but I like the concept of Medescreen, sort of empowering unemployed doctors to be able to run their own practices and also empowering access. Right. And those doctors can then go into underserved communities and start practices there and serve those communities. I think that’s a really great model. And our topic that we want to go into is sort of things that we’ve seen online, I mean, much like the public doctors, but we’ve seen a lot of conversation around the suitability of medicine in general for women. Right. And this discussion often focuses on sort of women’s symptoms not being understood or often being overlooked. Things like medical misogyny that female patients, nurses and doctors sometimes face.
Kami 00:18:55 – 00:19:15
And also just the state of medical research and how little of it is dedicated to sort of women’s health. And then I imagine, by extension, that it also affects children’s health as well. Right. So would you say that medicine in South Africa is in a similar state to what we’ve been seeing in the conversations happening internationally?
Joy Saville 00:19:15 – 00:20:19
Yeah, I do, I do. Look, I mean, medicine is universal. And so the way in which we practice here, yes, of course we’ve got our unique epidemiology in South Africa, but we still use global standards. And so, yeah, in terms of, you know, medical misogyny, in terms of research, of the way in which women present, you know, you know, do we present in the same way as men, present the current model that is currently being taught to us as med students and medical doctors, you know, is this. Is this based on male patients? Is this based on female patients? A lot of it has been based on men and male presentation. Also, you know, I was reading up about something about, you know, just like treatment that is specific for women. We don’t have, you know, we don’t have treatment specific to us.
Joy Saville 00:20:19 – 00:20:40
And so, yeah, in that way, there are many similarities between the way in which things are run in the States and the way in which things are done here in South Africa. I think also, in terms of, just to make it practical, there’s some big examples, like something like menopause, you know.
Kami 00:20:40 – 00:20:41
Yeah.
Joy Saville 00:20:41 – 00:21:40
Something that every woman, it’s inevitable. It’s an inevitable phenomenon for every woman. We are going to go through menopause, and yet, like, it is a subject that we know so little about as medical doctors. In terms of our training. We don’t get sufficient training on it. You know, the extent of it is you’re not producing eggs, your estrogen is dropping, cessation of your period for a year, the end, the End and coming into private practice and seeing just like the diverse impact that menopause has on females and not knowing, you know, personally, like had I not done my own research, I don’t think I would have known that. A lot of presentations that women between the age of 35 to 50 are coming with. It’s actually like menopause.
Joy Saville 00:21:40 – 00:22:33
So women are often misdiagnosed. They are often given cocktails of medication, to treat, you know, this array of symptoms that they come with when there is, you know, suffering is not. Menopause is inevitable. Suffering is not. Yeah, and so, yeah, just something like that, something as simple as menopause is something that is often neglected in our medical spaces. The other thing would be analgesia for women, you know, if we go for an intrauterine device, you know, something like the merino. We’re not really, we don’t get any analgesia or we’re not, we don’t receive any anesthetic for them. You know, we get very basic analgesia.
Joy Saville 00:22:33 – 00:23:22
But if you had a lesion on your skin, you’re going to get anesthetised, you know, you’re going to get that local anesthetic. You don’t want to feel that if someone is putting a device into your uterus and you’re not getting anesthetic. And so there is this disparity between the way in which men are treated versus the way in which women are treated. And I think that’s a global thing. That’s not something that’s unique to South Africa. But we do have our own unique discrepancies. Access to medicine in general is a huge problem in the South African context. But again, like when you look at things like reproductive and maternal health care, especially if you come from a rural community, you have a lack of access to those things.
Joy Saville 00:23:22 – 00:24:06
Other things like, you know, gender norms. So women are often at higher risk of the transmission of HIV because a man gets to say that he wants to or doesn’t want to use a condom. Yeah, yeah. So, so yeah, they are all of those disparities that exist then another big one is gender based violence. This is like a pandemic in South Africa. And even if you have not been a direct victim of GBV, like as women, we still walk around with that kind of fear every single day that we might be the next statistic.
Kami 00:24:06 – 00:24:07
Yeah.
