New private hospital for Tokai

Hospital manager Gavin Pike in the multi-million rand cardiac catheterisation unit laboratory, or "cath lab".

Melomed private hospital group recently opened a new hospital in Tokai, and the Bulletin was taken on a tour by facility manager Gavin Pike and Melomed spokesman Randal Pedro.

The hospital cost almost R400 million, has 148 beds and four operating theatres, with extra theatres for obstetrics and endoscopy.

Before it was built, residents raised concerns that it would add to Main Road traffic congestion. Mr Pike said those worries had been taken into account in the design, and the building had various entrances, including ones for the women’s health section, the emergency room and the car park.

Located on the corner of Keyser Street and Main Road, Tokai, and just off the double-storey reception area is the renal unit.

“One of the things that set this hospital apart is that it was purpose built, and so this unit has easy access, while the oncology unit, on the fifth floor, was designed to provide therapeutic views,” said Mr Pike.

Also on the fifth floor is the haematology/stem cell transplantation clinic, and at the helm is Dr Shahroch Nahrwar. As a physician and specialist haematologist, he manages a wide range of blood-related organ disorders.

Bone marrow transplants and/or stem cell replacements are done in cases of cancer of blood-related organs or bone marrow failure syndromes: leukaemia and aplastic anaemia.

Dr Nahrwar said that before the mid-1990s bone marrow transplants had been done under general anaesthetic and required puncturing the sternum and pelvis in several places to suction out the soup-like marrow, which contains the stem cells. This would take a few hours and was invasive but it did not affect the donor in the long-term, as bone marrow regenerates rapidly and naturally.

“Nowadays, haematologists often use a white cell stimulant to generate and release more bone marrow stem cells into the blood. These stem cells can subsequently be quantified and harvested, if sufficiently present, with a special cell separating machine to which the donor will be connected via two peripheral drips or one central femoral cannula for mostly less than seven hours,” said Dr Nahrwar.

He said stem cells and other white cells were then collected in a bag while all the other blood cells were returned safely to the donor, who would not feel anything during this procedure and could either sleep or watch television.

Dr Nahrwar said stem/white cells could either be given from a healthy donor to the sick patient the following day, after being kept overnight in the fridge, or they could be stored at ultra-low temperatures (this is called cryopreservation) for future use.

“The latter is mainly used if the patient is both the donor and receiver of their own stem/white cells so that when they undergo intensive high-dose chemo and/or radiotherapy they can be rescued with their own stem cells, which will subsequently repopulate and recover the patients destroyed bone marrow,” said Dr Nahrwar.

He said all transplants were done after the patient had been prepared with what is called conditioning chemo and/or radiotherapy.

“That ideally only will be offered if the patient’s blood-related organ is in remission to ensure the best outcome after the transplant and superior survival,” said Dr Nahrwar.

Another multi-million rand machine can be found in the cardiac catheterisation unit laboratory, or “cath lab”. It performs angiograms – a kind of X-ray – that allows doctors to see blood flow and locate clots in the blood vessels.

Once a blockage is located, the doctor can intervene by placing a stent into the patient immediately, in this lab.

Dr Ebrahim Kader of Morton & Partners said future plans included developing a stroke service using the cath lab to dissolve a blood clot, or extract an artery.

Some of the technological advances include free wi-fi throughout the building, iPads replacing chalk boards above the ward beds with patient/doctor details and the Melodoc patient-management system. The latter is a partnership with Pathcare, Morton & Partners and Melomed Tokai.

“It allows our specialists the ability to access and manage patient records anywhere in the world. They can be at a convention in Canada and use a single encrypted login either via an iPad or personal computer,” said Mr Pike.

With secondary infection being a concern for patients in hospitals, Melomed Tokai has built specialised isolation units with sluices in between the wards to prevent the spread of infection. Another feature in reducing cross contamination between wards includes restricted access for visitors, patients and staff. In the neo-natal ward there is a closed viewing room.