The Department of Plastic Surgery was first instituted as an independent department in 1994 when Professor Anil Madaree was appointed to the Chair. At this time the department was situated at the Wentworth Hospital but in March 2003 the department moved to the new Inkosi Albert Luthuli Hospital.
Since Professor Madaree was appointed to the Chair of Plastic Surgery he has developed many interests – the main ones being his involvement in cleft lip and palate and facial clefts. He is deeply involved with Operation Smile – a movement which goes to rural places and under developed countries to operate on children, and adults, who have cleft lips and palates. During these times he usually takes along one or more of his registrars so that they may learn to work under adverse conditions.
Some of the countries and places visited have been: Bolivia, Madagascar. Swaziland, Mt Frere, The Congo , Mauritius, The Phillipines and Forteleza.
In many instances they have also come across patients that have tumours and other deficits that require operative assistance and as there are no other doctors, or facilities available, they carry out the operation as is shown on the woman below.
When the people of the district and surrounds hear that the team are coming, crowds gather together to be seen and assessed. The team usually spends 10 days in one place operating, in many cases under primitive conditions where often water and other commodities are scarce. For example in the Congo they ran out of water and had to use alcohol, or anything else they could find, to cleanse their hands. Operating theatres are not always available and the teams have to share a room for operating.
A brief history of the Department of Plastic and Reconstructive Surgery
Early in the 1940’s Major Jack Penn and Lieutenant Colonel Norman Petersen were sent by the South African army to England to work under Sir Harold Gillies at Rooksdown House, and under St Archibald MacIndoe in the Burns and Plastic Surgery unit at East Grinstead. These two were thus the first two South African Plastic Surgeons.
Jack Penn returned to Johannesburg where Harry Oppenheimer allowed him to use his home “Brenthurst” for the establishment of a military hospital for the treatment of injured servicement requiring “plastic surgery”.
Norman Petersen was stationed at King George V Hospital, the British Army Hospital in Durban for the treatment of airmen injured in the desert war. When the war ended in 1945 he moved to Cape Town.
After the war, the plastic surgery service in Durban was carried on by Jack Penn who once a month spent a “long weekend” in Durban, operating at Addington Hospital.
Franklin (Barney) Bishop, after obtaining his FRCS(Edin) in general surgery settled in Kimberly. Becoming bored with general surgery in the early 1950’s, he went to England, where he worked under Pomfret Kilner, plastic surgeon at Oxford, for a year. In 1953 he returned to South Africa and settled in Durban as the first plastic surgeon to Addington Hospital and various other hospitals in the Durban area. He was never accepted by the Natal Medical School but provided a service to King Edward VIII Hospital on a fee for service basis over the years. These were the days when the general surgeon was the true general surgeon operating on all surgical problem patients. The super specialities of orthopaedic surgery, neurosurgery, urology, paediatric surgery and plastic surgery were all bitterly opposed by the general surgeons who protected their academic and financial territory. The result was that the academic and surgical services of Barney Bishop and the general surgeons were in a state of continual conflict.
In 1956 a number of beds were allocated to Barney Bishop at the old British Naval Hospital known as Wentworth Hospital. This was to be used for treatment of European “plastic surgery patients”. Coloured patients remained at Addington Hospital.
In 1957 Barney Bishop organized the first plastic surgeons clinical meeting in South Africa. Professor Pomfret Kilner from Oxford, together with other overseas visitors participated in a small congress and clinical ward round held at Wentworth Hospital.
In 1958 Barney Bishop was offered the use of a whole ward dedicated to the treatment of plastic surgery at Wentworth Hospital. This became the nucleus for the present Department of Plastic and Reconstructive Surgery. At this time the “unit” was allocated the status of a sub division of the department of General Surgery at the Medical School, Natal University. Staffing of the unit was allocated to full time specialists, plastic surgeons in private practice with part time sessions and a staff of young surgeons in training.
In 1959 Barney Bishop met a doctor Michael Harris who showed an interest in Plastic Surgery. Barney Bishop made arrangements for him to obtain two years training at the Nuffield Department of Plastic Surgeons under Pomfret Kilner and Patrick Clarkson. Michael Harris returned to South Africa and registered as a specialist plastic surgeon. He joined Barney Bishop in private practice and was also awarded sessions at both Addington and Wentworth Hospital which he retained until his death. In 1967 Barney Bishop retired from active practice in Durban Provincial Hospitals to start a plastic surgery practice in Pietermaritzburg which was taken over by Wolf Losken in 1973.