Joy Saville 00:24:07 – 00:24:54
And for those that are unfortunately statistics, there’s no specialised mental health care services available in our hospitals to deal with. That kind of stress and that kind of trauma that is caused. So, yeah. So unfortunately, you have a long way to go to bridge this gap. I know that as a doctor, I know that the number of female doctors is increasing in South Africa. That’s great. We still have still more male dominated, but I do think that there is an effort to increase the number of female doctors. But there’s a long way, we have a long way to go before we have that kind of equity in medicine.
Kami 00:24:54 – 00:25:22
And just speaking on sort of different presentations in men and women, what are. And also with the issue of women’s symptoms often being overlooked, can you tell us what some of the most common overlooked symptoms are during pregnancy especially? And just things that we might not necessarily regard or know as danger signs until it’s actually now and a big problem.
Joy Saville 00:25:22 – 00:26:40
Yeah, yeah. In terms of overlooked symptoms. Yeah, I would, I would definitely want to start this conversation by saying that during pregnancy, you know, for all women, whether this is your first baby or your fifth baby, like one of the most important things that you can do for yourself, for your health and for the health of your little one is to get booked early into some sort of antenatal care. Because they are, you know, some of these danger signs that I will speak of, sometimes they can present as normal pregnancy symptoms and you would need a critical eye to establish whether or not this is something that needs further investigation or if this is just pregnancy. Okay. So please, ladies, even if you’re an experienced mom and you have done this so many times, get booked, get your answers, okay. The other thing that I think is also really important to mention is youth services.
Joy Saville 00:26:40 – 00:27:40
So for our teen mommies, and this is, we often see late booking with our teen moms because of the stigma that is attached to pregnancy in the teen years, or fear that their parents are going to find out or fear that it’s not going to be well received in that kind of clinic setting. And I do think a call to healthcare workers is to be more youth sensitive, to provide a space that is safe for our youth to enter into, you know, free of any sort of judgment or discrimination. But our teens are also a high risk group when it comes to pregnancy. And so they also need to, you know. Yeah. For their life and for the life of that little baby that’s growing inside of them. They also need to book early. But as healthcare workers, we also need to receive them more sensitively.
Joy Saville 00:27:40 – 00:28:47
So that being said, in terms of dangerous answers, what I’ll do is I’m just going to look at some of the common causes of maternal death in South Africa and then we’ll look at, like, some danger signs there. So the first big cause of maternal health there, he’s actually not related to pregnancy infections, not related to pregnancy. So things like hiv, tb, pneumonias, those are the three big ones. And again like something like HIV, pregnant women are at higher risk of transmitting or of becoming infected with HIV during the time of pregnancy. We now have, you know, we’ve changed things up a bit where we actually, actually do tests at every antenatal visit. Okay. So this is again just highlighting the importance of looking for antenatal care so that you can get tested at every visit. We do a verbal screen for tb.
Joy Saville 00:28:47 – 00:29:34
So the symptoms would be, you know, a cough, more than two weeks, loss of appetite, loss of weight loss. As a technical woman, we don’t want to see a loss of weight and then night sweats and then any fever, you know. So if you are feeling hot and you know, and not only just internal heat, you know, you churn on your head and you are feeling hot, this warrants further investigation. Okay. This warrants you going in and getting checked out so that the infections are not related to pregnancy. Then medical and surgical conditions. Okay. That’s another big one, another big cause.
Joy Saville 00:29:34 – 00:30:09
And the biggest like sub cardiovascular heart disease. So yeah, this is why I’m saying like you can, we can often miss this if you are not coming in. Yeah. Shortness of breath, which is a pregnancy symptom. The bigger your tummy grows, the less space for your lungs to expand so you can be short of breath. Fatigue, another one that can just be mistaken as a pregnancy symptom. And then swelling, swelling of the legs and the ankles. Okay.
