Leadership in Training: One story from South Africa

When Dr. Nomawethu Tonjeni, a physician from South Africa, applied to the International Hemophilia Treatment Centre (IHTC) Fellowship Program in 2012, she wanted to learn everything there is to know about the diagnosis and treatment of patients with bleeding disorders.

Having previously attended educational workshops in California, Sendai, as well as the Hemophilia 2010 World Congress in Buenos Aires, she was keen to learn more. She was awarded a fellowship that year, and undertook her training at the Manchester Haemophilia Comprehensive Care Centre, U.K., under the guidance of Prof. Charles Hay and his team.

“My first impression was that of a huge, first-world, well-equipped hospital and the largest laboratory I have ever seen,” said Dr. Tonjeni. “The wards, clinics, and weekly programme were well organized”. The IHTC had a multi-disciplinary team that included doctors, nurse clinicians, laboratory scientists, physiotherapists, and social workers. She felt that the staff provided her with world-class quality training because for her they were “excellent and knowledgeable teachers.”

During Dr. Tonjeni’s four-week fellowship in Manchester, she had the opportunity to learn about various aspects of hemophilia treatment. “I learned a lot about the management of pregnant women with thrombosis or bleeding disorders; a service which is not offered in my country.” She also attended pediatric hematology clinical sessions; learned about the UK national database, home therapy, as well as using smart phones as tools; received a tutorial about various laboratory investigations relating to hemophilia and hemostasis. Her schedule included observing the co-management of patients with other disciplines, such as Obstetrics and HIV clinic. One of the highlights of her stay at the Manchester Royal Infirmary hospital was the national U.K. accreditation team visit of the Manchester Haemophilia Comprehensive Care Centre. “It was a lesson on how to establish a hemophilia centre, and what needs to be in place” said Dr. Tonjeni.

Nowadays, Dr. Tonjeni visits peripheral hospitals and clinics to train other doctors and nurse clinicians on how to diagnose and treat patients with bleeding disorders. She also helps raise awareness in schools, and gives talks on the radio. As a chief specialist physician and head of the Haemophilia Clinic at the Nelson Mandela Centre Hospital in Mthatha, Dr. Tonjeni has noticed an increase in the number of patients who attend the clinic. She also reports that the senior management of her hospital is fully supportive and provides the budget so that the clinic has continuous supply of factors. Their laboratory services have also improved, physiotherapists have received up to date training, there is an urologist for medically supervised circumcision, and there are now regular dental check-ups for patients.

Dr. Tonjeni is now part of a network of more than 600 trained IHTC fellowship alumni who are trying to improve care of patients with bleeding disorders around the world. She is grateful for her IHTC Fellowship training. “It has opened my eyes to a lot of things: how to set up a clinic, what needs to be in place, the organization of the clinic, research, database, home therapy, prophylaxis, use of smartphones, importance of support services (multidisciplinary team) and much more.”

The WFH would like to thank Bayer for their exclusive support of the IHTC Program.