Fund Raising
There are two common cancers of the gastrointestinal tract in the South African population, oesophageal cancer and colo-rectal cancer, and one common cancer of the liver, hepatocellular cancer. Little is known about the causes of oesophageal and colo-rectal cancers, although much is known about the causes of hepatocellular cancer.
In low-income (resource-poor) countries such as those in Africa, incidence rates of liver cancer are many-fold higher than in the great majority of industrialized (resource-rich) countries. This cancer is one of the leading causes of cancer-related deaths in sub-Saharan Africa with age adjusted incidence rates of between 27 and 113 per 100000 of the population per annum compared with rates of less than 5 and usually less than 3 per 100000 per annum in industrialized countries. The principal causes of hepatocellular cancer in Black Africans are chronic infection with the hepatitis B virus and high levels of dietary exposure to the fungal cancer-causing toxin, aflatoxin. Although a number of risk factors for hepatocellular cancer have been identified, much remains to be learnt about the pathogenesis of the cancer.
Like hepatocellular cancer, oesophageal cancer occurs commonly in Black Africans, especially in those living in the Transkei. The patients with this tumour often present at a late stage to the doctor when surgical treatment is no longer an option. Although a great deal of research has been conducted into oesophageal cancer, the causes remain largely unknown.
Colo-rectal cancer is a disease of high-income industrialized countries, and in many western countries is the second leading cause of cancer related deaths. Colon cancer is largely due to the presence of pre-existing polyps (small growths) in the colon. Detection and removal of colon polyps endoscopically at the time of colonoscopy will prevent this potentially devastating cancer from occurring thus reducing the rate of colon cancer-related deaths.
In South Africa it is widely accepted that Academic Gastroenterology is not functioning as it should. Research output is down and fewer trainees are choosing it as a career path. This was highlighted by a recent report by Professor Sandie Thomson President of SAGES (The South African Gastroenterology Society) published in the South African Medical Journal in November 2004. Human resources have diminished largely due to the resignation of heads of departments and emigration, and manpower is critically short. All gastroenterology units have poor state-of- the-art equipment with most of the equipment, such as of fibre scopes are more than 10 years old and well beyond the normal lifespan of these instruments. On average one third of the scopes are non- functional at any time.
There has been a critical decline in the number of peer - reviewed gastroenterology and liver related publications and presentations in South African and international meetings. The reasons cited are that fewer academics undertake or promote research because of a large service load, lack of funding, and lack training in research.
It is therefore vital in South Africa to attempt to attract and keep trained gastro-enterologists and hepatologists in the academic and state sector. Research and trainee teaching must be regarded as integral parts at all levels of service provision and must be preserved and promoted.
The Gastroenterology Foundation of South Africa was established in 2006 to address these issues and was initiated through generous contributions by the pharmaceutical industry.
The aim of the foundation is to contribute towards the continuing medical education of Medical and Surgical Gastroenterologists and Hepatologists in South Africa.
The Foundation plans to contribute to the postgraduate experience of Gastroenterologists and Hepatologists by assisting in the financing of fellowships in South Africa and abroad, and to encourage research if the field of Gastroenterology and Hepatology in South Africa
A major focus is to hold an annual conference in South Africa updating all those interested in Gastroenterology and Hepatology on practical advances in these specialties.
The foundation is autonomous, directed by a group of trustees chosen from a broad spectrum of academic experience. It will function independently of SAGES, the South African Gastroenterology Society, but will interact with SAGES, to provide those who qualify, the appropriate assistance.