Joy Saville 00:30:09 – 00:31:01
So if you have any of those, it’s important for us to discriminate whether this is something to do with your heart or is this just features of, like a later pregnancy? Okay. Yeah, so that’s cardiovascular. The other one is hypertensive diseases in pregnancy. And so the hypertensive disease is also a big one, a big cause of premature deliveries and of your, either your neonatal death, your early neonatal death or your stillborns. Okay. And with the hypertensive disorders, the danger signs over there would be a severe headache, blurry vision, shortness of breath, pain in the top part of the tummy. Okay. And then again swelling.
Joy Saville 00:31:01 – 00:31:28
Okay. And oftentimes we see swelling even in the face. Okay. A later symptom of or later red flag of uncontrolled blood pressures in pregnancy is something called eclampsia, where the woman starts to fit. Okay, but obviously we don’t want it to get to that point because that’s. That’s quite late. And that’s where things become quite dangerous.
Joy Saville 00:31:28 – 00:32:21
Like, again, high fisher in pregnancy, if managed correctly, moments that we can do well. But if it’s not managed, if it’s missed, if you are eight months pregnant and now only coming in for antenatal care and your blood rushes through the roof, you know, it poses a big risk for both you and your baby. Okay, so there’s the hypertensive disorders. Another one is obstetric hemorrhages. Okay. So this would include any sort of vaginal bleeding from 26 weeks onwards and up until the postpartum period, typically the first 24 hours after giving birth, but it can be up until six weeks. Okay, so any sort of bleeding and pregnancy is a red flag. All right.
Joy Saville 00:32:21 – 00:32:59
Yeah. The obstetric hemorrhages, like I said, after 26 weeks. But then earlier on in pregnancy, if you are bleeding, even if it is, you know, not a lot of blood, if it’s like spots of blood, but you’re having severe lower abdominal cramps. Okay, we want to rule out ectopic pregnancies. We want to rule out miscarriages. Okay. Yeah. So those are some of the red flags with looking at just like a common, you know, the top causes of maternal deaths in South Africa.
Kami 00:32:59 – 00:33:35
Yeah, I think that was, like, a lot of information. I know, but it was a lot of important information. Right. Because some of these symptoms, I’ve heard, like, people that were pregnant be like, yeah, my feet are swelling. I’m just gonna put them up. You know, a lot of these things aren’t regarded as red flags until, like I said, it’s like, a big issue. And so I think it is important to sort of have just these general basics of, like, what is common. And like, you mentioned, like, getting into your antenatal care early on so that these things are able to be spotted at every turn.
Kami 00:33:35 – 00:34:12
You know, sure. Now, in South Africa, but in South Africa in particular, the probability of a child dying before reaching their fifth birthday is approximately 35 per 1,000 live births. What are some of the common reasons behind this issue? And is there anything that you would recommend that we can do at a parental level and then also maybe at a sort of governmental, like, public health level that can help lessen this figure? Because I think 35 and 1,000 is a lot.
Joy Saville 00:34:12 – 00:34:33
It is a lot. It is a lot. And it’s really, really tragic. I think the tragedy of the statistics is that a lot of these deaths are preventable. So it’s heartbreaking that it can actually be prevented. But yeah, let’s.
Joy Saville 00:34:33 – 00:35:03
Let’s get into some of the causes first. Okay, so the big one, there would be 10 deaths in the neonatal period. Okay. So that’s the first 28 days of life. And a lot of these maternal conditions that we discussed, they are risk factors or they predispose our little ones of being born prematurely. Yeah. Being born with, you know, birth asphyxia. So a lack of oxygen to the brain.
Joy Saville 00:35:03 – 00:35:31
Yeah. Which. Which then makes survival less likely. Okay, so again, just going back to the booking of antenatal care and the importance thereof. Early booking is essential. Okay. Then there are your top three, you know, very preventable causes. Aerial disease.
Joy Saville 00:35:31 – 00:36:03
Okay. Pneumonia, and then severe acute malnutrition. Okay. So this accounts for the other 75%, or not exactly 75%, but this accounts for a large majority of deaths in our children under five years of age. There is a report that’s available. It’s called the fourth triennial report Report of the Committee of Morbidity and Mortality in children under five Years. Okay. Or comics.
