The 2024 department
“The emergency work happens only at Frere Hospital because there are not enough anaesthetist doctors to cover all on-calls at Cecilia Makiwane Hospital. So, we admit patients at night and on weekends at Frere Hospital, we operate on them. As soon as they are stable, sometimes even the first postop day, definitely the second day, we send them to the Cecilia Makiwane Hospital to recover, and then they go home from there. We admit or lodge some patients at Cecilia Makiwane Hospital because of the lack of space at Frere Hospital. They stay there as lodgers and come the day before for the operation at Frere Hospital. After the operation, there is often no transport for them to return home because our patients come from as far as 550 kilometres away. Some of them come from even further than that. The government ambulances ferry them, but there are no ambulances from Friday to Sunday. So, patients have to stay. If somebody is ready to go home on Friday morning, they must stay till Monday morning to get an ambulance. We have three full-day operation lists at Frere Hospital in town and two full-day operation lists at Cecilia Makiwane Hospital.”
An exciting charitable development
In 2012, Dr Lazarus applied to the Carte Blanche’s Make a Difference foundation for a new operating theatre suite at Frere Hospital. They donated 20 million rands to refurbish an unused “Black” theatre used as a junkyard for 25 years to build a state-of-the-art Paediatric Operation Theatre Suite. It is called Carte Blanche Pediatric Operation Theater Suite, which started functioning on the 17th of October 2014. “That’s like our dream came true, and it is the jewel in our crown. It is our most prestigious infrastructure upgrade. We call it our second home and look after it like our own home. It is the only paediatric operation theatre suite between Eastern Cape Province’s state and private facilities. None of the private hospitals have a dedicated children’s operation theatre suite. We have two operation theatres; one is a digital theatre, which has all endoscopy stacks and all the equipment for minimally invasive surgeries in children. And the other is a non-digital, like a regular theatre. Establishing the Carte Blanche Paediatric Operation Theatre suite gave us the theatre time our children deserved. Because before that, we had only one and a half theatre days at Frere Hospital. And the half was on a Friday afternoon.”
Fig 1: Carte Blanche Paediatric Operation Theatre at Frere Hospital, commissioned in October 2014
Starting their not-for-profit organisation
In 2012, Dr Chitnis and his mentor, Dr Lazarus, started a not-for-profit organisation to raise money for the specialist needs of their department, which the provincial government could not fulfil. It is called the Eyabantwana for the Children Trust. Eyabantwana is the local word for children. After 12 years, it has thrived with an established brand that locals can donate to and active fundraising events, including an annual cycle ride for which they have approximately 35 cyclists raising money for the charity. “The trust has donated 2.25 million rands over the last 11-12 years, which is not a small amount for the poorest province in a middle-income country.” This year, in 2025, the Trust is donating a flexible paediatric gastroscope after the existing equipment broke down and could not be fixed or replaced for several months. It had a significant impact on patient care; “we could not do basic life-saving procedures like oesophageal dilatation, banding of varices, and we felt crippled. We could use adult scope only on bigger children, but on younger children, we could not use adult scope at all.”
Fig 2: The logo of the Eyabantwana for the Children Trust
Training the next generation
His department has four full-time consultants with joint appointments at Walter Sisulu University. Dr Chitnis himself is an associate professor. His department is accredited to train four registrars in paediatric surgery, and currently, all of their positions are full. However, he is not stopping there; “We have applied to the local medical council, the Health Professions Council of South Africa (HPCSA), to increase the numbers to eight, which should come through by March this year. Currently, all registrar posts are occupied, and there are about five other doctors, most of them are women who want to train to become paediatric surgeons. There is a big demand for training in paediatric surgery, and our department is now known for providing good quality care and training despite limited resources.”
During COVID, Dr Chitnis had to change the pattern of weekly academic meetings from face-to-face to virtual (Zoom) meetings. Since late 2020, Dr Chitnis has conducted a Zoom academic meeting on the first Tuesday of every month. “I invite a national or an international expert in paediatric surgery from anywhere in the world to give a talk on a common paediatric surgical topic. Then, we have questions, answers, and comments. And that took the department’s name across continents, seas to wherever, from the Middle East to the West Indies, America, India, and the rest of Africa. So that also opened many doors, and we found that extremely useful. Over a year ago, I started my own YouTube channel. I upload all these edited videos on my YouTube channel for colleagues worldwide to watch.” These are all edited and summarised by Dr Chitnis.
He also uses the MedAll platform, which Dr Phil McKinley started. It is based in Europe and is free to all medical professionals. “The beauty of MedAll is that if people watch 80% of the video and answer five simple questions in a survey, they can get a CPD certificate. So, I have formed a separate community for the Department of Paediatric Surgery on the MedAll platform.”
And next
Dr Chitnis has received smart glasses from Ohana One. This technology is free for all InterSurgeon members. Dr Chitnis says, “I am for the free spread and transfer of knowledge, information, and skills. The more colleagues I can reach, the better for their community. Obviously, in these interactions, I learn a lot, so it is not a one-way street. It is not only that I am giving, but I learn a lot by interacting with colleagues.”
The final word
“I am here because of my mentors. I had super-duper mentors from Pune, Mumbai, Glasgow, Cape Town, East London, and Durban. I was lucky to get associated with them, learn from them, and take their advice, making me what I am today. So, it is my mission to pass this baton to the young ones. They are very clever. They are techno-savvy, have ideas, and know how to get things done.”
If you want to contact Dr Chitnis, click here for his InterSurgeon profile.