Two plastic surgeons set up in private practice in Durban in 1965. They were Ken Dyer and John Youngleson . At this time there were no part time plastic surgery appointments in the Durban Medical School until Professor Chapman, professor of General Surgery, organized several general surgical part time sessions for Ken Dyer and John Youngleson who together with Lesley Linder (General Surgeon) undertook the start of the Natal hand Service at King Edward VIII Hospital. Out of this evolved The Natal Hand Club (1967) and in 1985 the Hand Surgery Emergency Service which involved plastic, orthopaedic and general surgeons.
Mike Harris was the primary organizer of the pattern of the clinical and teaching programme of the Plastic Surgery Unit in Natal. It was both Barney Bishop and Michael Harris who in 1966 neogtiated with the Professor of General Surgery (Prof David Chapman) to arrange for the Durban Plastic Surgery Unit to be officially recognized as a sub Department of the Department of Surgery. Finally in 1969 this was achieved and the Plastic Surgery Department was recognized as a “teaching unit” of the Medical School, Durban. During Michael Harris’ term of office plastic surgery was expanded to cover Wentworth hospital, Addington Hospital, King Edward VIII Hospital, Clairwood Hospital and in 1972 the newly commissioned R K Khan Hospital.
In 1974 Willie de Villiers completed his primary surgical training at Addington and took over the running of the plastic surgery department at R K Khan Hospital. 1976 saw Willie de Villiers together with Derek Adendorf initiate the Journal Club which continues to this day. During 1978 John Read and Willie de Villiers were the first plastic surgery registrars to complete the microsurgical training programme initiated by Professor Lynne Baker at the Department of Surgery, Medical School. Later during 1978 Willie de Villiers became a full time Principal surgeon and Head of the Sub Department of Plastic Surgery. He resigned as Head of the Department in 1981 and entered private practice in Durban retaining part time sessions at Wentworth and R K Khan hospitals.
1975 saw the introduction of Warwick Morris as a part time consultant in the department. In 1976 he, together with Wolf Losken, and with the backing of the Association of Plastic and Reconstruction Surgeons, motivated for the formation of a Craniofacial Unit at Wentworth Hospital. Permission was granted but the Director of Hospital Services stipulated that it be established in Pietermaritzburg. Thus from 1976 to 1995 Wolf Losken (Pmb), Warwick Morris, Peter le Roux (Neurosurgeon) Patrick Uys (Maxillofacial surgeon) and Arthur Wright (Orthodontist) traveled to Pietermaritzburg to fulfil their duties in the Craniofacial Unit. The end of 1995 saw the relocation of the Craniofacial Unit to Wentworth Hospital. After Willie de Villiers’ resignation Warwick Morris took over as acting head of the department in a part time capacity until Edward Bowen Jones was appointed full time head in 1982, and when Wolf Losken emigrated to the USA in 1988, Warwick took over as Head of the Caniofacial Unit. Jan Kleynhans replaced Wolf Losken on the team and later in 1995 Anil Madaree replaced Jan Kleynhans. In 1991 Warwick Morris established a craniofacial service in Johannesburg and still travels to Gauteng on a regular monthly basis.
1982 saw Edward Bowen Jones appointed as the New Head of Department. He established a number of specialized clinics for Cleft lip and Palate and Occuplastic over the next few years which flourished and continue to this day. He also introduced the Burns Surgery service at Clairwood Hospital as well as developing the Microsurgical service. Edward Bowen Jones undertook the administrative work to make application for the establishment of a full professorial chair in Plastic Surgery at the University of Natal but before the post was advertised he resigned as Head of the Department in 1991 to enter private practice in Durban. He continues to hold a number of clinical and teaching sessions in the Department.
Professor Anil Madaree was appointed the first full time Professor of Plastic and Reconstructive surgery at the University of Natal in 1994. He had worked as a registrar in the department from 1985 to 1988 when he obtained his FCS degree and registered as a specialist plastic surgeon whereafter he was appointed to a consultant post He later furthered his training at the university of Pennsylvania, Philadelphia in the USA. Shortly after his return to South Africa in 1991 he was appointed Head of the Sub Department of Plastic Surgery (July 1991). His particular interests were Craniofacial surgery, cleft lip and palate repair and wound healing and keloids. He still currently holds the chair of Plastic and Reconstructive Surgery.