Joy Saville 00:36:03 – 00:36:39
I’m just gonna say comics for short. And this report was published in 2020, and it reviews 2017-2020 stats of childhood mortality. And one of the big behind childhood deaths in the under five population. And this was across the board with parents, with health care workers in the accidents and emergency department as well as in the wards itself, not recognising danger signs. Okay.
Kami 00:36:39 – 00:36:40
Yeah.
Joy Saville 00:36:40 – 00:37:30
So again, when it comes to parents, you know, just the knowledge of what are these danger signs? And if my child has a danger sign, what does that mean? Like, what am I supposed to do? And typically, any danger signs warrants immediate, you know, going to the hospital or to the clinic immediately. Okay. In our health card booklets that moms receive for their babies at birth, there is a page that lists a lot of these dangerous sites. Okay. I just want to go through it with you. All right? And it has pictures as well, so that, you know, there can be some understanding. And then we’ll talk about some of the shortcomings of this. All right? So that the child is coughing and breathing fast.
Joy Saville 00:37:30 – 00:37:59
Okay? And it says more than 50 breaths per minute. A child under 2 that has a fever and is not feeding, a child is vomiting, everything. The child has diarrhea, sunken Eyes and sunken throat, fontanelle. The child is shaking, convulsions. The child has dangerous signs of malnutrition, swollen ankles and feet. The child is not moving and does not wake up. And the child is unable to breastfeed. Okay? So it is important for parents to have knowledge of this.
Joy Saville 00:37:59 – 00:38:47
But one of the big shortcomings of this is that it’s only provided in English. Okay. And living in a country like South Africa, we definitely need to offer this information in more than one language. The other thing is that there’s still as. As much as they’ve tried to keep it simple, there’s still medical terminology here. A fontanelle, you know, I don’t know how many lay people know what a fontanelle is. And so we really do need to look at working on our language so that it can actually address the educational needs of the people that we are trying to educate. The other big issue here is that some of these signs are late signs.
Joy Saville 00:38:47 – 00:39:24
You know, like lethargy. A child is not moving and does not wake up. That is a late sign. We do not want a lethargic child coming to hospital. The prognosis there is not great. And so that was another thing that was mentioned in the comic was that patients present late. You know, and I’ve worked in the pediatric department and I’ve seen it is a nightmare, especially with your diarrheal disease. You know, kids are in shock, they are so dehydrated, we cannot find a vein.
Joy Saville 00:39:24 – 00:40:15
Anyway, our resources are limited. We try to put lions into the bone directly. You know, sometimes it works, sometimes it doesn’t work, but it really is a nightmare to work with a shocked baby. And so again, early presentation, early presentation and education. So we should be. And again, this is again, when we talk about resources, human resources. You know, I know a lot of hospitals and a lot of clinics, they have health health promoters that provide education and training to provide, you know, informative discussions around some of these conditions. I’m not sure how I know in Gauteng, in the clinics that I was at, there was always a healthcare promoter.
Joy Saville 00:40:15 – 00:41:00
But going more rural, you know, is this something that’s available to people in the more rural areas? But yeah, we should be educating our parents in their language in a language that they understand with simple, you know, language, not medical terminology on these danger signs. Then like I said, you know, failure to recognise danger signs early, even in the hospital type setting. And again, I think this is a. It’s another resource problem. You know, the ratio of healthcare workers to patients is disproportionate. There aren’t enough healthcare workers. And so this often results in. We should be reviewing, you know, the child comes in dehydrated or shocked.
Joy Saville 00:41:00 – 00:41:54
We should be reviewing this child as frequently as we can. Again, there are guidelines as to the times that we want to review, but oftentimes, you know, someone that came fresh out of the system, you are running around all night. You know, you are in the theater delivering premier babies. You are dripping, you are in the, in the high care setting, trying to tube little babies. And so the review process can often be delayed. And so this is, you know, this failure of recognising danger signs and acting on it. Soon enough, you know, you can often, you go back in and the child is worse or more dehydrated than what they came in. Maybe because their drip moved.
