Cardiac disease is the greatest cause of mortality of non-communicable diseases worldwide.
In South Africa, where 85% of the population of 60.6 million is indigent and wholly dependent on public healthcare, it is the third highest cause of death.
In addition to a dire lack of facilities, capacity, knowledge and expertise, the catastrophically disproportionate physician-to-patient ratio constitutes nothing short of an incipient humanitarian disaster. Approximately 13000 indigent children are born in South Africa annually with congenital heart disease (CHD), and roughly a third of these patients require surgery.
Of the estimated 4200 operations required, less than 800 are performed in public health facilities annually.
Twenty-eight percent (17 million) of the population of South Africa are under the age of 14 years, of which 14.4 million are indigent. There are 24 full-time paediatric cardiologists serving the public sector population at a physician-to-patient ratio of 1:600000.
Furthermore, with only seven independent congenital cardiac surgeons in the South African public sector (1:2000000), it is estimated that it is being served at 6% of the World Health Organisation recommendation of 400 operations/1 million of the population.
The situation in the rest of Sub-Saharan Africa is considerably worse. Despite several international charities supporting paediatric heart disease worldwide, none of these are active in South Africa.
