History and achievements of haematology at the University of Cape Town: a confluence of ideologies

摘要

Traditionally the teaching and management of widely divergent disorders arising primarily in the bone marrow or lymphoreticular system and reflected in the peripheral blood followed, in South Africa, the European tradition, which based the discipline in Pathology rather than Internal Medicine. Countrywide our universities developed undergraduate teaching and postgraduate training along these lines from whence generations of distinguished haematologists established centres of excellence both locally and worldwide. In keeping with a subtle shift to the concept of the clinical scientist and increasing complexity of comprehensive patient treatment, particularly exemplified by the haematologic malignancies where improving outcome favoured emergence of specialised units, the cross-speciality programmes started locally and continue to gather momentum. The University of Cape Town aligned itself with this changing international practice and created a new and autonomous department mandated to develop and fully integrate clinical and laboratory components. The success of the new dispensation culminated in establishment of an experimental immunohaematopoietic stem cell transplantation programme. Over time translational research carried this into the clinic with subsequent dissemination to other centres and eventually into the private sector. Latterly, with changes in health care delivery throughout the country this forward-looking structure was reversed after a successful 25-year period, with a split into two Divisions. Clinical Haematology became part of Internal Medicine and Haematological Pathology now resides within the ambit of the National Health Laboratory Service. From that time little if any significant change has occurred in the state system. However, of interest is the establishment of a university-style department in the private sector that has been consolidated as a satellite within Faculty of Health Sciences at Stellenbosch University and Tygerberg Academic Hospital. This historical record documents the background and various phases that occurred during four decades from 1970 acknowledging the selfless support as well as encouragement of many peers and colleagues, whilst never overlooking the courage of our patients and their families, primarily at Groote Schuur.