Joy Saville 00:41:54 – 00:42:36
Their drip is not actually in the vein anymore. So they’re just getting a lot of fluid in their arm. Yeah, so that’s some of the things that the comic addresses. They also speak about a lack of facilities like a high care facility or intensive care units in your higher level hospitals. And this is also a big reality for us. Sometimes we have kiddies that have very specialised needs and they need these specialised services. But the high cares and the ICUs are, you know. Yeah, so resources, a lot of resource constraints.
Joy Saville 00:42:36 – 00:43:24
I think the things that we can change in the immediate period is providing education. The other thing is when it comes to something like malnutrition. And malnutrition is often a risk factor that not only is a direct cause, cause of, of childhood death, but it can also be an indirect cause. So malnourished children are just, they’re more likely to get infections. And this, there’s this two fold thing with malnutrition. The one is, you know, malnutrition causing infection. The other side is the infection causing malnutrition. Right. But again, kids are supposed to, you know, up until 18 months, they’re coming in quite regularly for the vaccinations.
Joy Saville 00:43:24 – 00:44:39
And then from 18 months to 5 years of age, they should be coming in every six months to receive vitamin A supplementation, to receive the deworming meds. And then this also provides an opportunity to check weight, to check height, to assess their milestones. And I think sometimes when a child is falling off their growth chart. Okay. When there’s a decrease or a plateau, this is when we should be acting already. We shouldn’t be waiting until they are severely malnourished before we should be employing our allied health services, our dietitians, our social workers to investigate, you know, what is the type of food that this child is eating? Is the mom on a grant? Is the child receiving a grant? You know, this is the type of food that you can buy with that grant money that is going to nourish this child and give this child the nutrients that it needs so that they don’t become malnourished. So I think those are, you know, two very big areas that I don’t think are going to have any sort of cost. Well, they will be.
Joy Saville 00:44:39 – 00:45:03
There’s always a cost implication, but it is something that we can, we can change in the immediate period. The other things, the resource and the lack of resources, are much bigger problems that, at a much higher level than my own, they need to deal with and discuss how to remedy that.
Kami 00:45:03 – 00:45:45
Yeah. And I think an overarching message that I’m sort of picking up from this episode is that it’s very important to go to the doctor’s office and don’t miss your checkups, don’t miss your appointments and stuff. Right. Because I think, like you are saying, a lot of these things are preventable, but either because of a lack of resources, a lack of access to a healthcare facility or whatever other reason, people are coming in late and then it’s hard to sort of address the issue. And speaking of sort of things like access. Right. There is the conversation then that we must have about private health care versus public health care. Right.
Kami 00:45:45 – 00:45:53
And I think there still is this sort of villainisation of the public health care sector and the quality of public health care as well.
Joy Saville 00:45:53 – 00:45:54
Right.
Kami 00:45:54 – 00:46:33
I mean, there’s a lot of like, intimates, like you go into public health care, it’s going to take forever. You might go in there and not come out. You might, There’s a lot of that going on. But you have worked in the public sector itself. Right. So I just want to get your perspective on sort of public health care and sort of from a doctor’s perspective, the state of public health care and how the conversations that go on are sort of maybe contributing to the issue of people not showing up at the doctors. Right. Because if you don’t have access to a private facility, you do have access to the public.
Joy Saville 00:46:33 – 00:47:10
Firstly, I want to say that we never want to diminish someone’s lived experience. Okay. Because the experiences that you’ve had are, it’s valid, it’s valid experiences. And also just to mention that a lot of these experiences are not unique to the public health care system. Okay, yeah. But the truth is that in the public system, you know, health is expensive. You know, now being in private, I can see the cost of health care. You know, a simple chest X-ray, I mean, I was just inquiring about a patient of mine that’s not a medical aid.
Joy Saville 00:47:10 – 00:48:38
An X ray is more than 700 grand. A lot of these blood tests that we, that we do in, well, in our practices, you know, they can amount to thousands of rands. And so a big benefit of being in the public sector is that it’s either very low cost, okay, you’re going to pay a literal fraction of what you would be charged in the private sector. And then also just like accessibility, like, just like in terms of, you know, certain surgeries, you know, minor procedures that would be completely unaffordable if you had to do out of pocket payments in the private sector is available to you in the public sector. Also you have the benefit of, especially if you are at the academic hospital, you have the benefit of working, of working with some of the, you know, best professors and doctors in the world. You get to consult with, you know, people with so much knowledge and insight. It’s one of the, it’s like a perk and a not perk of being in the South African health care system as a medical practitioner is that you get exposed to so much. Because we are a middle income country.
