SCAN Program

The SCAN Program is based at the Chris Hani Baragwanath Academic Hospital and consists of two staff members – myself, Anrie Le Roux, a paediatric medical officer, and Nkosikhona Masikana, the SCAN Program Assistant.

The conception of the SCAN Program started back in 2016.  During my internship (2014/2015) at the Chris Hani Baragwanath Academic Hospital (CHBAH), I enjoyed the paediatric rotation the most. 

I decided to explore the option to specialize in paediatrics a bit more, and therefore I did some paediatric time during my community service at the Rahima Moosa Mother and Child Hospital (RMMCH).  It was during my community service time that I came across my first suspected child abuse case which I found fascinating.  Post community service I joined the Intensive Care Unit (ICU) at the CHBAH as a medical officer.  I spent 6 months working in the ICU and during this time I came across more child abuse cases. 

I realized that Healthcare Practitioners (HCP) shy away from such cases.  We are not always sure how to manage cases of child abuse (or maybe we are just not comfortable dealing with it).  Two specific cases changed my career.  The first being a child who demised on the fourth admission to the burns ICU. 

I will never forget the father’s cry.  I had to ask myself: “how does it happen that a child dies on a fourth admission?  Why has this not been picked up on the first or second admission?”. 

The second case being a child who was allegedly a victim (survivor) of a sexual offence.  During the management of this case, it was said that this “alleged sexual offence was not an ICU problem” which led to me asking another question: “whose problem is it then?”  By this time, I knew I had a special interest in child abuse and neglect.  It was at this point that I decided:  I want to “specialize in child abuse”.

There is currently no such specialty or sub-specialty in South Africa.  Because I wanted to do “child abuse”, I decided the best place for me to be is in the Department of Paediatrics.  Not to specialize in paediatrics as such, but to have a “home-base” from where I could work. I joined the Department of Paediatrics at the CHBAH in July 2017, as a medical officer in the paediatric medical casualty and Paediatric Outpatient Department (POPD) (known as Ward 31).

In the December of 2017, the Nelson Mandela Children’s Hospital, in partnership with the Sick Kids Hospital (Toronto, Canada), sponsored 3 doctors to attend the Child Maltreatment Conference held in Toronto.  I was one of the fortunate doctors identified by the Head of the Paediatric Department, Professor Velaphi.  During our short visit, we also had the privileged to spend some time at the Sick Kids Hospital in Toronto, specifically the SCAN (Suspected Child Abuse and Neglect) Program. This is a program run by the Paediatric Department, specializing in the management of SCAN cases.  In Canada you become a Paediatrician, and then sub-specialize in SCAN.  With my return, I was even more interested and motivated.  This is when the “SCAN Program” was born.

Back in South Africa, I wanted to equip myself to become an expert in the field of child abuse.  I completed my Postgraduate Diploma in Clinical Forensic Medicine through the University of the Free State in 2019.  I have also done short courses in Child’s Rights and Child Law (University of Cape Town, December 2017) and Protective Behaviours (March 2018). 

In 2023, I completed my Master of Science in Medicine degree in the field of Bioethics and Health Law through the University of the Witwatersrand, and in 2024 I sat for the Diploma of Child Health (DCH) exams through the College of Medicine (South Africa).

I started running the SCAN Program at the CHBAH, under the Department of Paediatrics, in 2018.  This program has been endorsed by Prof Velaphi.  I use to attend to SCAN patients, before, during, and after my work in Ward 31.  We have grown over the past years, and currently are working in affiliation with the Surgeons for Little Lives (SFLL), a Public Benefit Organization (PBO).  Since the partnership, SCAN now has one day a week to focus on its work.  The SFLL provides the SCAN office space and consultation rooms for the outpatient clinic.  They are funding the salary of the SCAN assistant and sponsors stationery and equipment.  Furthermore, they also assist in SCAN research.

The SCAN Program runs one day a week and renders several services.  We do inpatient consultations, assisting in the management of cases admitted as a result of SCAN.  Once these patients are discharged, they are booked for the outpatient SCAN clinic, which also takes new outpatient consultations, ensuring ongoing care.  Furthermore, our services include: teaching of undergraduate- and postgraduate students on SCAN related topics; SCAN lecture presentations to various departments upon request; creating awareness through radio interviews at Eldos FM and talks during awareness days arranged by the Social Services Department at the CHBAH; SCAN assessments for patients undergoing adoption and court proceedings; and data collection for research purposes.

The SCAN Program Assistant, Nkosikhona does the program administration.  This includes organisation, data capturing, managing the bookings for the SCAN Program Clinic, and follows up on patients who defaulted. 

Our aim is to establish and grow the SCAN Program, and to run this program on a fulltime basis.

– Anrie Le Roux