Joy Saville 00:48:38 – 00:50:14
These professors, they have so much knowledge and insight and again, that knowledge and insight, had it been privately would come at such a big cost. And people that are recipients of public health care, they get to experience it at either free or low cost. That being said, yes, of course, waiting times of trust, that’s one of the big shortfalls of being in the public sector is that you are going to have longer waiting times. You know, it’s not as convenient. Again, it’s this discrepancy of health care professionals and patients or resources in terms of hospitals, the amount of hospitals that we have available and the number of patients that we need to deal with. So yeah, waiting times are often, you know, it is, it’s, it’s long waiting hours. And I also know sometimes you, you, if you face someone that is a bit grumpy. But I also feel like, just like as someone that has just come out of the public sector, am I as someone that’s come out of the public sector, like give that, that doctor or that nurse the same amount of grace as what you would want to receive from them because the likelihood is that they’ve been on their feet for more than 24 hours.
Joy Saville 00:50:14 – 00:51:13
They have not rested, they have not slept, they have barely eaten. You know, they’re just pumping themselves full sugar just to get through. But at the same time, they could be the most passionate doctors about your health. They might just have a bit of a sour face at that moment. But yeah, there’s, there is, I mean, there’s again, there’s a, there’s a lot of work that needs to be done to provide dignified service to our communities in the public health care sector. But at the same time, I don’t think that we must ever forget to downplay the expertise and the heart and the work that a lot of these doctors are putting in to provide services. Often sacrificing their own time, their family life, their own health. That’s a big one.
Joy Saville 00:51:13 – 00:51:26
So, yeah, that is, it is necessary to weigh things out a bit. But there is, there’s a lot of benefit of being a recipient of public health care.
Kami 00:51:26 – 00:52:20
And I think that was a very balanced answer because, yes, it does have its challenges. But like you said, you do have access to some of the best doctors in the country. And yeah, that can go a very long way. But yeah, I think this conversation has been very enlightening and I think it will also open up more conversation right around the state of health care, especially with the focus of this year’s World Health Day being around sort of maternity and sort of women’s health and the impact that that then has on infants as well. Now, before I let you go, Dr. Joy, I would love to play a game with you. We have a game that we play here at Interstation called Hot Takes. And how it works is I just ask you a series of rapid fire questions and you answer hot or not, depending on how you feel about the subject.
Joy Saville 00:52:20 – 00:52:24
Okay, okay. Okay, I can do this.
Kami 00:52:24 – 00:52:28
Hopefully the rain doesn’t mess with our connection too much.
Joy Saville 00:52:28 – 00:53:31
I know.
Kami 00:52:31 – 00:53:40
But yes. So tell me, how do you feel about matching family outfits on Easter?
Joy Saville 00:52:40 – 00:53:42
Not.
Kami 00:52:42 – 00:53:49
Not. Why not?
Joy Saville 00:52:49 – 00:53:12
You know what that is? That’s so much work that goes into matching your outfits. I have no time for that life. I think it’s beautiful for other people. It’s beautiful on other people. Yeah. On me. I don’t know, I’m just like too, like low stress, low maintenance. Exactly.
Kami 00:53:12 – 00:53:18
And how do you feel about animals in little sweaters?
Joy Saville 00:53:18 – 00:53:34
The cutest. The cutest ever. I get cuteness aggression when I see animals in little sweaters. Yeah, I know there’s people judging me right now. That’s okay. It’s okay to judge. My doggies have sweaters.
Joy Saville 00:53:34 – 00:53:52
I have a dog that can’t regulate his temperature. So when it’s cold, I need to put a little jacket on him. And then I have another little doggy that I just adopted that he’s so small. He’s like a little newborn baby that’s going to stay a newborn forever. I definitely want to dress him up. Okay.
Kami 00:53:52 – 00:54:00
It’s so cute. I definitely agree with you. How do you feel about tiny bonsai trees?
Joy Saville 00:54:00 – 00:54:04
Tiny bonsai trees. They’re cute. I love plants.
Kami 00:54:04 – 00:54:05
Yes.
Joy Saville 00:54:05 – 00:54:31
I don’t own a bonsai tree because when I got into my plant life journey, I actually had brown fingers, not green fingers. I was killing things all the time. And I know bonsai’s are quite sensitive and so. So I haven’t yet got myself a bonsai. But you have given me a fantastic idea for this weekend. I’m gonna go bonsai shopping like a cute little.
Kami 00:54:31 – 00:54:41
Oh, my goodness. Love that. We’ll follow your bonsai journey and see how it pans out. How green your fingers have become.
Joy Saville 00:54:41 – 00:54:46
They’re green now. Things are flourishing this year. Flowers and it’s beautiful.
Kami 00:54:46 – 00:54:53
Lovely. That’s a good thing. But how do you feel about building blanket forts with the kids?
Joy Saville 00:54:53 – 00:55:18
Hot. Yeah. But I think one of my core childhood memories is building blankets with my brother. And definitely when my daughter was growing up, you know, the things that we could do together that didn’t cost any money because I was a broke student at university. And so we love building little things. Forts and making little houses and having little picnics under the blankets. Yeah.
Joy Saville 00:55:18 – 00:55:20
Such a fun thing.
Kami 00:55:20 – 00:55:27
It is. That’s so cute. How do you feel about church potlucks?
Joy Saville 00:55:27 – 00:55:37
Hot. Anything with food and community food and people. It’s my thing. Yeah. Yeah.
Kami 00:55:37 – 00:55:43
And how do you feel about worship? So services with a full band and lights and all of that.
Joy Saville 00:55:43 – 00:56:01
I’m for the vibes. I’m for the vibes. I’m low maintenance in some areas, but I love a good show. I love the fans and the music and all the good vocals. It’s actually something that my business partner and we do once a month.
Joy Saville 00:56:01 – 00:56:19
It’s full post Fridays. I think they have it in Cape Town and you’re in Johannesburg and so. Oh, we just. Oh, it’s just amazing. We just love, you know, the vibes are vibing. People are like just feeling the spirits. Yeah. Yeah.
Joy Saville 00:56:19 – 00:56:20
So definitely. That’s my thing.
Kami 00:56:20 – 00:56:28
Definitely heights. How do you feel about sleeping with pets in your bed?
Joy Saville 00:56:28 – 00:56:28
Not. Not for me. I love my babies. I am a terrible sleeper. If I could sleep by myself, I would. That would be my dream. That would be my dream. I’m just such a light sleeper.
Joy Saville 00:56:43 – 00:56:57
Any movement will disturb my sleep. Knowing that there’s a life next to me and a little life would disturb my sleep. Yeah, it’s not for me.
Kami 00:56:57 – 00:57:02
How do you feel about naming your plants like their pets?
Joy Saville 00:57:02 – 00:57:13
Oh, no, I do that. That’s my quirk. I’ve got Mona Lisa. I’ve got Frida. I’ve got Medusa. I’ve got this. Yeah.
Joy Saville 00:57:13 – 00:57:26
All my plants have names. I’ve got peace. Yeah. If I go through all of them, we’ll be here all day. But definitely, I name everything. It’s even fish.
Joy Saville 00:57:26 – 00:57:33
We’ve got, like, a lot of fish over there. There’s a Moana in there. Yeah, yeah.
Kami 00:57:33 – 00:57:36
They all have such iconic names. Like a Medusa.
Joy Saville 00:57:36 – 00:57:50
Exactly, exactly, exactly. Yeah. Medusa’s leaves. Medusa’s leaves look like snake skin. So, okay. Hence the name Medusa.
Kami 00:57:50 – 00:57:55
And how do you feel about cocomelon?
Joy Saville 00:57:55 – 00:58:15
Not. Not. I’m so grateful that I did not have to experience the era of cocomelon. I mean, I’m sure it is a lifesaver for most parents with young children. Yeah. In my time, we were jamming at the Clamber Club. That was our jam.
Joy Saville 00:58:15 – 00:58:19
But cocomelon, I think maybe it’s just because my child is older now.
Kami 00:58:19 – 00:58:20
Yeah.
Joy Saville 00:58:20 – 00:58:35
If I have another baby. Exactly. If I had a little one, I would simply cocomelon. Because we all need our sanity. We all need a little bit of time just for us mommies. Yeah. So no judgment to the mom to put on cocomelon.
Joy Saville 00:58:35 – 00:58:46
And if they kids jive to that. Yeah. But sure, I know that’s trauma.
Kami 00:58:46 – 00:58:49
During the baby shark era.
Joy Saville 00:58:49 – 00:58:50
She was a baby shark. Yeah.
Kami 00:58:50 – 00:58:56
Oh, gosh. What a time.
Joy Saville 00:58:56 – 00:59:04
She was a baby shark. But you know what? Actually, now that you say it’s like a sweet memory, but living it.
Kami 00:59:04 – 00:59:14
I remember my baby cousin is also a baby shop girl. And, oh, my goodness, the whole day, that’s what you’re hearing in your head. It’s like, babe.
Joy Saville 00:59:14 – 00:59:17
All of the time.
Kami 00:59:17 – 00:59:23
Dr. Joy, how do you feel about kids picking their own outfits?
Joy Saville 00:59:23 – 01:00:01
I love it. I love seeing their little personalities come through in the quirky little outfits that they wear. And I love that kids are just so free of, like, you know, what the world thinks about them. We focus so much on the opinions of others that we don’t really express ourselves truly. We’re not really true to ourselves. But kids don’t have that. They have no inhibition. So I love when kids pick out their mismatched outfits, little tutus and gumboots and goggles.
Joy Saville 00:59:59 – 01:00:01
I think it’s the cutest thing ever.
Kami 01:00:01 – 01:00:07
And it has such a vibe. You’re like, maybe I need to give myself some. Some gumboots.
Joy Saville 01:00:07 – 01:00:07
Absolutely, absolutely. And jump in some puddles. See, why are we not jumping in puddles like we used to?
Kami 01:00:15 – 01:00:18
And it’s raining today, so. Definitely.
Joy Saville 01:00:18 – 01:00:24
Exactly. I just need the gumball. I need to go and, you know, invest in a few good gumbo.
Kami 01:00:24 – 01:00:59
Exactly. But Dr. Joy, that brings us to the end of our game and of course the end of our episode. Thank you so much for joining us today and for sharing all of that insight. And hopefully this episode is going to reach people that need to hear that information, especially all of the sort of signs that you gave throughout the episode. I think those are very important for people to cue in on. Now before I let you go, do you have any socials that you want to plug? Any resources and stuff like that that you would like for us to drop in the comments as well?
Joy Saville 01:00:59 – 01:01:18
Yeah, absolutely. So we actually just launched our website. Yesterday was our launch day for our website. It is so beautiful. We are so grateful. Thank you, thank you. Thank you very much. Yeah, we had an amazing team work on our website that really captured our heart.
Joy Saville 01:01:18 – 01:01:43
So please do check that out and stay with doctors Dr. S Taz and Joy Co Za. Okay, so that is. And then on social, on LinkedIn, on Instagram, on Facebook, the same doctors Taz and Joy. Okay, that’s our social media handles. So please come check us out, see what we are doing. Like we said, we have a heart for community.
Joy Saville 01:01:43 – 01:02:09
We also do. We need your support with our community developments. Without outreach projects through Medescreen, you can actually buy vouchers. Yeah. So you can put that link down as well to the medic screen site where people can sponsor a voucher and then we go out and. And do wellness screenings and education on community members.
Kami 01:02:09 – 01:02:09
Perfect. We will link all of that in the description box for everybody at home to find. But thanks again for joining us today, Dr. Joy. And thank you at home for tuning in as well. See you in the next episode.